Why Disability Claims Take So Long to Get Approved

For anyone currently in the process of applying for Social Security benefits, a common question is “why is the decision taking so long?” While some attribute the lengthy process to bureaucratic sluggishness, that isn’t always the case. To properly evaluate each case, sometimes the SSA takes a lot of time to make their decision. Here are some reasons that can delay your disability claim decision.

Preliminary Disability Benefits Application

After you submit your application at the Social Security office, a claims representative will request medical records from each doctor provided. Because it often takes a doctor’s office or hospital a month or more to fulfill the request, some of the wait time comes from Social Security waiting for your records to arrive so they can be reviewed. Reading through these documents, which can sometimes be hundreds of pages, is a time-consuming process.

In the meantime, you may be asked to complete forms regarding your daily activities, symptoms, or past work history. Completing these forms to the best of your ability and returning them to Social Security before any deadline they may give you helps the evaluation process move more smoothly.

You may also be asked to attend a physical or mental exam, where you’ll be evaluated by a doctor employed by Social Security. After the appointment is completed, the doctor who examined you must take the time to write a report, which is subsequently sent to Social Security to be reviewed and considered along with your medical records and any forms you completed. Typically, this process takes 3 to 6 months (but sometimes longer, in more complicated cases).

Re-evaluation Process

If your initial application is denied, you may file an appeal called the Request for Reconsideration. Once filed, Social Security does just that: they reconsider their first determination, alongside any new medical evidence, forms you complete or further exams you may be sent to.

When you appeal the first decision, you are asked to fill out form SSA-3441. This form asks you if there have been any changes in your condition, any new conditions, and for more information about your treating sources and how recently you may have treated with them. As in the initial application, Social Security will request any updated medical records that may exist. You may be asked for clarification in some of your answers.

It is important that Social Security is aware of any new treatment. As with the initial application, reconsideration of the first determination also takes approximately 3 to 6 months, depending on your claim’s circumstances.

Disability Hearing

Once all the evidence is reviewed alongside the initial determination, and you are denied again at the Reconsideration level, you may request a hearing in front of an Administrative Law Judge (ALJ). You will be asked to complete another SSA-3441 when you appeal but updated or missing medical evidence must be provided either by the claimant or the claimant’s representative to be added to the file.

At this stage of your claim, the file that has been created for you thus far in the determination process is organized and exhibited in preparation for a hearing. Once the hearing staff has prepared your file, either you or you and your representative will be asked to attend a hearing. By law, you will be notified at least 20 days prior to the hearing date so that you can make suitable arrangements to attend. The exact wait time still varies from claim to claim, as some people may have more complicated claims than others that require extra time to prepare.

So What Can I do?

When you aren’t working and income is limited, it’s understandable to want quick answers. Fortunately, the Social Security Administration understands the dilemma of the disabled person and will make every effort to make a timely judgment for you, but it’s not an overnight process. Understanding the process can help a claimant make sense of all the time he or she must wait for an answer.

The wait can be daunting but taking an active role in making sure the Social Security Administration gets all the information they need in a timely manner, such as completing forms accurately and attending state-sponsored exams, is the best course of action for a claimant.

Because most claims get denied the first time, it’s important to consult an expert in the field, and that’s where we can help. We’ve been serving Orange County and its residents for over 30 years and have the experience and knowledge to get your SSDI claim approved.

If you have questions or would like a free consultation, contact the Kenneth G. Marks Law Firm at (949) 288-4455. We look forward to serving you!