While many Social Security disability hearings in Colorado have decisions issued in 45 to 90 days, some cases wait for four, five, even six months without a decision.

I was recently asked if a long wait after a hearing is a bad sign?

I previously wrote about my experience with how long it takes to get a decision after a Social Security hearing. Many lawyers who have been doing Social Security cases for a while can’t help but notice that the longer it takes to get a decision, the greater the chances that the case will be denied. However, that is not the whole story. Here is my take on this issue.

Social Security approvals often result in fast decisions

Even if the judge does not rule at the hearing, a decision in an approval is often sent within the normal 45 to 90 day window.

Social Security denials take longer to be processed

In the case of denials, I frequently see cases sent out to a decision writer which adds up to 4 months to the decision process.

Why so long? There is a backlog of cases waiting for a decision writer to become available. This results in a case waiting for months after a hearing just to have a draft decision written. Note: this is before the decision even comes back to the judge for approval and/or editing. Combined with the original 90 day wait, some of these decisions are not issued for up to six or seven months after the date of the hearing.

So, if it takes more than 3 months to get a decision, it’s going to be a denial!?!

Not necessarily. While there is some correlation between lengthy decision times and denials, it is not a clear cut signal. Judges also use decision writers on cases that are going to be approved, which means even approval decisions sometimes four or more months before they are issued.

Don’t try to read the tea leaves

Ultimately, the only thing that counts is whether you are approved. Trying to read meaning into how long the decision takes is just guessing. It does not change the odds of winning or give you any meaningful information. Unfortunately, many people tear themselves up inside wondering what it means if a decision takes months to be issued.

All you can do is take a deep breath, let it out, and try to go on with your life while you wait.

I was recently asked how long after Social Security sends you to a doctor for a consultative examination will it take to get a decision.

I previously wrote about how long it takes to receive an initial decision after you apply for Social Security disability benefits and how long it takes to get a Social Security hearing.

Unfortunately, there are no hard and fast rules for how long it will take to get a decision after the consultative examination. But, you can make a pretty good guess. 

I usually see a decision four to six months after an application for either disability insurance (SSDI) or Supplemental Security Income (SSI) benefits.  

So, if Social Security schedules a consultative examination 3 months after the application was filed, as an estimate, you can expect a decision in the next 30 to 90 days.

How long after the consultative examination did you get your decision? Let me know in the comments!

How long after you complete your application for Social Security disability benefits (or Supplemental Security Income – SSI benefits), does it take to get a decision?

In Colorado where I practice, it usually takes between four and six months after you apply to get the initial decision. Sometimes, Social Security will describe this as between 120 and 180 days.

I am often asked:

I got an informal denial. What is that?

An informal denial typically means that Social Security is denying you because you may not be eligible for disability benefits. This is different from being denied because you are not disabled.

You may be disabled, but if you are not eligible for any type of Social Security benefits, you may be denied through an informal denial.

For example:  you, your spouse, or your household makes too much money or has too many assets.  This results is a financial denial. This sometimes happens in Supplemental Security Income (SSI) cases where, in addition to being disabled (unable to engage in a Substantial Gainful Activity, e.g. full time work), you also have to prove financial eligibility.

Another possibility is that you have not worked long enough (and earned enough quarters of coverage) to qualify for benefits, or you do not have quarters of coverage within the right time period to qualify for benefits.

In both examples the problem is eligibility:  Social Security does not think you can even get your foot in the door.

The flip-side of this, is that Social Security is not even considering whether you are medically disabled. They are not even getting to that step of the analysis.

If you disagree with the informal decision, the general recourse is to request a formal decision. The informal decision will tell you exactly how to do this, for example, by completing the application process or submitting a form.

Since Social Security is denying your case very early on in the review process, you may want to review your case with an attorney to see if there is a significant problem with your eligibility. If so, the lawyer may be able to direct you in how to get over this hurdle.

After waiting months (even years) to get your Social Security hearing, and then months more to get the decision, you finally have it!  Social Security has found you disabled. It is “Favorable” (either Fully Favorable or Partly Favorable).

Ok, now what? When do my benefits begin?

Here’s the thing: Social Security disability claims have two parts:

Part 1. Determining if you are disabled? That was what the hearing was about.
Part 2. Determining your eligibility for benefits, the benefit amount, and the amount of back benefits if any.

Part 1 is done. Part 2 is just starting…

Social Security needs to determine your monthly benefits and the amount of your back benefits.

If you were applying for both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), your benefits for each program are calculated separately by different Social Security offices. In other words, your file now flies off in two separate directions. SSDI is processed by a regional payment center, while your SSI benefits are processed by your local Social Security office.

Once the processing is complete, you will receive separate notices about your benefits for each program. In the upper left side of each notice it will either say “Retirement, Survivors & Disability Insurance” or “Supplemental Security Income.” That is how you know whether the letter is talking about your SSDI or SSI benefits.

Your SSDI benefits will probably be calculated first. Once your monthly benefits and back benefits are calculated you will receive a “Notice of Award” letter, summarizing your benefits. This is usually followed by an “Important Information” letter, which gives you more information, including when you can expect payment.

Your SSI benefits are handled by your local Social Security office. You have to be disabled and qualify financially to receive SSI. Your local Social Security office will contact you to go over your income and assets to see if you still qualify. Please note: Social Security will consider your SSDI benefits in determining your financial eligibility for SSI.  So, your SSI benefits may be reduced or eliminated for any months that you also receive SSDI benefits.

Just as under the SSDI program, you will receive a “Notice of Award” letter followed by an “Important Information” letter describing your Supplemental Security Income benefits and when you can expect a check.

Processing your benefits should take approximately thirty (30) to ninety (90) days.

The good news is that this part of your Social Security case is mostly automatic.  You may be asked to provide paystubs, bank statements or other documents, but remember you are in the home stretch!

photo credit: thomas_sly

You finally got the decision on your Social Security case and it says… “Partly Favorable.”

This does not mean that you are “partly disabled.” Usually, it means one of the following:

• The Judge found you disabled, but not as far back as you wanted; or
• The Judge is approved a “closed period” of disability: that you were disabled from one date through another date. For example: the Judge might find that you were disabled from May 1, 2005 through December 31, 2007.

If you are ok with the partly favorable decision, give yourself a pat on the back for winning your Social Security case.

If, however, the partly favorable decision just makes you angry and you are thinking of appealing, please keep the following in mind:

1. When you appeal a partly favorable decision, you appeal the entire decision, including the part that says that you are, or were, disabled.
2. The Social Security Appeals Council can take a look at the Judge’s decision and say that the Judge should not have found you disabled at all.
3. Then, your case will go back to (probably) the same Judge, with the implicit suggestions to give you less or nothing at all.

Please note: it is rare for the Appeals Council to completely overrule a partly favorable decision and recommend a denial, but I have seen it happen. So, keep this possibility in mind when considering your options.