The SSDI Process

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There are four levels in the Social Security Administration's (SSA) review and award system for Social Security Disability Insurance.

There are four levels in the Social Security Administration's (SSA) review and award system for Social Security Disability Insurance.

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  • 1. The SSDI ProcessThere are four levels in the Social Security Administrations (SSA) review and award system for socialsecurity disability insurance. There is an additional level that takes you out of the SSA system to FederalCourt, although only a small percentage of applicants will pass through all five levels.Level One – Application. Complete the initial Social Security disability application and in most instances,a detailed Activities of Daily Living Questionnaire. There is an extensive amount of paperwork tocomplete at this initial level.The Disability Determination Services (DDS) in your home state will secure medical evidence andevaluate all the information to make the initial disability determination. The wait period at level Onemay take as little as three months, but the average is four to six months. Only about 35 percent of initialapplications are approved.Level Two – Reconsideration*. If the initial disability application is denied, you have 60 days to ask for areconsideration or first appeal. Your medical and vocational information will need to be reviewed andupdated. A different individual within the Social Security Administration reviews the application, and theSSA will send you a letter explaining how it made its decision. The average wait period at level Two isthree to five months. Approximately 87 percent of first appeals are denied.Level Three – Hearing. If the reconsideration is denied, you must again notify the SSA within 60 daysthat you will appeal the decision; this level takes you from the SSA claims processors and into the handsof an administrative law judge (ALJ). The ALJ will make an independent decision based on the evidence(including all testimony at the hearing).Approximately 62 percent of second appeals are awarded to the applicant. The SSA estimates theaverage time spent at this level was 360 days in 2011. If a disability hearing ends in another denial, thedecision can be appealed again.Level Four – Appeals Council. If the hearing ends in a denial, you have 60 days to ask for a review by theAppeals Council. At this level, the Appeals Council will review the disability hearing decision todetermine if it was rendered properly according to the law. Only 2 percent of third appeals result in afavorable decision for the applicant. The SSA estimates the average time to receive a decision on thisthird appeal in 2011 was 358 days.Level Five – Federal Court. There is also an additional appeal available which is pursued by less than onepercent of claimants -- Federal District Court (FDC). Approximately 70 percent of these are denied with asmall amount receiving a decision in FDC that resulted in an award. The remainder of those areremanded (sent back) to the hearing level for an additional hearing.Award: If your claim is awarded, the general guidelines regarding when to expect payment, including
  • 2. retroactive payments (if applicable), are two to four weeks for claims awarded at levels one and two,and one to three months for claims awarded at levels three and four. These time frames represent anaverage or general guideline – specific time frames may be shorter or longer.How much you receive is determined by a complicated formula using the amount of your past earningsthat have been subjected to FICA taxes. The average monthly benefit for an individual was $1,072 in2011. However, your monthly award is dictated by your lifetime earnings so for many people theiraward could be much higher.Continuing Disability Review: Your eligibility for SSDI benefits is subject to review at certain intervalsafter benefits are first awarded. These intervals are based on if your condition is expected to improve.These reviews are usually at one, three, five or seven years.If you have questions regarding the Social Security Disability Insurance process contact Allsup at 1-866-502-8372 or visit www.allsup.com.