Bill Gordon and Associates

At stage one the applicant’s initial application is filed by either contacting your local district office in person, filing over the phone, or completing the application online. Typically it will take between 90 and 120 days before a decision is rendered and 7 out of 10 applicants will be immediately denied. If your claim is denied you will be notified by mail and you will receive a dated denial letter. Once the denial is received you have sixty days from the date of the denial to appeal.

Initial Stage

Should the applicant decide to request reconsideration (it is recommended that you do) you are asking the Social Security Administration to reconsider their decision. It is during this stage that your claim is sent to a branch of the SSA called the Disability Determination Services (DDS) to be evaluated by a disability examiner. The job of the examiner is to gather past medical evidence as well as ask you, the claimant, to complete specialized questionnaires which will give them additional information regarding the severity of your condition. Once your examiner has completed his or her evaluation, a second denial is usually issued. Remember that at this stage 9 out of 10 applicants are denied. If you are denied a second time, you will receive another date stamped letter in the mail. Once the denial is received you have sixty days from the date of the denial to appeal.

Reconsideration Stage

In the hearing stage, the claimant submits a second appeal which requests that the Social Security Administration provide them with an opportunity to present their case before an Administrative Law Judge (ALJ). An ALJ will typically hear over a thousand Disability cases a year. It usually takes approximately nine to twelve months from the time the Request for Hearing is submitted to the time when a hearing date is granted. Once a hearing date is granted the claimant (and their appointed representative) will be sent a “Notice of Hearing”.

Hearing Stage

Should I have a representative accompany me to my hearing?

Absolutely. Though it is not necessary to have an attorney to represent you at your hearing it is highly beneficial. Not only will your representative physically accompany you to your hearing, they will be able to present your medical evidence and case in an organized way which can impact the ALJ’s final ruling.

Where will my hearing occur?

Your hearing will typically occur at the Office of Disability Adjudication and Review (ODAR). However, SSA does take distance into consideration, and for claimants that do not live nearby their hearing will be held closer to their residence, usually at a federal or bank building.

If you and your representative believe that your claim was unfairly denied at the hearing stage, you may request that the Appeals Council review the ALJ’s decision. The Appeals Council serves as a review board and reviews (at the claimant’s request) those decisions which resulted in an unfavorable decision. Should the Appeals Council take a look at your case they may decide to do one of two things:

Appeals Council Stage

1. They will issue a remand.
When this happens it means that the Appeals Council has looked at the ALJ’s decision, read all statements submitted by your representative and has decided that the decision should be re-examined and issues a remand. If a case is remanded, it is sent back to the Office of Disability Adjudication and Review (ODAR), submitted to the ALJ who originally heard the case, and a new hearing is set.

2. They will deny your request for review.
In this circumstance the Appeals Council has reviewed the ALJ’s decision, the evidence, and the statements made by your attorney and find no reason to require another examination of your case. Should you be confronted with this situation it is advisable that you contact SSA and make a new application.

The final stage of the appeals process comes if you disagree with the Appeals Council’s decision, or if the Appeals Council decides not to review your case. In this situation, you can file a civil suit in a federal district court. This is the last stage of the appeals process.

Federal Court Stage

The civil suit is filed in the district court of the United States for the judicial district in which you reside or where you have your principal place of business. If you do not reside within any such judicial district or if you do not have your principal place of business within any such judicial district, the civil action must be filed in the United States District Court for the District of Columbia. There is a charge for filing a civil action in Federal court.

As explained in detail in the letter you receive from the Appeals Council, if you file a civil action, you must send the Social Security Administration copies of the complaint you filed and of the summons issued by the court. These copies must be sent by certified or registered mail to the Social Security Administration’s Office of the General Counsel that handles the area where the complaint is filed.