In order to be eligible to receive Social Security benefits you must file an application. Sounds simple enough, right? It used to be a complex, time consuming task, but filing a Social Security disability benefits application is a little easier now that a claimant can file online. However, you still need to provide original documents to the Social Security Administration (SSA) office to complete your application. If you still want to file in person, I recommend that you call your local SSA office and schedule a time to file the application. Your application date will be the date you called to schedule the appointment, not the actual date that you file the application. This is called your protective filing date. This could mean an extra month of benefits depending on when the protective filing date is compared to the actual filing date.
Most claimants will be denied at the initial application stage. Unless it is abundantly clear from your medical records that you cannot possibly work, you will be denied.
If you receive a denial of your application, you must file an appeal within 60 days of the date of the written denial. The SSA assumes you received the denial notice within 5 days of the date on the notice. Some people compute 65 days as the appeal time. This is a potentially dangerous practice. If you miss your appeal time, you must file a new application. Only if there is good cause can you file a late appeal. If you miss your deadline to file your appeal and file a new application, it is possible to reopen the previous application.
The initial appeal is a Request for Reconsideration in North Carolina. Some states have done away with this appeal stage. Another agency, Disability Determination Services (DDS), reviews the initial application, evidence and decision and decides if this determination was proper. The DDS worker will update your medical records based upon the information you provide in your disability appeal report that must be filed with your Request for Reconsideration filing.
The DDS worker may schedule doctor appointments for you if they believe they need additional medical evidence in order to make their determination. You are required to attend these appointments.
If you are denied at this level, you will receive a written denial letter. Again, you have 60 days from the date of the denial in order to file your next appeal, a Request for Hearing before an Administrative Law Judge. Again, the SSA assumes you received the written denial notice within 5 days from the date of the denial letter. When the SSA is ready to schedule your hearing, they will send you a notice not less than 20 days from the date of the hearing. The hearing office is called the Office of Disability Adjudication and Review (ODAR). You will either appear in person before an Administrative Law Judge (ALJ) or appear by video. This depends on how close you are to the nearest hearing office and which judge will hear the case. You can object to a hearing by video, but this may mean you have to travel a longer distance for a hearing in person. If a hearing office has a large backlog of cases, sometimes cases will be sent to hearing offices outside of North Carolina. You will have a hearing at your local hearing office by video with a judge in a hearing office in another state.
The hearing is the best time to present all of your evidence. If you receive an unfavorable decision at the hearing, you can appeal, but this appeal is generally limited to whether the ALJ committed any error in making the decision. The appeal from a hearing is made to the Appeals Council in Virginia.
If you receive a denial from the Appeals Council, you may be able to file an appeal in Federal District Court. The Appeals Council is the last level of administrative review of your claim. By filing in Federal District Court, you are asking for judicial review of your claim.
This process can be lengthy and difficult. An experienced attorney-representative can make a difference for a claimant.