In 2020, 9.6 million Americans collected over $143 billion in government Social Security disability benefits. However, the Social Security Administration (SSA) denies approximately 66% of all claims filed. The Social Security disability approval process can also take up to six months, and sometimes longer before a decision regarding your initial claim is made.

The help of an advocate or attorney can potentially reduce the time required to receive your benefits by increasing the chance of approval on your initial application. An experienced representative knows how to properly prepare your claim and avoid the pitfalls and mistakes in the Social Security disability approval process that applicants often make when filing independently.

Social Security Disability Approval Process: Initial Evaluation

After you submit your disability claim, a representative of the SSA will evaluate your claim to determine if you meet the basic requirements to receive benefits. The representative will also evaluate the amount of income you currently earn on a monthly basis. You do not need to be unemployed to be eligible for disability benefits; however, there is a maximum amount of monthly income you may earn to be eligible. If you exceed that limit, you may be determined ineligible. Find out if you may qualify now.

Social Security Disability Approval Process: Disability Determination

Once the SSA representative has determined that you meet the basic requirements of eligibility, your application is advanced to the second level of evaluation. The evaluation is handled by the Disability Determination Services (DDS). The office of DDS will make the initial determination of eligibility for your claim. The DDS consists of a team of evaluators that may include disability specialists such as physicians or psychologists.

Before DDS makes a determination, an examiner decides whether you already submitted all required information and documents. If the examiner believes the agency needs further documentation, DDS will request that evidence from your health care provider(s). At this point, the DDS may request other information from you or your health care providers that they believe is necessary to evaluate your claim.

Rapid communication is essential to expedite your claim, so be sure to include current contact information as well as a fax number. Because the SSA frequently sends or requests new documents, we highly recommend having an easily-accessible fax number or email address for this purpose.

Social Security Disability Approval Process: Consultative Examination

The DDS will request that you undergo a consultative examination if they determine that your claim cannot be determined based on the information and documents submitted. A doctor other than your primary physician may perform the consultative examination. However, because your doctor is most familiar with your condition, you may request that the DDS allows your physician to conduct the consultative examination. If the DDS determines that your doctor has the resources and is qualified to conduct the examination, the DDS will approve your request.

Throughout the evaluation, the DDS considers your health problems and how they might affect your ability to perform previous jobs. They will also consider your level of education and your age. The DDS considers the diagnosis provided by your physician; the severity of the condition; the length of time you have suffered from the condition; and, most importantly, how this condition limits your daily routine and work-related activities. Debilitating factors come into consideration, especially in how much they limit your ability to perform work-like activities. These factors include things like:

  • Chronic pain
  • Physical limitations
  • Mental limitations
  • Prescription medication and their known side effects

How Long Does It Take?

The DDS evaluation process can take up to six months (sometimes longer) before you receive a decision. If the SSA denies your claim, don’t give up! The majority of denied claims are due to your initial application, especially if you file on your own. This can happen for a variety of reasons: technicalities, inadequate medical documentation, inadequately presenting the disability and other mistakes.

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