As of November 2023, the backlog for Social Security Disability Insurance (SSDI) claims has hit a grim milestone: 1.15 million people who filed claims for disability are still waiting for a decision. The Social Security disability backlog has not been this large since the financial crisis of 2008.
The Impact of Staffing Issues on SSDI Applications
The Social Security Administration (SSA) releases monthly workload statistics that backs up what those who have been dealing with the agency have known for a long time: the disability decision process is taking too long, and is only getting slower. Since the start of the pandemic, the number of claims for disability have declined, but the wait times are still increasing. The SSA attributes these delays to the 7% reduction in workforce, resulting in the lowest staffing levels in 25 years.
Compounding the backlog problems was the 25% attrition rate for Social Security employees, leading to the SSA’s need to hire and train new employees to perform complex and important jobs. Because the rules governing Social Security are so complex, training for a typical employee can take over one year.
To illustrate how slow Social Security is getting, the average wait time for the SSA’s phone line is currently 36 minutes. The SSA is a massive agency that has a great impact on a large number of people, paying over $1.4 trillion in benefits to over 71 million people every year, so staff and budget cuts can have a significant impact on the American population and economy.
As this article will discuss, delays at the initial levels of the Social Security process can impact wait times at the hearing level. It’s important to follow these trends as disability claims are adjudicated and processed in order to prepare mentally and financially while your claim for disability is pending. This is especially important when facing a potentially lengthy period of time with no source of income, as the SSA does not provide any monetary assistance while applications are processed.
Increased processing time for initial applications
As of November 2023, Social Security disability applicants waited an average of 225 days, or over 7 months, for a decision on the initial disability application. Current wait times for Social Security applications are at the highest levels in 14 years.
Even when the decision finally comes, it often offers little relief. Only one in three applications are approved at the initial level. The remaining two-thirds of disability applicants who are not approved at the initial level must file a request for reconsideration, the first appeal in the disability process. According to Social Security studies, only 55% of applicants appeal initial denials.
This highlights the importance of consulting a disability attorney regarding any decision from the SSA. An experienced lawyer can explain your appeal rights, deadlines for filing appeals, and the statistics discussed in this article. Because most appeals are ultimately adjudicated by an administrative law judge, and the odds of an approval are higher at the administrative law stage, Social Security lawyers ensure that the initial denial decision from Social Security is not the final determination.
Unfortunately, the trend at the request for reconsideration stage is similar to the initial stage, as wait times and backlogs are also increasing at the appeals stage..
Delays in the reconsideration process
Disability reconsiderations, the first stage of appeal, are taking 183 days, or 6 months, to adjudicate. Only 15% of disability reconsiderations are approved on appeal, while the remaining 85% are denied. Of the 85% denied, only 77% appeal to the administrative law level. This reinforces the importance of consulting an experienced disability attorney to understand the appeals process and the right to appeal any unfavorable reconsideration decisions. Appealing a reconsideration denial is especially important because the approval rate at the next stage, the hearing before an administrative law judge, is 51% nationally. If a request for hearing is not filed within 60 days (plus an additional 5) from the date of the reconsideration denial, the disability applicant must start the application process over, resulting in waiting another 7 months on the application and 6 months on the reconsideration appeal.
Like initial applications for disability, reconsideration decisions are decided by the DDS (Disability Determination Services). DDS offices are state-level, rather than a single federal office adjudicating all claims. The attrition rate of 25% at DDS offices has led to the backlogs at the initial and reconsideration levels. However, once a reconsideration denial is appealed, the case is transferred from the DDS to the hearing office (Office of Hearings Operations, or OHO).
Delays in judicial decisions
Nationally, the average wait time for a final decision from an administrative law judge after a request for hearing is , or over 1 year. This represents the time an appeal is filed in response to a request for reconsideration to the date of the administrative law judge decision. In combination with the many months waiting at the lower levels, many disability applicants are waiting nearly two years to get a decision on their case. Because many disability claimants had not chosen a remote phone or video hearing option, their cases were delayed for up to several years during the pandemic while the hearing offices were closed. These so-called “aged” cases have contributed to the average wait times at the hearing level.
It’s important to note here that, unlike the lower levels, the hearing wait times are location-specific. For example, nationally, the OHO is reporting a 663-day average wait time to process hearing requests, while San Jose is reporting an average 493-day wait time. In our experience at LaPorte Law Firm, the reported wait times at the Bay Area hearing offices in San Jose, San Francisco, San Rafael, and Oakland are lower than the reported national averages.
Impact on applicants
Behind all of these statistics are real people. We see the hardship caused by delays on our clients, who are sometimes forced to move in with relatives, move to cheaper areas out of state, dip into retirement savings, claim early retirement, or pursue other public benefits such as food stamps and general assistance to survive. Some people are forced to attempt to return to work while they are still suffering from a disability, causing an exacerbation of physical or mental symptoms due to the exertional demands of working. As mentioned above, the process can be confounding and confusing, with attempts to contact Social Security for updates met with frustratingly long wait times on hold. Some people give up on the process outright, or fail to pursue appeals due to discouragement.
Understanding the SSDI Appeal Process
The SSDI appeal process begins with the initial application rejection. This is when the SSA denies an applicant’s request for disability benefits.
- After the rejection, the applicant has the opportunity to file a Request for Reconsideration, where the application is reviewed again by a different examiner. If the reconsideration is also denied, the applicant can then proceed to the next stage: hearing by an administrative law judge (ALJ).At this stage, the applicant presents their case in front of a judge. During the hearing, the judge will review the case, listen to the applicant’s testimony, and may consider any new evidence. The judge then makes a decision based on all the information presented.
The odds of success often go up at the judge’s level because the judge has more discretion and can consider the applicant’s situation in a more holistic manner. This can include the applicant’s age, education, work history, and the combined effects of their impairments.
After the hearing, the decision of the judge can take anywhere from a few weeks to a few months. This period depends on various factors, including the complexity of the case, the judge’s workload, and the need for additional evidence or expert opinions.
How Long Does It Take for a Disability Judge to Make a Decision?
Typically, the judge will take 2–3 months after the hearing to write and mail the decision. However, there are no strict deadlines for a judge to make a decision. Depending on the judge, sometimes the decision will arrive in the mail several weeks to several months, or more. It’s important to note that the hearing wait times discussed above (372-day national average for the processing of a hearing request) includes the time between appealing a request for reconsideration and the date the judge writes the legal decision. For example, in a case where the total wait time on the hearing request is one year, and the judge takes three months to write a decision after the hearing, the hearing date occurred nine months after the request for hearing, because the final decision took three months to write.
In some rare cases, the judge will make a decision on the day of the hearing. Sometimes this is informal, where the judge tells the attorney and disability claimant that the case is approved. In other cases, the judge will go through the formal process of issuing a fully favorable bench decision, in which the judge will read the decision into the record on the day of the hearing. A bench decision is advantageous because the written decision will arrive more quickly than cases where the judge and decision writing legal staff draft the decision after the hearing
In California, each hearing office has the current wait times publicly available. Once the hearing office is assigned to your case (the hearing office location can be found at the top-right address on SSA correspondence once your case is at the hearing level), check the current wait times.
How to Navigate the SSDI Process Amid Delays
By following the tips outlined below, you can successfully navigate the SSDI claims process even amid prolonged wait times.
Understand the Social Security Disability Insurance process
Before embarking on a disability application, it’s important to understand the general process, the timelines for decisions, and your appeal rights. Understanding that the statistics are not as favorable at the initial and reconsideration levels can help alleviate the disappointment of receiving a denial decision in the mail. You should be familiar with the levels of appeal and the likelihood that your case will ultimately be decided (and hopefully approved) by an administrative law judge. By staying up to date with the current wait times at the initial, reconsideration, and hearing level, you can better prepare to weather a long period of living without an income from work or disability.
Prepare thorough documentation
The outcome of most Social Security disability cases rest on the strength of the medical evidence. Those who stay in consistent treatment for the duration of the disability claims process, follow up with their physicians and pursue all referrals to specialists, and undergo all the recommended medical tests are in the best position to receive a favorable outcome.
Further, those who pay close attention to all mailed correspondence from the SSA, including requests for work history, self-employment, the function report, list of medications form, recent medical treatment form, authorization to disclose medical information form (this form is important because without it, the SSA cannot request your medical records and therefore cannot make a decision about your disability), remote hearing agreement form, etc. Promptly completing and returning any requested forms will ensure that your case is not further delayed.
Be prepared for a lengthy waiting period
As discussed, it’s important to be prepared for the lengthy Social Security disability process. This can mean applying for any public disability benefits you may be eligible for (short-term state disability or workers’ compensation benefits), contacting your HR representative to find out if your company provides long-term disability through a private company, and discussing the application for disability with your physician. By managing expectations at the outset, you can plan and prepare financially and emotionally for the process, putting yourself in the best position to succeed.
Partner with a disability attorney
Experienced Social Security disability attorneys provide free consultations to discuss the disability process and rules governing Social Security disability. If you haven’t applied for disability, you should contact an attorney to go over your unique situation, since timing a disability application with your end of work date is important. Some people apply for Social Security disability too soon and are denied on the basis that their disability does not meet the SSA’s 12-month rule. An attorney can also ensure that all deadlines are met, submit medical evidence, prepare written briefs, and prepare you for testifying at your disability hearing.
Because the Social Security Administration recognizes that a disability applicant often does not have the money to pay an attorney due to the loss of work income, attorney’s fees are contingent on a successful outcome and capped at the lesser of $7,200 or 25% of the past due benefits on approval. After November 30, 2024, the maximum attorney’s fees are capped at $9,200. There are no up-front fees or costs until the case is approved. Here is more information about our attorney’s fees.
Follow up regularly
As the Social Security disability process unfolds, it’s crucial to follow up with the SSA and, if represented, with your attorney about the status of your case. This includes updating the SSA and your attorney if you have a new doctor, or had a medical test such as an MRI or EMG. If you move during the process, it’s critical to submit your new address to the Social Security Administration so that you can continue to receive important notices and meet all deadlines.
Appeal if necessary
If you weren’t approved on the initial application, don’t lose hope. People who appeal unfavorable decisions increase the chances that their case is approved at the administrative hearing level. While most requests for reconsideration are also denied on the first appeal, the majority of cases appealed a second time to an administrative judge are approved. This means that many otherwise meritorious disability cases are denied by the administration. If you know that you cannot work due to a disability, do not despair and continue to fight for the benefits you deserve.
FAQs
An ALJ decision is the written document prepared by the administrative law judge. The ALJ decision is based on all evidence in the case file, including the testimony at the hearing. An ALJ decision can be fully favorable, partially favorable, unfavorable, or a dismissal. You have 60 days to appeal the ALJ decision to the Appeals Council.
After the hearing, the ALJ assigned to a case will consider all the facts of the case, including hearing testimony and medical evidence in the file. Once the ALJ makes a decision, the actual written decision must still be drafted, usually by legal staff assigned to the ALJ. It’s important to remember that many cases involve thousands of pages of medical records, and it can take some time for the decision writing process to occur after the hearing.
For tips about how to testify at your disability hearing, check out our free ebook, “How to Prepare for Your Hearing”.
