How Long Does It Take To Get Disability Benefits When You First File?
Initally disability claims, or applications for disability, are usually decided in under 120 days; though, occasionally some claims can be approved in under 30 days if the disability examiner has quick access to the medical evidence.
Reconsideration appeals--a request for reconsideration is the first appeal--are often faster since A) they involve the same process as an initial claim and B) the medical records, other than any new evidence which has recently come into existence, were previously gathered at the initial claim level. Due to these factors, the average time for a decision at this level is usually less than 60 days, though, as with a disability application a case can take longer or less time depending on various circumstances.
Disability hearings take the greatest amount of time since the wait for a hearing is often a year or longer, and a decision following a hearing can take months.
All this said, there is no decisive answer to this question since when a claimant will get disability benefits will depend on:
1) What level the claim was approved at (meaning at the disability application, reconsideration appeal, or disability hearing level)
2) Whether or not the case entailed processing issues such as the disability examiner encountering difficulty obtaining the claimant's medical records or having to schedule multiple consultative medical examinations, or having to defer the case because the claimant underwent a particular type of surgery, or suffered a myocardial infarction (heart attack) or cerebrovascular accident (stroke).
The disability process
The Social Security Disability or Supplemental Security Income (SSI) disability process usually involves an initial disability claim and perhaps a series of appeals in order to be approved for disability benefits. A certain percentage of cases will, of course, not involve appeals. At any level of the system, a person can meet or equal the social security administration's disability criteria through a Social Security Disability impairment listing.
What is an impairment listing? In brief, Social Security has a disability handbook that contains impairment listings that address specific medical conditions. These are grouped and organized by body systems such as cardiovacular, muskuloskeletal, respiratory, etc. To be approved for disability on the basis of a listing, a claimant's medical records must provide information that is specified in the listing.
If a person is not approved by satisfying the requirements of a listing (most cases are not approved on the basis of a listing because the criteria is very specific and often difficult to meet), an approval can also be made through a medical vocational disability allowance if their condition causes significant limitations to their functional ability. Functional abilities relate to work activity but are as specific as the ability to sit, stand, or walk for lengths of time, lift objects of a certain weight, see and hear, communicate with others, learn and retain information, and so forth.
Medical vocational approvals are much more common than being awarded disability benefits on the basis of satisfying a listing. When a medical vocational decision is made, a disability examiner will consider an individual's RFC, or residual functional capacity (what someone is able to do in spite of their disabling condition) and compare this to their education, their history of past work, their age, and the potential transferability of their job skills to other work.
If the determination is made that the demands of the claimant's past work, and the demands of any other work that they might be considered capable of switching to, are too great when considering their remaining, or residual, functional capacity, they will be approved for disability benefits in either the Social Security Disability or SSI program, and in some cases in both programs.
Finally, aside from "meeting a listing" or receiving a medical-vocational approval (which basically means that an individual is unable to work at any of their past jobs, or switch to a new form of work), if an individual has a terminal condition their disability claim will not only be approved at the initial disability claim level, but the processing of the claim will be expedited to ensure that the individual is paid as soon as possible.
Rates of approval
The disability application, or initial claim, approval rate tends to average between thirty to thirty-five percent. The rate of approval varies by state, but on an average basis, this rate of approval has been extremely consistent for the last twenty years.
This, of course, means that approximately 70 percent of the people who file an initial disability claim will have to use the appeal process to pursue disability benefits following their initial claim denial.
The first appeal, the request for reconsideration typically has a higher rate of denial and, on average, 82-85 percent of these first appeals are also denied. The likely reason for this is that the reconsideration process is exactly the same as the process used to decide a disability application. In both instances, the case is handled by a disability examiner at the agency known as DDS, or disability determination services. Though a different disability examiner will handle the reconsideration, both this examiner and the examiner who worked on the initial claim use the same process. Very often, they will be located in adjoining units, or right down the hall from one another. All things considered, it is not even slightly surprising that most reconsideration appeals are also denied.
At the disability hearing, the process changes substantially and so does the rate of approval. At a hearing, the primary responsibility for gathering updated medical records will fall to the claimant and their disability attorney if they have one. The claimant will actually meet the decision-maker, in this case a federal judge. And the claimant and their attorney will have full opportunity to present arguments and evidence as to why the case should be approved. Represented claimants at disability hearings often win their cases more than 60 percent of the time--meaning that the majority of individuals who are denied at the disability application level will eventually be approved if they do not give up on pursuing their claim.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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