Features

Enter the Maze

October 1, 2004

Disability benefits applications pass through a long, complex series of reviews, beginning with an assessment by a state Disability Determination Service and ending with a decision by Social Security's Appeals Council. Here's how it worked in fiscal 2003.

1. INTAKE

Claimants submit detailed information on disabilities and work history online, by phone or in person at one of Social Security's 1,300 field offices.

2,477,413 claims

2. INITIAL DECISION

The state Disability Determination Service gathers medical evidence and other information. It then reviews the claim and makes a decision.

37% approved
63% denied
Time To Process: 97 days

3. RECONSIDERATION

Claimants who were denied may ask the state agency to reconsider their cases.

567,425 claims
15% approved
85% denied
Time To Process: 96 days

4. APPEALS HEARING

Next, claimants can appeal to Social Security's Office of Hearings and Appeals, where a federal administrative law judge (ALJ) will review the case. The high approval rate at this step encourages claimants to appeal DDS decisions.

477,568 claims
61% approved
13% dismissed
26% denied
Time To Process: 344 days

5. APPEALS COUNCIL REVIEW

An administrative appeals judge reviews the decision made by the Office of Hearings and Appeals. After this step, claimants who are denied can sue the agency in federal district court.

91,316 claims
2% allowed
72% denied
2% dismissed
25% remanded back to the ALJ
Time To Process: 294 days

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