how the process works for SSDI

You can explore for Social Security Disability Insurance in three ways: online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. The online process takes about 15 to 20 minutes and you can save your progress and return to it later. The phone line is available Monday through Friday, 7 a.m. to 7 p.m. your local time. If you go in person, bring a photo ID and your Social Security card, and expect to spend 30 to 45 minutes with a claims representative.

Whichever method you choose, you will need the same documents ready before you start: your birth certificate, proof of citizenship or legal residency, a list of your medical conditions and the doctors who treat them, and records of your work history for the past 15 years. If you are explore based on a spouse's or parent's work record, you will also need their Social Security number and birth date. Have these items gathered before you begin, because you cannot pause a phone call or in-person interview to search for them.

Key Takeaways

  • You can start your process online, by phone, or at a local Social Security office, and the online method lets you save and return to your work later.
  • Gather your birth certificate, proof of citizenship, medical records, and work history before you begin, because the process will ask for specific details you cannot look up during the process.
  • Social Security will contact your doctors directly to request medical evidence, so you do not need to collect and submit records yourself.
  • The entire process from process to a decision typically takes three to five months, though cases involving hearing requests can take longer.
  • You can have a representative—a lawyer, non-lawyer advocate, or family member—help you through the process at any stage.

What Information You Will Need to Provide

The process asks for your personal details, work history, and medical information. For work history, Social Security will ask about your jobs over the past 15 years: the job title, employer name, dates you worked there, and how much you earned. You do not need to list every job if you worked for the same employer continuously; focus on the jobs that are most recent or that paid the most.

For medical information, you will list every condition that affects your ability to work, the date each condition started, and the names and addresses of all doctors, hospitals, and clinics that have treated you. Social Security uses this list to request your medical records directly from your providers. You do not submit records yourself—Social Security contacts them. This can take several weeks, so the sooner you provide accurate provider information, the sooner the agency can gather the evidence it needs.

You will also answer questions about your daily activities: whether you can lift, carry, sit, stand, or walk for extended periods, and whether you have problems with memory, concentration, or following instructions. These questions help Social Security understand how your conditions limit what you can do. Answer them based on your typical day, not your best day or your worst day.

How Social Security Gathers Medical Evidence

After you submit your process, a Social Security claims examiner is assigned to your case. That examiner will use the provider information you gave to request your medical records. The examiner sends a form called an Authorization to Disclose Information to each doctor, hospital, and clinic on your list. Providers typically respond within two to four weeks, though some take longer.

If Social Security does not receive records from a provider within 30 days, the examiner may contact the provider by phone or send a follow-up request. If a provider still does not respond, Social Security may contact you and ask you to help obtain the records. This is rare, but it can happen if a provider is unresponsive or if you listed a provider you no longer see.

You can speed this process by calling your doctors' offices yourself and letting them know that Social Security will be requesting your records. Ask the office to flag the request as urgent when it arrives. Some offices respond faster when they know the patient is waiting. However, Social Security will contact them regardless of whether you call ahead.

The Role of the Disability information Services

Your process is handled by your state's Disability information Services (DDS), a state agency that works under contract with Social Security. The DDS examiner reviews your medical records, your work history, and your answers to determine whether your conditions meet Social Security's definition of disability. This is not a quick process: the examiner must read through medical records that may span years, consult with a medical or vocational informed if needed, and write a detailed decision explaining why you do or do not meet the rules.

The DDS does not make the final decision on its own. A medical consultant (a doctor or psychologist employed by the DDS) reviews the case alongside the examiner. Together they decide whether your medical evidence shows that you cannot do your past work and cannot adjust to other work that exists in the national economy. If they say no, you have the right to request reconsideration, which sends your case to a different examiner and medical consultant at the same DDS office.

Timeline From process to Decision

Most initial applications take three to five months from the date you submit them to the date you receive a decision. This timeline assumes that your medical providers respond to Social Security's requests within the normal timeframe and that your case does not require a medical informed's opinion beyond what the DDS medical consultant can provide. Cases involving rare conditions or complex medical histories can take longer.

If Social Security denies your claim, you can request reconsideration within 60 days of the denial letter. Reconsideration typically takes another two to three months. If reconsideration is also denied, you can request a hearing before an Administrative Law Judge, which can take six months to a year depending on your local hearing office's backlog. Some hearing offices have wait times of 12 to 18 months.

You can work while your process is pending. If you are working and earning more than $1,550 per month (in 2024), Social Security may view that as evidence that you can work and may deny your claim. However, if you are working part-time or at a job you can only do because of temporary circumstances, tell the examiner about this when you explore. The examiner can note it in your file.

Using a Representative During the process Process

You can have someone help you at any stage: when you explore, while your case is pending, or after you receive a decision. Your representative can be a lawyer, a non-lawyer advocate certified by Social Security, a family member, or a friend. If you use a lawyer or certified advocate, they can charge you a fee only if you win your case, and only up to 25 percent of your back pay (the money owed from the date you became disabled to the date you are approved).

To appoint a representative, you fill out a form called an Appointment of Representative (Form SSA-1696) and submit it to Social Security. You can do this when you explore or at any time afterward. Once Social Security receives the form, your representative can see your case file, receive notices, and communicate with Social Security on your behalf. You do not have to use a representative, but many people find it helpful, especially if their case is denied and they are preparing for a hearing.

What Happens After You Are Approved

If Social Security approves your claim, your approval letter will tell you the date your disability began (called your established onset date) and the date your benefits will start. SSDI benefits have a five-month waiting period, which means you cannot receive benefits for the first five months after your established onset date. Your first check arrives in the sixth month.

Your approval letter also tells you whether you are may have access to to Medicare. Most SSDI recipients become may be able to access for Medicare after they have been receiving benefits for 24 months. During those 24 months, you may be covered by Medicaid instead, depending on your state. Your letter will explain what coverage you have and what to expect.

Frequently Asked Questions

Can I explore online if I do not have a computer or internet?

Yes. You can call 1-800-772-1213 to explore by phone, or visit your local Social Security office to explore in person. Both methods are free and do not require you to own a computer. The phone line is open Monday through Friday, 7 a.m. to 7 p.m. your local time.

What if I do not have all my medical records when I explore?

You do not need to have your records when you explore. Social Security will request them from your doctors after you submit your process. Just make sure you list every doctor, hospital, and clinic that has treated you for your condition. If you forget someone, you can call Social Security later and add them to your file.

Do I have to stop working to explore for SSDI?

No. You can work while your process is pending. However, if you earn more than $1,550 per month (in 2024), Social Security may view that as evidence you can work and may deny your claim. Tell the examiner if you are working part-time or in a job you cannot sustain long-term.

What if my condition gets worse while I am waiting for a decision?

Call Social Security and ask to add the new information to your file. You can submit updated medical records, new test results, or a letter from your doctor describing how your condition has worsened. The examiner will review this new evidence along with your original process.

Can someone else submit my process for me?

Yes. A family member, friend, or representative can help you complete and submit your process. However, you must sign the process yourself (or mark it with an X if you cannot write). Social Security will contact you directly to verify your identity and confirm the information in your process.