The Social Security Disability Appeals Process – Do you Need a Disability Lawyer?

Americans who finds themselves unable to work due to a medical or mental condition  often file a claim for social security disability benefits.  Social security disability insurance benefits are an “entitlement” program.   That is, FICA tax payments are in part a premium for disability insurance benefits in the form of a monthly disability check and medicare elibility.  It is hardly surprising that someone who has worked and paid their taxes all their life expects disability insurance benefit approval to be quick and routine if they can no longer work.  Unfortunately, getting social security disability benefits is a long and confusing process.

Lawyers in the Social Security Disability Process

The social security disability application and appeal process was designed to be simple for the lay person.  The goal was for representatives or lawyers to be unnecessary.  Yet determining the inability to work under the Social Security has proven complex, and government bureaucracies such as the Social Security Administration seldom fail to create “red-tape” obstacles to the average person.

Lawyer are now actively involved in assisting disability Americans secure their social security disability insurance benefits.  

The Decision and Appeal

The Social Security Disability benefits application and appeals process can seem daunting. The more you know, however, the better your chance of presenting your application in the best light possible. If you receive a negative decision, you have the opportunity to appeal it.

The Initial Application

The Social Security Administration’s process for the initial determination of disability may take three to six months and occasionally longer. You can file a claim for social security disability online or by calling the social security toll free number at 1-800-772-1213 or by appointment with you local social security office.  Application processes are slightly modified during the COVID-19 pandemic.

Following the receipt of your application for disability benefits, a Social Security representative will review the information you have provided. In Texas if the representative is satisfied that the application meets certain basic criteria (like a long enough work history), the representative will forward the application and supporting materials to the Texas state Disability Determination Services (DDS) in Austin which is charged with deciding whether you have a disability that qualifies under Social Security Administration standards.

The Texas DDS may seek more evidence to further develop your file. The Texas DDS employs doctors and disability specialists to review medical records and collect additional information from treating doctors, clinics and hospitals. The agency may also send you to your doctor or a new doctor for an examination.

Reconsideration Request

Administrative Law Judge Hearing

A hearing before an administrative law judge is the most important event in the social security disability appeal process.  This is the step in the appeal process where you have the best chance of claim approval.  Unfortunately, disability claimants cannot just go “right to the judge”: you must have received an initial and then a reconsideration denial.

Appeals Council

Federal Court

If the Appeals Council has declined to review your case, your last stop in the appeals process is the US District Court.    Like the Appeal Council, Federal Courts are only interested in whether the SSA made a legal error in how your case was analyzed – not whether you are in fact “disabled”.   Consequently, like the Appeals Council, Federal Courts approve very few disability cases.

Disability applicants with an Appeals Council denial should carefully consider whether starting over with their disability claim – rather than going to Federal Court – is the best option.