1. File your application.
The first step to obtaining benefits is to apply An .application for SSDI or SSI can be made online, by telephone or in person at any local Social Security Administration office. If you plan to apply in person, we recommend that you call your SSA office and schedule an appointment at the local office or by telephone. When you meet with a SSA representative, you should have a list of the names and addresses of your doctors and a list of each prescription medicine that you take and the name of the doctor who prescribed it. You will also be asked questions concerning the types of jobs that you have held for the past fifteen years and to describe the nature of your condition and why it prevents you from working.
After you complete the application, the SSA will gather your medical records and may ask you to undergo a consultative examination with a physician selected by the SSA. Once the medical evidence is collected and reviewed, the SSA will send you a notice of determination on whether you qualify for benefits. SSA's statistics show that most claims are denied at the initial level so don't be discouraged if your claim is initially denied.
If your claim is denied, you will have sixty (60) days to request reconsideration. SSA will then conduct another review of your claim but, in most cases, the initial denial will be affirmed. Again, don't be discouraged because most social security claims are denied at the inital level of review.
2. Requesting A Hearing.
If you live in Pennsylvania and your application for benefits is denied, you have sixty days to file an appeal requesting a hearing before an Administrative Law Judge (“ALJ”) from that decision. If an appeal is filed, the SSA will schedule your case for a hearing before an ALJ where you will have the opportunity to present medical evidence and testimony supporting your claim for benefits. The hearing before the ALJ provides an extremely important opportunity for you to present evidence in support of your claim and is the only time throughout the administrative process that you will have to speak directly to the person making the decision on your claim. We regularly represent clients in social security cases before ALJ's sitting in Pittsburgh, Greensburg, Johnstown, Erie and Seven Fields, Pennsylvania as well as Morgantown, West Virginia.
3. Appeals Council.
If the ALJ denies your claim, you may file a further appeal to the Appeals Council which is located in Fairfax, Virginia within sixty days of the ALJ's decision. The Appeals Council conducts a review of the ALJ's decision and the evidence and testimony presented at the hearing to determine whether the ALJ erred in denying your claim for disability benefits. The Appeals Council will also consider any new evidence that you may submit supporting your claim.
4. Federal Court.
If the Appeals Council denies your claim, you may file a further appeal into federal district court. This appeal must also be filed within sixty days of the Appeals Council's decision. The district court's review of the SSA's decision is extremely deferential, and consists of a review of the administrative record to determine whether the SSA decision is supported by “substantial evidence” or whether the SSA committed an error of law.