Social Security Timeline
How long Will My North Carolina Social Security Disability Claim Take?
One of the chief concerns of my North Carolina clients seeking Social Security Disability benefits is how long the wait is until you can receive your first disability payment. That concern is usually followed up with the following questions: What about my back benefits? How can we speed up this process? If you know friends or family members who have applied for benefits before, you have probably heard about the large backlogs at the Social Security Administration (SSA). The length of the process depends on several things, however, most important on that list is your initial application date. This date marks the beginning of your journey.
The timeline for navigating a social security disability claim varies on a case by case basis. The Social Security Administration currently estimates that it takes somewhere between 3 to 5 months to get a decision on an initial application. However, most applications – even valid applications – are denied at the first step. Claimants must then work their way through the review and appeals process before recovering any benefits they may be entitled to under the law. Yet, there is good news. If your claim is eventually approved, you could be entitled to receive back pay up to from five months after the date your disability began.
Disability Benefits Process Timeline
The following timeline provides an overview for each in a Social Security Disability application.
1. You Become Disabled
When using Social Security terminology, the word “disabled,” takes on a whole new meaning. Under current SSA rules, you become “disabled” for purposes of disability benefits on the date when you can no longer perform “substantial gainful employment” due to your physical or mental impairment. Keep in mind though, simply being unable to continue at your old job alone, is not enough to qualify for benefits. You must not be able to carry out any substantial work and the medical or physical condition that disables you must last, or be expected to last, at least one year and/or end in death.
2. A Doctor Diagnoses Your Disability
If you become unable to work, you need to see a doctor as soon as possible. It is your duty to explain to the problems you are having, any pain you are experiencing, and what kind of movements or tasks you are unable to do any longer. Keeping the doctor informed about your changing condition is necessary to ensure you get the treatment you need. The doctor will likely perform an array of initial tests to diagnose your condition. Some of these tests may include: X-rays; MRIs; CT scans; Biopsies; Blood; and/or other bodily fluid tests.
The results of these tests, your diagnosis, and ultimately, your treatment plan, is vital to a successful Social Security Disability claim. Together with any reports from your former employers, this information forms the medical record evidence in your case. It is of the utmost important to make sure to your doctor knows that your condition has affected your ability to work and any limits you have in daily activities.
3. You Apply for SSD Benefits
You can apply for disability benefits in one of three different ways:
Online – You can fill out one of the forms available at the SSA website depending on which type of benefit you are applying for.
In person – You can apply at one of 36 local Social Security Administration offices in North Carolina. Go to the SSA website and type in your ZIP code to find the office nearest to you.
By phone – You can apply by phone and follow up by mailing in your documentation or delivering to your nearest Social Security Administration office. The number to call is 1-800-772-1213 or 1-800-325-0778 (TTY). The number is available between 7 a.m. to 7 p.m., business days. The interview usually takes about one hour.
4. Review of Your Initial Claim
The review of your Social Security Disability benefits claim is two-part:
Non-medical eligibility – A local Social Security Administration representative will verify the information in your application and make a determination if your earnings record qualifies you to receive benefits. There is a maximum amount of earnings you can have in order to qualify under current Social Security rules. This amount has varied over the past few years but is currently at $1220.00 a month or $14,640.00 for the year 2019.
Medical eligibility – The Social Security Administration then sends your case to Disability Determination Services (DDS). DDS is a state-run agency that makes determinations based on the evidence contained in your medical file. A two-person team, consisting of a claims examiner and a medical consultant, work in conjunction to determine if you meet the Social Security Administration’s definition of “disability.”
Once the team at DDS makes a determination they send your claim back to the SSA, where one of either two things happens. SSA sends you either: (1) a Notice of Award, if your claim is approved; or (2) a Notice of Denial, if your claim is rejected.
5. Disability Appeals Process – How Long Does a Social Security Appeal Take?
If you receive a denial from the SSA, do no worry. You are by no means alone. The SSA routinely denies nearly two-thirds of applications at the initial stage of the process. Once denied, you have 60 days from the date of your Notice of Denial letter to file a request for reconsideration. Please note that this is not the end of the appeals process, and you may have to continue to appeal your claim through additional stages:
Reconsideration – Your file is re-evaluated and any additional medical evidence you may have should be submitted to DDS for a review by another case officer. Sometimes after this stage, your claim could be approved if there has been substantial change in your condition.
Hearing – The hearing is held at the Office of Disability Adjudication and Review (ODAR) office for your geographical area. North Carolina offices are in Charlotte, Fayetteville, Greensboro, Wilmington, Greenville, Roanoke Rapids, and Raleigh. The most recent statistics indicate that about 48% of North Carolina disability cases are approved at the hearing stage. The average wait time for a hearing is 10.5 months at the Raleigh Office in North Carolina. At the hearing, your representative can present a case on your behalf, and an administrative law judge (ALJ) will decide your case based on the evidence presented.
Appeals Council – If you are unsuccessful at the hearing state, there is a chance that your case may qualify to be reviewed by the Appeals Council in Falls Church, Virginia. The average processing time for those reviews is around 345 days.
U.S. District Court – If unsuccessful at the Appeals Council stage, you may be able to file a lawsuit in your nearest U.S. District Court.
You Collect Benefits on an Approved Claim – If your claim is approved, you will receive a Notice of Approval letter including the necessary details about the amount of back pay you are eligible for, the monthly amount you will receive in benefits, the date of your first payment, and possibly the date your first continuing disability review, if necessary.
A Continuing Disability Review (CDR) is ordered. Sometimes, depending on the specifics of your mental and/or physical condition, a review to determine the severity of your disability may be conducted.
If medical improvement is expected in your case a review typically occurs around six to eighteen months from the start of your benefits
If improvement is possible –a review typically occurs every 3 years
If no improvement is expected – a review typically occurs every 5 to 7 years.
Your benefits continue unless your review determines that you are no longer disabled.