“How long will I have to wait for a decision?” This is probably one of, if not the most often asked, questions we receive about filing for benefits. Wait times for receiving a decision vary, and today we will address these stages and also look at why wait times change.
There are three stages of a disability evaluation: The first stage is the initial application, which is when you first file a claim. Internally, we are seeing about 3 to 7 months on average if you get denied.
The second stage is reconsideration, which is where we ask the Social Security Administration (SSA) to take a second look at the denied claim. Currently, that is taking about anywhere from 2 to 5 months.
The third stage is when the reconsideration is denied, and then there is a request for a hearing. Oddly enough, this is the fastest part of the process. We are seeing a hearing wait time of a couple of months, and these are scheduled about three months out. It will usually be approximately two to five months before you are actually in front of a judge.
From start to finish, if you have to go in front of a judge, it ends up being about a year and a half.
REASONS FOR THE WAIT
- There’s no deadline given to the SSA. There is no statutory deadline as far as when they are supposed to make a decision or when they are supposed to do anything. While the claimant has timelines imposed, the SSA may “get to it when they get to it.” As much as we do not like to admit this, it is true. We often remind our clients that at Parmele Disability Advocates (PDA), we meet all of the timelines and the deadlines that have been given to us. However, once it’s in the hands of the SSA, it’s a sit-and-wait process.
- The SSA is understaffed. Social Security is underfunded and must ask for more money to make sure they have the proper staffing to handle cases swiftly. Each year, Congress has given the SSA funds, but it is well below what they’ve asked for. Not only is the SSA losing people to retirement or moving to other jobs, but they’re also having a hard time filling those positions, or they are even having a hard time getting the funds to keep a position open and filled again.
- The inability or difficulty in getting medical records. The SSA has developed a system called “HIT,” and it is a HUGE medical records ecosystem where the SSA can hit one button, and based on your social security number, it generates a report within seconds of all your clinic visits. This covers only about 50 to 60% of all providers. What is missing is that there are quite a few individuals with behavioral health records. If you see a counselor, a therapist, or if you live in a smaller community whose smaller clinics are not accessible through HIT, a manual record request will have to be made. This means there is a paper request to the clinic that is usually understaffed, which then requires an employee to go into the system, print out the report, and mail it to a specific address. The records are then scanned in and uploaded for accessibility. Even having made these requests for years, our team sees this process taking sometimes upward of 2-3 months to get copies of these records. While this isn’t anyone’s particular fault, it is simply an old system, and waiting for these records may delay client treatment. That, in turn, can lead to your claim being extended.
- The medical condition may improve on its own. In some cases, the SSA will not render a decision within the first six months because they will wait to see if the person recovers or the situation improves. A great example of this is when a person has a stroke. They may not be able to walk right now, but they may be able to 6 months from now. Remember, SSD benefits are not a short-term disability program, so we have to prove that your disability is going to last at least 12 months or more, or sadly, result in death.
These reasons can change and become confusing and cumbersome to manage. Keeping track of submission dates, timeframes, and then getting in touch with the correct SSA team member can be exhausting. If you are considering filing a claim, your first step should be to contact the legal team at Parmele Disability Advocates. We will schedule a no-cost consultation where together we will review your claim, answer your questions, and help determine your next best steps. Our attorneys have helped over 61,000 individuals receive their disability benefits during the past 24 years. We feel this shows the knowledge and experience it takes to help you win.
Contact Parmele today at 866-815-5244 to schedule your no-cost consultation. We will be waiting for your call.