The Social Security Administration (SSA) has a multistep process for determining eligibility for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. While an ALJ (administrative law judge) hearing is often the final step, especially if your initial application is denied, there are instances where benefits may be approved prior to a formal hearing.
In this blog post, we’ll explore the circumstances under which you might receive benefits without a full ALJ hearing. We’ll discuss the initial application process, the reconsideration stage, and the potential for Compassionate Allowances. Understanding these options can help you navigate the SSDI and SSI claims process more efficiently.
What Are the Steps in SSDI and SSI Application?
The SSDI) and SSI) disability process begins with an application at the local SSA office. During the application process, you provide all necessary medical, work history, and personal information. Once the application is submitted, it is first reviewed at the local SSA office for non-medical eligibility, such as income and work history. You can learn more about these in our recent blog post regarding the non-medical requirements for Social Security benefits.
If you meet all non-medical eligibility, your application is forwarded to the Disability Determination Service (DDS) Office for a medical determination. At DDS, your health condition is reviewed to determine you are disabled. A team of doctors and trained staff review your medical condition to determine the severity of your disability and how it affects your ability to work. They may request additional information or schedule a medical examination for further evaluation. To learn more about the medical requirements for disability, learn more by reading The Complete Guide to the Social Security Disability Application.
The approval for disability is made based on the assessment of the medical and vocational information. To be eligible for SSDI or SSI benefits, you must not only be unable to do your previous work but also any other type of work considering your age, education, and work experience.
The process can be lengthy, often taking several months to over a year. If the initial application is denied, you can file the first appeal called the Request for Reconsideration. If the first appeal is denied, you can file the second appeal called the Request for Hearing. During the hearing stage, you may appear before an administrative law judge who decides whether you are disabled. Getting legal assistance can help navigate this complex process and increase the chances of approval.
Can You Get Approved for Disability Before Your Hearing?
Yes, it is possible to get approved for disability before your hearing. This can occur during the initial application or during the reconsideration stage, which is the first level of appeal after an initial denial. In the most recent data available, 35% of claims were approved at the initial application level and 15% of claims were approved at the reconsideration level.
A case may be approved before a hearing if there is thorough medical documentation of your disability that limits your ability to work full time. Rapidly progressing diseases or severe conditions may also lead to quicker approval without needing a hearing under the SSA’s Compassionate Allowances program. Also, if you have a condition that meets the SSA’s Blue Book listings, you may be approved for disability benefits prior to your hearing. Consulting with an experienced disability lawyer can also improve your chances of early approval.
If your case is not approved at the initial application stage or the first appeal stage, and you file a Request for Hearing, your case may be approved before your hearing date by an ALJ if the judge grants an On The Record (OTR) request. An OTR request asks the judge to make a decision in your case based on the documentation in your record without appearing at a hearing. You can request an OTR after you have filed your request for hearing. You should consider filing an OTR request if you have not worked after the start date of your disability and believe that the medical records in your file support a finding of disability. If the OTR request is granted, you will be awarded disability benefits. If the OTR request is denied, your case will proceed to a hearing.
What Happens if You Don’t Get Approved Before Your Hearing?
If you don’t get approved for disability before your hearing, you will have to attend the hearing and present your case to an administrative law judge. At the hearing, you will need to provide evidence to support your claim, including medical records, testimonies from medical professionals, and personal testimony about your daily life and limitations. These remote hearings can be conducted via telephone or video.
Steps to Ensure Your Application Is Approved
By following these steps and paying close attention to detail, you can significantly improve your chances of a favorable outcome when applying for SSDI or SSI:
Gather all relevant medical records
Medical records are an essential component of a disability case. The SSA will collect all medical documents that show your disability and its impact on your ability to work. This includes clinic or hospital records, lab results, MRI or X-ray reports, and doctor’s notes. You should only provide medical information pertaining to the relevant period of your disability. The SSA will only review the records of the doctors you have seen for the 1.5 years prior to the application or since your alleged onset date of disability.
Document your daily life
During the disability application process, the SSA will want to know about your daily activities and how your disability affects your ability to perform routine tasks. They will ask about this in the disability application or in a questionnaire that asks about your daily activities. It is important to list and provide examples of your limitations and how they would limit your ability to work.
Obtain work history records
The SSA needs to understand your previous work to properly assess how your disability affected your ability to perform work-related tasks. During the initial application stage, you will need to list all the jobs that you performed in the past five years. This is called your past relevant work. The SSA will send you a Work History Report form, which you will need to fill with details about your job duties. You should provide as much detail as possible and explain all the physical and mental demands of your work.
Stay up to date with your medical treatments
While your application or appeal is pending, the SSA will continue to request and review updated medical treatment records. It is important that you continue with your regular medical appointments and treatments while your claim is pending. It provides ongoing documentation of your disability and shows that you are proactive and committed to managing your disability.
Consult with a disability lawyer
Consider hiring a disability lawyer to guide you through the approval process. They can help you prepare your case and represent you at your hearing.
FAQs
Although the majority of initial application claims are denied, it is possible to get approved for disability at the application stage or the first appeal stage without the need for a hearing.
At the application stage, 38% of claims are approved. At the first appeal stage, 15% of claims are approved. And at the second appeal stage, 51% of claims are approved.
Once your hearing is scheduled, it is essential that you attend your disability hearing. If you fail to attend the hearing, the judge may dismiss your case. This will result in a denial of benefits. The hearing will only be rescheduled if you had “good cause” for failing to comply with the requirement to attend your hearing.
