How it works
Overview
Social Security disability claims follow the same path for everyone. Knowing the steps ahead of time makes the wait easier. Here is each stage in plain words: who decides, the general deadline to move on, and what we do.
The five stages of a claim
Most first applications are denied, so many people pass through more than one stage. Waits vary a lot by state and hearing office.
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1 Stage 1 of 5
Application
You apply online, by phone or at an office. The state agency gathers your medical records and may send you to an exam it pays for.
- Who decides
- An examiner at the state disability agency, with a medical consultant
- Deadline to move on
- No deadline, but filing sooner can protect back pay
- Typical wait
- Often several months
What we do: We file a complete application, list every provider and help with the forms about your daily life.
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2 Stage 2 of 5
Reconsideration
A fresh review of your whole file, plus anything new. It is still a paper review. You do not meet the examiner.
- Who decides
- A different examiner at the same state agency
- Deadline to move on
- Generally 60 days after you receive the denial
- Typical wait
- Often several months
What we do: We file on time, add missing records and get statements from your doctors.
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3 Stage 3 of 5
Hearing
You speak with the judge by phone, by video or in person. Experts may testify about your health or about jobs. Many claims are decided here.
- Who decides
- An administrative law judge (ALJ)
- Deadline to move on
- Generally 60 days after the reconsideration denial
- Typical wait
- Often many months, depending on the hearing office
What we do: We update the record, write a hearing brief, prepare you, and question the experts.
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4 Stage 4 of 5
Appeals Council
The council reviews the judge's decision for errors. It can deny review, decide the case, or send it back for a new hearing.
- Who decides
- Social Security's Appeals Council
- Deadline to move on
- Generally 60 days after the hearing decision
- Typical wait
- Often many months, sometimes longer
What we do: We read the decision for legal errors and tell you honestly whether review is worth asking for.
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5 Stage 5 of 5
Federal court
A lawsuit that asks a federal judge to review Social Security's decision. It is based on the written record, not new testimony.
- Who decides
- A United States district court
- Deadline to move on
- Generally 60 days after the Appeals Council's action
- Typical wait
- Often a year or more
What we do: We handle some federal appeals and refer others. Either way, we explain the choice before you decide.
About the 60 days: Social Security generally assumes you received a letter five days after the date printed on it, so in practice the window is often counted from that point. Do not rely on the extra days. If a deadline is close, call us the same day.
The five questions Social Security asks
At every stage, decision makers work through the same questions in order. The answer to each one decides whether they keep going.
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Question 1
Are you working above Social Security's earnings limit?
If you earn over the monthly limit for substantial work, Social Security usually stops here and finds you not disabled.
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Question 2
Is your condition severe?
It must limit basic work activities, like standing, lifting, remembering or getting along with others, and last or be expected to last at least 12 months.
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Question 3
Does it match a listing in Social Security's medical guide?
Social Security keeps a list of conditions and test results, often called the Blue Book. Meeting a listing can lead to approval at this step.
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Question 4
Can you still do your past work?
Social Security looks at the jobs you did in recent years and whether you could do any of them now.
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Question 5
Can you do any other work?
Social Security considers your age, education, skills and limits. The rules treat people 50 and older differently, which is why age often matters.
What working with us looks like
You should always know what is happening with your claim and what, if anything, you need to do next. This is the routine every client gets.
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1
A free first call
About 15 minutes. We ask where your claim is, read any letter you have, and check deadlines. If we cannot help, we say so and point you to who can.
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2
Two short forms
If we take your case, you sign Social Security's form naming us as your representative and a fee agreement. We go over both line by line before you sign.
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3
We gather the records
Marisol requests records from every provider on your list and follows up until they arrive. You do not have to chase clinics yourself.
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4
We handle the paperwork
Appeals, forms and letters go through us, and we keep copies of everything we send and receive.
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5
You hear from us monthly
A call or letter at least once a month while you wait, and right away when something changes.
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6
Decision, and our fee
If you win, we read the award with you and explain our fee. If you do not, we explain why and what your options are, and you owe no fee.
Deadlines at a glance
| If you get | You can ask for | General deadline |
|---|---|---|
| A denial of your application | Reconsideration | 60 days |
| A reconsideration denial | A hearing with a judge | 60 days |
| An unfavorable hearing decision | Appeals Council review | 60 days |
| An Appeals Council denial | Federal court review | 60 days |
| A notice that benefits will stop | Reconsideration, and continued payments | 60 days to appeal, about 10 days to keep payments going |
Not sure which stage you are at?
Read us the top of your latest letter and we will tell you where your claim is, what the deadline is, and what comes next. The call is free.