The “3 to 5 Months” Wait Time, and Why It’s Disappointing
The Social Security Administration (SSA) website claims that applicants typically wait three to five months to receive a decision—but how long realistically should you expect to wait? We’ll break down the timelines, expectations, and what-if scenarios of the Social Security Disability (SSD) application process. By the end of this article, you will know what to expect and how to answer the number one question in the disability application process: How long does it take to get disability benefits?
The Social Security disability office doesn’t have a deadline for either applications or appeals—that means that they are not obligated to provide an answer in any given timeframe. That’s why many applicants find that they wait six months to two years before finally receiving benefits. Here’s what you need to know about various types of claims and a brief overview of the four stages of application and appeals:
How Long Does It Take for Expedited Claims?
The SSA has two general criteria for pushing an application through faster. The first is that the disability is classified as terminal. “Terminal” means that it will significantly shorten a person’s life. An example of a terminal disability may be cancer.
The second criteria for being fast-tracked is that the condition is on the Compassionate Allowance List (CAL). People with a condition on CAL always meet the SSA’s definition of “disabled” and are often approved. If you’re eligible for an expedited claim, you may be approved as little as 30 days.
How Long Does It Take for General Claims That Don’t Qualify for Fast-Tracking?
First-time applicants win approval in 3-5 months, on average. In 2020, the SSA approved a little more than 1 in 5 first-time applicants. Most claimants have to appeal their initial denials, especially if they don’t have a lawyer handling their cases.
Appealed disability claims have four steps before you should attempt to reapply for benefits. The SSA may approve your claim at any point in this process:
- A hearing with an Administrative Law Judge (ALJ)
- An appeals council review
- Federal court
The amount of time it takes for you to win approval depends on which level of appeal your claim must go through. For example, some applicants who have their claim approved after reconsideration may be approved within six months. Applicants who take their claim to the appeals council for review may experience a wait time of two years. Appealing to a Federal court may take more than a year after the appeals council.
Inside the Social Security Disability Claim Review Approval Process
Getting your SSD benefits claim approved by the SSA is a lengthy process full of questions: What goes on behind the scenes during the Social Security disability claims approval process? How many people handle one application? How does the agency investigate a person’s work history and confirm his or her medical condition? These are common questions many who are thinking about applying for SSD benefits ask themselves and their attorneys. Most people don’t have an inside look at the claims approval process and may not realize a lot of work goes into examining each application.
[UPDATE: We’ve produced an infographic about the disability claims process—what the steps are, how many people get approved at each step, and even how a disability lawyer can get you approved faster and for more money. See the disability application process, visualized, here.]
The SSA has revised its disability approval process numerous times to make it more efficient and user-friendly to ensure all eligible applicants receive their needed payments. Understanding the internal process can help applicants gain a better picture of the SSD application timeline. Here are the basics of the process:
1. Application Handed Over to the State Disability Agency and a Disability Examiner
According to Tim Moore, a former disability examiner for the SSA, the first step in the long claims approval process is to send your Social Security disability benefits application to a state disability agency, which is also called Disability Determination Services (DDS).
This step is where your application will be assigned to a disability examiner, who is a case-processing specialist. Your application’s disability examiner will collect much of the needed information and provide the initial determination about your claim. This gathering is at the heart of your claim approval process.
2. Examiner Contacts Medical Personnel and Past Employers
Case-processing specialists must review all of the application’s information, and only after doing so may they contact your physicians for current medical records, or records that are no older than 90 days, Moore wrote. As a former examiner himself, Moore noted this is the step in the process where you might be contacted to undergo one or more consultative examinations (CEs) so the examiner can have your current medical condition on file. CEs are often only short physical or mental exams.
According to the SSA, appointed physicians must follow strict CE guidelines. Moore said CEs don’t necessarily provide objective measurements, and you may not be asked to undergo one. The examiner may also contact your past employers about your work history if you had been employed previously. Understanding your relevant past work history is essential to the process, Moore claimed.
3. Specialist May Ask You to Complete Daily Living Questionnaire
You might have to fill out a daily-living questionnaire about how your medical condition impacts your day-to-day activities. Your third-party contact person may also be asked to observe your daily activities.
4. Examiner Makes Initial Claim Determination
The case-processing specialist will then decide your residual functional capacity, or what types of activities you are able to do despite your limitations.
5. Application Goes to the Office of Disability Adjudication and Review
Once your case examiner provides a determination, your claim is sent to the Office of Disability Adjudication and Review (ODAR), according to the SSA. The ODAR is the department that schedules and holds disability hearings and fields all SSA applications, including retirement and survivors benefits. Because there is a limited number of judges and the ODAR’s two case-processing divisions have only a few hundred offices across the country, this part of the process can take up a large chunk of time.
6. Your Application Hearing
The ODAR will then schedule your case and notify you of your upcoming hearing date. According to the SSA, approximately 1,535 administrative law judges (ALJs) make more than 558,000 rulings every year, so it can take a while.
If your case is denied at the hearing stage, you should appeal immediately with the help of an experienced Social Security attorney or advocate. Hiring an attorney from the beginning may improve your chances of being found eligible the first time.
Why There Is Such a Long Wait for Social Security Disability Benefits?
While there may be ways to speed up the approval process, waiting for SSD benefits can take months—and even longer if you are appealing a denial. For some, not receiving Social Security disability payments can mean not paying bills or receiving needed medical care. Why does it take so long to receive Social Security disability benefits? Simply put, there are more applications than the SSA can handle.
Cutting Through the Backlog
Wait times differ across the country, but you should expect to wait at least six months. According to the SSA, the shortest wait times for 2021 are in:
- Akron, OH: 6.5 months (197 days)
- Evansville, IL: 6.5 months (201 days)
- Elkins Park, PA: 7 months (205 days)
- Houston, TX: 7.5 months (225 days)
In certain parts of the US, wait times can be as high as a year or more. Tacoma, Washington, for example, has a current claim-processing time of 497 days. For many people, waiting more than a year to have their application heard can be devastating. In an interview with WIVB, Ohio resident Kathy Nobilio said she was lucky her bank understood that she had been waiting for more than a year for payments.
“[My appeal for benefits] is just sitting there—nothing has been done,” Nobilio told the news source. “I’m afraid I’m going to lose my house. The bank has been very patient.”
Some people may think they could receive benefits faster if they apply for Supplemental Security Income (SSI), but the Ohio Bar says the “laws governing who medically qualify are the same” for both programs. According to the Federal Times, the issue may worsen as the number of SSA employees continues to decline.
“Given the expectation of leaner future budgets, SSA needs to plan to meet its mission with fewer resources,” the Office of the Inspector General said, according to the Fiscal Times.
If you’re thinking about applying for SSD benefits, working with a Social Security attorney or advocate can double your odds for approval the first time. That’s because appealing an initial denial only prolongs how long it takes to get disability benefits.
Getting Approved for Disability Benefits
While there may not be a concrete answer as to how long it takes for Social Security disability approval, there are ways to possibly speed up the process.
1. Consult a Lawyer
An attorney or advocate who specializes in Social Security disability cases knows exactly what you need in terms of documentation, evidence, and other resources to complete your application. Because they specialize in handling this sort of case, they can take the guesswork out of applying, which would otherwise slow down the process. Since 80% of all applicants have an attorney by the final stage, we recommend you start with one to improve your chances of a favorable outcome.
2. Disability Seriousness
The CAL list shows conditions so severe they automatically meet the Social Security Administration’s definition of ‘disability.’ If your medical condition’s on the CAL list, your application qualifies for faster review and approval. How long does it take for the SSA to process fast-tracked claims? For CAL list conditions, you can expect your claim’s review and approval to take about 30 days. Your first payment could arrive in as little as five weeks from your application date! About 8% of claims filed in the past year qualified for fast-tracking through either the CAL list or QDD process.
3. Provide Complete Information
All information you include with your application should discuss medical treatments for your disability. You should also provide names of all doctors who treat you, facility addresses (including hospitals, doctor’s offices and anywhere else you go for treatment) and your appointment dates. Offering all necessary information from the start saves the disability examiner from having to track it down later. In fact, those steps are often most responsible for slowing down the entire process.
SSD Application Process: How Long Does It Take If Your Claim’s Denied?
The SSD application process doesn’t end if your first claim’s denied. Instead, you have 60 days from the day your denial letter arrives to file an appeal. However, where you live largely determines how long you’ll wait for an appeals hearing. See average appeals hearing wait times in your state or region here. Currently, the national average wait time for an appeals hearing is 11.8 months. In other words, you’ll wait at least 1.5 years from the date you apply if you win SSD benefits on appeal.
Applicants who miss the deadline to appeal must start the SSD application process all over again. Unfortunately, if you reapply immediately after receiving a denial, the SSA will automatically reject your next disability application. For this reason, you should always appeal instead of submitting another application! You must wait at least 12 months before you reapply to avoid automatic denial of your next disability claim.
You May Qualify for Legal Assistance
The last thing you want if you’ve recently become disabled is for this process to take two years or longer, so it’s a good idea to speak with an experienced Social Security disability advocate or attorney before you start the application process. Not only will they be able to help you prepare, but they also know what to do in the event that your application gets denied during the first round. The faster the SSA reviews and approves your claim, the faster you’ll receive the benefits you need.
Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!