How long does it take to receive a Social Security (SSDI/SSI) Disability decision?
Dealing with a severe medical condition can be frustrating and challenging on its own. Most people dealing with Social Security are unaware of how unusually long the disability process takes. In my article “THE PROCESS,” I explain in brief detail what types of actions are taken at each level of the disability process. What’s not included in the article is the approximate timeline your case will go through to get a decision. Have you ever wondered why it takes so long to get an answer from Social Security as it relates to your disability claim? This article will explain in greater detail the processes and time implications your claim will go through from the time you initiate the application until a decision is rendered at the initial disability level.
Initiating the application: Time to completion: 2 weeks to 1 month: When you file an initial application for SSDI/SSI, there are a lot of moving parts that have to happen before a disability caseworker ever lays eyes on your claim. If you file an SSDI claim only, your claim is submitted to a Title 2 caseworker at your local Social Security office. That individual will review the application to determine if there are any errors that affect its ability to be properly processed by the disability office. Once a determination is made that there will likely not be any technical issues with your claim, the caseworker will send a completed copy of the application to your mailing address for review. If you processed the application online, Social Security still requires that all applications have a “wet” signature before processing can begin. Once you receive the application in the mail, you will have a chance to review your answers again. If you are satisfied with the answers, you will sign the application and send it back to your caseworker at Social Security. If you initiated the application in person, you will have an opportunity to sign your application at the conclusion of your interview. While this will speed up the process of getting your claim sent to the disability office, there is usually a wait time before you can obtain an appointment to have the application completed inside the office. This wait time can be anywhere between 2 weeks to an entire month. Initiating the application from home and waiting for your signature pages in the mail can take up to 2 weeks. The caseworker then has to find time to process your paperwork once it’s received back into the office, which could take another 2 weeks or more.
Initial disability claim: Timeline to completion: 1 day to 180 days: Barring any special circumstances requiring additional development, your caseworker at the Social Security office will forward your claim to the disability office for processing. Depending on the workload your disability office has, your wait time will vary. If the office’s workload is lower than normal or near normal thresholds, your claim will be assigned to a caseworker within the first 5 days. If the office’s workload is higher than normal, your claim will be sent to a backlog. In backlog, the disability office has acknowledged receipt of the claim but has not assigned the case to a caseworker for processing. This is done to keep the average number of cases per caseworker at a manageable level. At any given time, the caseworker who is assigned to work your case also has at least 120 other cases that they are working at the same time. When numbers are that high, it makes it difficult to maintain good quality of cases. The reason for this is that cases have specific activities that need to be performed and accounted for during processing. If a caseworker has 120 cases to work on at any given time, there could realistically be at least 75 cases that require action. This could be anything from reviewing medical records, making a phone call to a provider to check the status of medical records, review evidence sent in by the claimant, analyze and take notes on medical records, create a summary of a claimant’s claim, schedule a consult with medical provider on staff about the appropriate course of development action on a claim, make arrangements to schedule an appointment for a claimant, the list goes on. Having to keep track of all of this information can cause caseworkers to get burned out as there is a lot of moving parts that they have to be aware of when processing just one claim through to decision. In my article “The Life of a Social Security Disability Examiner,” I detail most of the things a disability examiner is faced with on a daily basis while they are at work.
Once the claim is assigned to a caseworker, the caseworker has a list of “Day One” responsibilities that must be performed. Introduction letters must be sent to the claimant and their representative, if applicable. Forms appropriate to the case must be sent out such as an SSA-3373-BK, SSA-3369-BK, SSA-5665-BK, etc. Requests for medical reports from the claimant’s providers should be sent out at this time as well. Depending on the facts of the claim, the caseworker may need to make phone contact with the claimant to gather additional information that will help in cutting the processing time. Once all of these initial requests are made, the caseworker’s system has a time tracking system that has an expiration date for every action the caseworker initiates on the claim. Forms sent to the claimant have an initial expiration date of 10 days. Forms sent to the school have an approximate expiration date of 14 days. Requests for medical records have an initial expiration date of 30 days. To help speed up the process of your disability claim, it is best practice to answer any requests for information within 5 days. The forms that a caseworker sends to your home for completion usually take an hour or two to complete accurately and completely. Completing this information will keep your caseworker from making an unnecessary call to you to find out why you have not sent the forms back. Caseworkers really do not have time to make these types of calls. Do them and yourself a favor and just respond to the requests as soon as you receive them.
All of the initial requests for records are what drives the processing time of a claim. Waiting for answers to all of the requests for records can be as fast as 10 days or be as long as 90 days. A 90-day processing time on records requests can mean multiple things and not all of them being bad. Sometimes, a caseworker will have to make multiple requests to a particular provider to get updated treatment records that may approve a claim whereas the information received from previous records would have denied the claim.
Once all of the requests for records have been answered, your caseworker will begin evaluating all of the facts of your claim. If the information is sufficient to make a decision one way or the other, the caseworker will prepare a summary of the evidence and submit the claim to a medical/psychological consultant (MC/PC) on staff for review. This process can take anywhere from 2 days to 2 weeks. It is highly dependent on how much medical and lay evidence is in the claimant’s file. Claims with fewer medical records will in most cases be faster to process than a claim with hundreds of pages of records. If the medical/psychological consultant decides there is insufficient evidence to make a decision for whatever reason, the case will be sent back to the caseworker for additional development. In this instance, the medical/psychological consultant will ask for a consultative examination (CE) to get additional details about a particular condition or combination of conditions. This request requires the caseworker to schedule the CE. A CE can add up to an additional 90 days in processing to a claim. This is because when a caseworker initiates the request for a CE the schedulers in the office have to coordinate with the medical contractors about openings. Because 40% of the cases at most disability offices are underdeveloped, CE’s are needed to make an informed determination.
Once a claimant has attended the CE, the caseworker must then wait for the report to come in from the medical contractor. This process can take anywhere from 5 days to 21 days. Once the report is received back in the office, the case is again forwarded to the medical/psychological consultant on staff for signature. After the MC/PC sends their recommendation back to the caseworker, the claim begins its final phase of processing. The process time can vary at this step because a few factors will dictate how much additional development will be needed to make a decision on a claim. Some of the factors include the claimant’s age, proposed residual functional capacity (RFC), and work history to name a few. This part of the process can take anywhere from 1 day to 5 days, and it is dependent on how much work needs to be completed to meet quality standards set by Social Security. However, once the caseworker has resolved all outstanding issues at this step, a decision will be made on the claim and the case will be closed.
I hope this article has given you some insight on what goes on behind the scenes of what happens to your disability claim once it is received at your disability office. The process could go a lot faster, but given the vast amount of claims each disability office has to process per fiscal year, the timelines here are not that unreasonable. Here are some tips to make your case process a little faster:
1. Respond to all requests for information as soon as possible. The faster you provide information to your caseworker to quicker they can work those items out of your claim.
2. Answer all calls from your caseworker. Your caseworker will not have many reasons to call you, but if they do then there must be something either you or your representative need to give them so that processing can continue.
3. If you happen to miss a call, return all calls from your caseworker as soon as possible. Missing a call from your caseworker can drag on the processing of your claim by at least 7 to 10 additional days. Your caseworker usually has a designated time during the day when they man their phone. If you miss that time, you can very well play phone tag with them for 7 to 10 days.
4. Make it a priority to of yours to call your caseworker at least bi-weekly to check the status of your claim. Be courteous and mindful that your caseworker has a minimum of 119 people just like you that are waiting for a decision. This article is giving you the details of what your caseworker is or should be doing to get your claim processed. If they tell you they are working on it, ask if there’s anything you can do to expedite the process. This can be helpful if one of the providers you listed on your application has been uncooperative in providing information.
5. Keep all CE appointments your caseworker schedules for you. As I discussed on the article, a CE can add 30 to 90 additional days to the processing of your claim. Missing an appointment can increase your claim processing time by at least 60 days.
My firm offers consultations FREE of charge during business hours Monday through Friday. If you have questions about Social Security Disability, I have an answer for you. Get help with your Social Security Disability claim now.
Published January 30, 2020
Michael Vallien is a Baton Rouge-based non-attorney representative for Social Security Disability claims. He runs and operates Disability Blueprint, LLC, a firm dedicated to helping individuals get the Social Security Disability benefits they deserve.
