Social Security Disability - Procedures
In order to qualify for SSI benefits, an individual must have limited income and resources. SSI provides payments to individuals (including children under age 18) who are disabled and have limited income and resources. It is the amount of income available to the claimant that is the major factor in deciding eligibility for such benefits.
To be eligible for disability Title II benefits (SSD), a claimant must be currently insured under the Social Security program. This is based upon the number of years during which a claimant worked in employment from which Social Security contributions were deducted. A claimant must have earned at least 20 quarters of coverage in the preceding 40 quarter period. This means that the person has worked under Social Security for at least five of the 10 years (20-out-of-40 quarters) just before becoming disabled.
The first stage in applying for disability benefits is that you must first file a written application at a local Social Security office. An initial determination is then made by SSA as to entitlement of disability benefits. A written notice is mailed by SSA to you stating the reasons for the determination, and if it is a denial, information as to your right to appeal this denial.
If denied on the initial level, the second stage in applying for disability benefits is filing for a Reconsideration within 60 days after the notice of initial denial is received. This is the first step in the administrative review process. The SSA then reviews the initial evidence considered and any other evidence it receives. After its review, the SSA will mail a written notice to you stating specific reasons for its determination and giving you information as to the right to a hearing.
If you are denied at the reconsideration level, you can appeal this decision and file a Request for Hearing within 60 days after the date the notice of the previous decision was received. Once we file this request, it takes approximately twelve to fourteen (12-14) months for the Office of Hearings and Appeals to call us and schedule a hearing date. The hearing is not scheduled until the Judge receives your file and reviews it. (Unfortunately, our office has no control over scheduling hearings.)
A hearing will then be held before a federal administrative law judge (ALJ). The ALJ will take testimony from you and witnesses, plus any additional medical evidence that may be presented. Because of the huge backlog of Social Security Disability claims, it normally takes at least two to six months for us to receive the Judge's ruling. Some Judges take longer than others and Social Security law permits a Judge to take whatever time the Judge feels is necessary and appropriate to prepare the written order.
After the hearing, a written decision will be issued by the ALJ. It usually takes another 60 days following a favorable ruling for the Social Security Administration to figure out how much you are to be paid. That determination will come in the form of an "award letter", which usually is sent directly to you with a copy to your representative.
This decision is binding unless the decision is appealed to the Appeals Council. Once again, this appeal must be requested within 60 days after the date you receive the hearing decision.
The Appeals Council may deny the request for review, or it may grant the request and either issue a new decision or remand the case back to the ALJ. The time limit on this appeal could be up to one year or less. Unfortunately, there is nothing we can do to make the decision happen any sooner.
Should you disagree with the Appeals Council's decision, you must once again file an appeal within 60 days, this time to the Federal Appeals Court. To do so, a Complaint is filed in the District Court against the Social Security Administration.
(Principal Office)
118 SW Fort King Street
Ocala, Florida
(352) 629-0480
(Satellite Office)
802-A N.W. 16th Avenue
Gainesville, Florida
(352) 337-0065
