The Long Wait for Social Security Disability Hearings & Determinations

An individual who applies for Social Security Disability (“SSD”) benefits must be disabled and not working or have earnings so modest they are not “gainful” according to the Social Security Administration (“SSA”). Understandably, claimants want their SSD applications decided quickly to mitigate financial stress due to their lost or reduced income.

Unfortunately, most SSD applications are not decided quickly. It generally takes about 4-to-6 months to receive a decision on a claimant’s initial application.

After the SSA denies an individual’s initial application, he or she can appeal that decision by filing a request for reconsideration.

If the SSA denies reconsideration, the individual can request a hearing before an Administrative Law Judge (“ALJ”). In 2010, a claimant had to wait about 15 months before he or she could appear before an ALJ; by 2015, that wait had increased to 19 months.

Fortunately, the wait has since decreased; as of 2020, a claimant will wait about 10 months to have a hearing in Rochester. Nonetheless, a claimant still waits about 22 months from the time he or she applies for benefits to the time he or she appears before an ALJ.

On average, ALJs in the Rochester Hearing Office issue 1.66 decisions per day and approve 68.5% of the applications they consider. It is important to note, however, that not all hearings held in Rochester occur before local ALJs.

If a claimant’s application is denied after a hearing, he or she can file an appeal with the SSA’s Appeals Council. It takes 1-to-2 years for the Appeals Council to render a decision. As of March 2020, there were 117,626 appeals pending before the Appeals Council.

If the Appeals Council remands a case back to the hearing office for further consideration, the claimant will have a second hearing before the same ALJ who previously considered their claim. Thus, cases brought before the Appeals Council may last four years or more without a final resolution.

An unfavorable Appeals Council decision can be appealed to federal court, an action that kicks off another lengthy process.

For the most recent data regarding processing times, visit this Social Security website.

Are there Exceptions to the Normal Waiting Period?

Yes, but such exceptions are rare. To have your claim heard before others who have been waiting longer, you must prove circumstances so significant that the SSA grants an exception and expedites review of your case.

Expedited review may occur in the following critical cases:

  • TERI cases (for terminal conditions or illnesses);

  • Compassionate Allowance cases (specific conditions—like certain types of cancers—that can shorten an individual’s processing time);

  • Veterans who have a U.S. Department of Veteran Affairs Compensation rating of 100% Permanent & Total;

  • Military casualty/wounded warrior cases (permanent injury sustained while on active duty after October 1, 2001);

  • Potentially violent cases (high risk of suicidal or homicidal action); and

  • Dire need cases (documented loss of food, shelter, or necessary medical care without ability to obtain it).
In dire need cases, the claimant must allege the following specific, immediate circumstances:

  1. a lack of food (without it and unable to obtain it);

  2. a lack of medicine or medical care (e.g., the claimant needs medicine/medical care but is without it and unable to obtain it or lacks health insurance or has restricted access to necessary medical care because of a lack of resources); and/or

  3. a lack of shelter (e.g., utilities have been shut-off and the home is uninhabitable, homelessness, expiration of shelter stay, or imminent eviction or foreclosure with no means to remedy the situation or obtain shelter).
Most critical cases require extensive documentation to prove entitlement to expedited claim processing. Moreover, you usually have to ask the SSA to expedite your case; they may not automatically identify your case as “critical” even if you meet the relevant standards.

Even if your case is considered critical, it does not always mean that you will be approved for SSD benefits. Thus, it is important to ensure your case is fully prepared for consideration before pursuing critical case designation.

How You Can Help Us

If you think you may qualify for an expedited hearing because of your dire financial need, please provide us with all the relevant documentation.

If the SSA finds that you might qualify for an expedited hearing, it will notify us. Here are the steps that must occur BEFORE a hearing will be scheduled:

  • The SSA must make available to us the file that it has assembled for your case.

  • We will review and copy the pertinent parts of that file. We will assemble a list of the evidence that the SSA has collected.

  • We will work with you to identify and collect all additional evidence. Depending on the level of cooperation from your medical providers, this process could take 30 days or more.

  • Once we have collected the additional evidence, we will prepare a pre-hearing memorandum that summarizes your medical record and argues why you are entitled to benefits. Depending on the complexity of your case and the amount of evidence, this process could take 14 days or more.

  • After the SSA reviews our memorandum, they will decide whether a hearing is necessary and, if so, when that hearing will occur. There is no way to estimate how long this process could take.
There are rare occasions when the SSA decides that a hearing is unnecessary because a fully favorable decision can be rendered “on the record.”

Once we have a date for the hearing and an Administrative Law Judge has been assigned, we will meet with you to prepare for the hearing.

If you have questions about the issues discussed above or other SSD-related issues, please contact us.

Print Friendly and PDF