What Is the Social Security Process?

Hi, I’m Shalonda Pickford of Pickford Law Firm.

Have you filed a Social Security application for disability benefits, and you want to know how that process is going to go? I’m here to discuss that today.

So. you filed your initial application. At this stage, you’ve spoken with the Social Security representative who has gotten all of the information that you tell them. You told them about your doctor’s visits, your emergency room visits, your medications, all of the physical and or mental conditions that are bothering you. They’ve got all those medical records.

And now it’s at the decision-making service, where a team of medical examiners, doctors, nurses—everybody—they’re looking at that information, and they’re going to base their decision on what is in your file. Anything you told that representative as far as what is hindering you from working, the decision will be based upon that information in the file.

Now, if you are approved at that phase, great—they’ll start paying your benefits. However, if you’re denied at the initial application, you’re going to have to file an appeal.

So you were denied at that initial claim. Remember, I said you’d have to file an appeal? Well, this appeal is called a request for reconsideration.

At this level, we’ll get additional information from you regarding any updated medical records. Maybe you’ve gone to see your doctor again, maybe you present it to an emergency room again, maybe you have new medications or a new diagnosis. Well, we’ll need all this information for that reconsideration request, because it will go back to the decision-making service.

A different set of medical examiners including those doctors and nurses and researchers will look at that claim, again based upon the new evidence in the file, and they’ll make a decision.

Now, you can either be approved or denied at the reconsideration level. If you are approved, great. Your case will be moved back to the local Social Security office, where a representative will contact you to get your benefits started.

However, if you are denied, you will need to file another appeal. So we’re here—you were denied at the reconsideration level. Now you’re going to file another appeal. But this is for a request to go before an administrative law judge or an LJ. At this level, you will testify before an administrative law judge.

We will talk about all of your conditions, mental and physical. The judge will review all medical records that have come in on your behalf from that initial application up through the date of the hearing. The judge will be the decision-maker at this particular level.

If we are approved here, wonderful. We’ll get that decision. You will call Social Security. You’ll say “Hey, I received a fully favorable decision letter.” They’ll update all your information and get you in to pay.

However, if you are denied at this hearing level, there is another step—the Appeals Council Review. So, we’ve made it to the Appeals Council. Here. They are going to review the judge’s decision.

Keep in mind the Appeals Council is located in Falls Church, Virginia. It is the national Appeals Council, so every denied hearing that wants to appeal and have the appeals constitute review their claim will be sent to the central location. It is definitely a marathon and not a sprint.

At the Appeals Council, they will review the decision. And if they agree with the judge, they’ll dismiss your case. If they don’t agree with the judge, they will remain the case for the judge to rehear on the issue that they did not agree with him or her on or they could actually pay benefits at this level.

This level normally takes nine months to a year to receive a decision. If you are dismissed, or you do not agree with what the Appeals Council decision is, you have the option of filing in federal court.

So I’ve just explained the processes of Social Security. You have your initial application, your reconsideration, your hearing, the Appeals Council, and the federal court. Feel free to contact us at Pickford Law Firm today for a free case review.