Anyone who is considering applying for Social Security Disability Insurance Benefits (DIB) or Supplemental Security Income (SSI) is probably already feeling a bit desperate and so the answer to this question is always “too long.” Such a person has likely been suffering from a significant and painful impairment for some time which has forced her to stop working. Some people may have the benefit of temporary state disability benefits, but this is a short-lived help, no more than 12 months. Most people who call us are looking at dwindling or non-existent resources and are very worried about how long the SSA decision making process will take. You need to know this information so that you can make plans for getting through the process.

There are three (or more) possible points in time that an applicant can receive a decision. After an application for SSA disability benefits has been filed, the application is sent to a state agency for analysis. The state agency orders medical records and asks for more information from the applicant and her family. Sometimes medical treatment providers are slow to respond. Sometimes the agency feels that additional information is required and sends the applicant to an examination paid for by the agency. Sometimes an applicant’s inability to fill out additional required paperwork in a timely manner can slow down or derail the process. A decision is typically made within three to five months of the application, but it could take longer (some applications made during Covid were held up for many months due to the Agency’s inability to schedule in-person medical examinations.) This is called the Initial Decision. The Initial Decision is favorable in approximately one-third of the applications. In other words, two-thirds of applications for DIB and SSI are denied at the initial decision level.

If you have been denied at the Initial Decision level, you have 65 days from the date of the denial letter to appeal and ask the Agency to reconsider its decision. Again, the appeal is sent by SSA to the state agency and a new analyst. The analyst obtains any missing or new treatment records and makes another decision. In up to 90 percent of those appeals, a second denial is issued. This decision is typically made within two to three months of the reconsideration appeal being filed.

If you receive a denial at this reconsideration level, you have a right to request a hearing. Again, that appeal must be filed within 65 days of the date on the reconsideration denial letter.

A hearing will be scheduled within 6 to 18 months from the date of hearing request. The length of this wait is highly variable at the moment due to SSA’s use of phone and video hearings during Covid, as opposed to in-person hearings, which has reduced wait times but also introduced a level of unpredictability regarding the hearing itself. The claimant or his representative is responsible for providing updated medical treatment records during this period as well as supportive statements from treatment physicians or others. Success at the hearing stage increases but is still under 50 percent overall. However, the win rate with an attorney/representative is significantly higher. This means that unrepresented individuals have a much lower win percentage than 50 percent. This is because representatives can help the individual meet all applicable deadlines and understand the rules and regulations of SSA. They also make an effort to ensure that all of the necessary medical records are submitted in advance of the hearing. When you have a representative, your job is to take care of yourself by obtaining consistent medical treatment.