Disability Application Process
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Your first step should be to call a lawyer who specializes in Social Security disability claims. Most attorneys, including our office, will meet with you at no cost and with no obligation. Meanwhile, you should make sure you are receiving high-quality medical care. The best possible situation for a disability case is to have a regular doctor who specializes in your specific medical problem, knows you well and has seen you for a long time and knows your entire medical history. We recognize that this is the ideal situation and that it might not be possible for everyone. If you can’t see a specialist regularly, then get the best medical care you can afford, and follow your doctor’s recommendations.
You will need to document as much information as you can. Work with your doctor to make sure he or she knows everything that is wrong with you. It is difficult to prove disability if your doctor doesn’t know that you are in pain or have other symptoms. Keep written records of your doctor’s appointments, hospital visits and medical procedures.
Initial application stage – This can be done through our office, or you can file the application yourself through Social Security either by phone, online, or by making an in-person appointment. After the representatives at SSA determine which program or programs you are eligible to apply for, they will send your claim for medical review. This is handled by a state agency, called Disability Determination Services. This is the office that will order your medical records, collect information directly from you, and review your file to determine whether you meet SSA’s disability criteria.
If your case is denied, you will receive a letter stating that you do not meet Social Security’s definition of disability. First, don’t be discouraged. The vast majority of disability applications are denied at this stage. Second, do not take Social Security’s explanation to heart. It will say that you are not sick enough, that you can go back to your old job or that you can do other kinds of work. This form is sent to everyone who is turned down. Don’t take it personally, and don’t let it hurt your feelings.
You will need to send in a written form, a Request for Reconsideration, appealing the denial, along with some other forms that can be requested from Social Security. These forms also can be filled out and filed online. If you are our client, we will provide you with the necessary forms, answer any questions you have, and file your appeal online. Social Security will send your case back to the state agency, and they assign your case to someone different who will update your medical file and make a new determination.
If you are denied again at the reconsideration stage, you will need to file a Request for Hearing. If you are our client, we will provide you with the necessary forms, answer any questions you have, and file your appeal online. Your case will be sent to the local hearing office, the Office of Hearings Operations (OHO). There are three main OHO locations in South Carolina, as well as several satellite offices which are not staffed, but allow individuals who live far away from Charleston, Greenville, and Columbia to attend hearings closer to where they live.
If you are our client, we can monitor the status of your file at the hearing office. The file will be assigned to a judge and placed in a queue to be scheduled for hearing. It is not possible to request a particular judge, nor to change judges once the case has been assigned. For represented claimants, the hearing office does not gather additional information of any kind about your case. That is the responsibility of your representative. We also meet with our clients before a hearing to discuss the case, and to prepare them for the kinds of questions they can expect at their hearing.
When your hearing date finally comes, you will have a short, informal, conference-like administrative hearing before the Social Security administrative law judge, or “ALJ”. These hearings are for the purpose of gathering further information about your case for the ALJ, who will determine whether you are disabled. In most cases, the ALJ will not make his or her decision at the hearing. ALJs issue written decisions, which are received by mail, usually a month or two after the hearing.
While many people who are disabled win their benefits at the hearing stage, it is possible that you will be turned down again. This is not the end of the line, however. You can appeal to the Appeals Council, which is located in Falls Church, Virginia, simply by filing a Request for Review. This can be done by mail or online. You also can send additional information or a written argument to the Appeals Council.
We carefully review unfavorable decisions by an ALJ to determine if they are suitable for appeal. However, not all unfavorable cases can be successfully appealed. This issue is no longer whether you are disabled, but rather, there must be an argument that the ALJ made a legal error in his or her written decision. The ALJ is given great latitude in interpreting the facts of a case, but cannot outright ignore evidence, and must follow certain regulatory guidelines in reaching a decision.
The Appeals Council turns down the large majority of appeals they receive. The main reason to send your case to the Appeals Council is to preserve your right to then appeal to the Federal District Court.
If you are denied at the Appeals Council level, the next step is to file a lawsuit in the federal District Court. At Milton English & Whitten, we have handled thousands of cases over the past 30+ years, and our rate of success at the federal court level is impressive. Many of the cases are referred to our office by other attorneys who do not practice in federal court, because this is a highly specialized area of law.