Ultimate Social Security Disability Guide: SSDI, SSI, How to Win, Information
The Social Security Disability Process
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The Disability Process

This page will show how the Social Security Disability (SSDI) and SSI process works.  This will show what steps are taken and how the file is processed.  If you are wondering:  How does Social Security determine if someone is disabled then got to page called are you disabled?  If you have already decided you need a lawyer for your claim click on Find a Lawyer.

What steps to take in a Social Security Disability Claim



The first thing you need to do is apply for Social Security disability benefits.  Applications are taken at the local Social Security Administration offices.  If you are applying for Social Security disability (SSDI) you can apply by phone, mail, online or in person.  Your Lawyer or representative can also file your application.  Supplemental Security Income (SSI) on the other hand must be done in person at a local Social Security office.  Your claim for disability benefits will then be processed by Social Security field offices and state agencies.  The Social Security field office will verify your age, marital status, employment and if you are covered under Social Security by paying into the system thru your taxes.  The file is then sent to Disability Determination Services (DDS) to determine if you are medically disabled.  The DDS is responsible for getting the medical information needed from your doctors and usually consultative examining doctors that are paid by the Social Security Administration.  Ounce DDS determines they have enough medical evidence they will make the first decision if you are disabled.  If you are found disabled the DDS will then send the file back to the Social Security field office to asses the amount of your disability benefits and will then begin paying those benefits.  If the DDS finds you not disabled then the file is also sent back to the Social Security field office were the file waits to see if you appeal the decision.  If you appeal the decision in some states you go to the process of reconsideration.  This is basically a repeat of the above process.  In other states if you appeal your initial denial you will go straight to the hearing stage before an administrative law judge.  In states that have reconsideration if you are denied this second time you go to the hearing stage.  Your case is now in another office called the Office of Hearing and Appeals (OHA).  On a side note the Office of Hearings and Appeals is now called the Office of Disability Adjudication and Review or ODAR.  The wait time for a hearing is long usually anywhere from 12-18 months and sometimes longer.  If you win at this stage and your case is not reviewed by the Appeals Council it will be sent to local field office for payment.  If you lose at this stage you can appeal the decision to the Appeals Council.  The Appeals Council can deny your appeal, remand the case for another hearing, or find you disabled.  If you lose at the Appeals Council your only recourse is to file civil action in United States Federal Court.

The new Social Security Disability Process is coming and is all ready being tested in the Boston region.  The Boston Region is comprised of the states of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.  Update Feb. 2008:  The Disability Service Improvement Process that was tested in Boston Region will be terminated and will not be coming to other regions.  I will be changing this page when this becomes official.

      

SOCIAL SECURITY

News Release

Commissioner Barnhart Unveils New Social Security Disability Determination Process

Jo Anne Barnhart, Commissioner of Social Security, issued a final rule establishing a new disability determination process. The new process, built upon Social Security’s electronic disability claims process, will shorten decision times and pay benefits to people who are obviously disabled much earlier in the process.

“The changes we are making in the disability process will greatly improve the quality of service that Social Security provides to millions of disabled workers and their families,” Commissioner Barnhart said. “The new process uses 21st century technology and creates accountability at every step. It reflects my goals of improving the accuracy, consistency and fairness of our process and ensuring that we make the right decision as early in the process as possible.”

The new disability process provides for:

  • A quick disability determination process for those who are obviously disabled. Favorable decisions would be made in such cases within 20 days after the claim is received by the state disability determination agency.
  • A new Medical-Vocational Expert System (MVES) to enhance the expertise needed to make accurate and timely decisions. The MVES will be composed of a Medical-Vocational Expert Unit and a national network of medical, psychological and vocational experts who meet qualification standards established by the Commissioner.
  • A new position -- the Federal Reviewing Official -- that will review state agency determinations upon the request of the claimant. This will eliminate the reconsideration step of the current appeals process.
  • Retention of the right to request a de novo hearing and decision from an Administrative Law Judge if the claimant disagrees with the decision of the Federal Reviewing Official.
  • Closing the record after the Administrative Law Judge issues a decision, with provision for certain good cause exceptions to this rule.
  • A new body -- the Decision Review Board -- to review and correct decisional errors and ensure consistent adjudication at all levels of the disability determination process. The current Appeals Council will be phased out gradually.

Social Security plans to phase in the new process on a region-by-region basis beginning with the Boston Region this summer. The Boston Region is comprised of the states of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.

The new disability process is the result of a collaborative effort that began during a discussion Commissioner Barnhart had with President Bush early in her term. On September 25, 2003, Commissioner Barnhart presented Congress with an approach to improving the disability process. Since then, Commissioner Barnhart and Agency staff conducted hundreds of meetings with interested groups and individuals. Social Security also carefully considered nearly 900 suggestions received during a 90-day public comment period that followed publication of a proposed regulation to improve the disability process on July 27, 2005.

"The comments we received during our extensive outreach effort and in response to our proposed rule were extremely helpful and deeply appreciated,” said Commissioner Barnhart. “I was very impressed with the professionalism, time and effort that the interested parties put into their suggestions. I believe we have improved the final rule as a result."

The preamble to the final rule explains the changes that were made to the proposed regulation as a result of the comments the Agency received. To ensure that discussions and improved understanding continue even after implementation of the final rule, the preamble also notes that Social Security plans to continue to meet with interested parties as the new process is rolled out.

In conjunction with the changes in the disability determination process, Social Security is conducting several demonstration projects aimed at helping people with disabilities who are interested in working. These projects support the President’s New Freedom Initiative and provide for work incentives and opportunities earlier in the process. In these demonstrations, the Agency will test providing cash supports, various forms of medical benefits and employment supports such as transportation assistance. Social Security will look at how making these available will help people with disabilities successfully work.

“From the beginning, I have been committed to developing a disability determination process that provides the level of service the American people expect and deserve,” Commissioner Barnhart said. “I am confident that this rule will do just that.”

NOTE TO CORRESPONDENTS: For more information on the new disability determination process, go to www.socialsecurity.gov/disability-new-approach.

The final rule is on public display at the Office of the Federal Register.

# # #

Note: Copies of most SSA press releases, as well as other Social Security information and statistics,
are available at SSA's Internet site, Social Security Online, at http://www.socialsecurity.gov.

SSA Press Office 440 Altmeyer Bldg. 6401 Security Blvd. Baltimore, MD 21235
410-965-8904 FAX 410-966-9973

 
         

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What is the new Social Security Disability process and what affect will it have on claims?

Under the current system the process has the following stages.  After you apply you get your initial decision.  If you lose and appeal you get a reconsideration decision.  If you lose again and you appeal you go to a hearing before an ALJ.  If you lose here you can appeal to the Appeal Council.  And lastly, if you lose at this stage you can file a claim in United States District Court.  Some states have already done away with the reconsideration stage.

Under the new Disability Service Improvement Process (which is coming everywhere but right now being tested in the Boston Region).  You apply and then get an initial decision.  Your case will then be reviewed by a Federal Reviewing Official.  If you are denied you then go to a hearing before an Administrative Law Judge.  The case will then be reviewed by a Decision Review Board (there will be no claimant appeal to this board they act on their own except in cases were the ALJ has dismissed the case).  The final step is if the claimant is denied the claimant has a right to file in Federal District Court.

I have a few problems with the new system.  If a claimant is denied at the hearing level you can not appeal to an appeals council or similar body.  You must rely on the decision review board to review the claim and make a judgement on whether the ALJ made a proper decision.  I have found in my practice that the only tool to defeat ALJs that consistently deny legitimate claims is a well placed argument to the Appeals Council.  A reviewing official may not catch a significant error by the ALJ.  The only recourse an individual has if the reviewing official does not remand or reverse the decision is to file in US District Court.  This is most troubling for those who are not represented and even those that are represented because many lawyers will not take a case to US District Court.  Federal Court cases are extremely complicated and asking an unrepresented claimant to present a winnable pro se case is an extremely difficult task.  I know it will also force my practice to file more US District Court cases on cases that might have been remanded if there was an Appeals Council.  This will certainly cause even larger case loads for the US District Courts and increased waiting times.  April 2007 Update:  It appears there is momentum to keep the Appeals Council in some form I will keep track of this and report anything new on this.
February 2008 Update:  Commissioner Astrue has announced termination of the Disability Service Improvement Process in the Boston region.  This is great news and means it will not be implemented nation wide as originally planned.  The DSI process will remain in effect untill it is officially stopped. 

 We have attempted to provide up to date and accurate information, however the information in this site is not guaranteed.  No attorney client realtionship exist.  The information in this site is not a substitute for consultation with a quilified attorney.
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