Frequently Asked Questions in Social Security Disability

The initial claim is filed with the District Office or Field Office in the municipality in which you reside, via telephone, online or an in-person visit. If the Claimant meets non-medical requirements, the file is sent to the Disability Determination Service, to do the medical evaluation.

Social Security Disability is an insurance program, in which an individual must have enough quarters of coverage pain into Social Security through payroll taxes, to have both fully insured status and disability insured status. Fully insured status requires having one quarter of coverage for every calendar year in which he/she turned 21, up to the calendar year before becoming disabled.

Once the initial application is sent, the Social Security Administration will send additional forms to the claimant (e.g. Supplemental Pain Questionnaires, Medication Listing; Vocational Training), order medical records from treating physicians and other providers and may schedule a consultative examination with an appointed Medical Examiner (ME).

If a claim is denied at the initial level, the claimant can file for Reconsideration. The Reconsideration process allows the Claimant and her attorney to have the record reviewed by the Disability Determination Services. The record can be supplemented, additional medical examinations ordered and a legal analysis of the factual record can be made. National success at the reconsideration level is approximately 25%.

Most appeals of denied Social Security Disability claims end up before a Social Security Judge, at the Office of Disability Adjudication and Review (ODAR), sometimes called the Hearing Office. Some cases may be reviewed by an attorney advisor, for consideration of a possible on-the-record decision, without hearing. In most cases, the case will be set for a hearing.

This is an opportunity for the Claimant to explain to the Judge, the detailed basis for disability, by elaborating and explaining the “day to day” problems faced. The attorney representative can cross-examine vocational and medical experts and make legal arguments to the Court. Nationally, there is a huge range of outcomes, depending on the Social Security Judge. Some Social Security Judges have a high statistical record of denial, while others an opposite high record of fully favorable decisions. In fact, there are U.S. Congressional Committees currently examining this phenomenon, among other aspects of the Social Security Disability program.

All attorney fees must be approved by the Court. By Federal law, an attorney representative will take either 25% or a maximum of $6,000.00, whichever is LESS, from past benefits awarded. If the appeal is unsuccessful, no fees will be due to the attorney.

If a claim is denied by a Social Security Judge, it can be appealed to the Appeals Council, by filing a request for review. There is also a limited right of appeal to the U.S. District Courts.