Receiving an approval for Social Security benefits can be a long and frustrating experience for many Washington residents. The Social Security Administration is very deliberate in making these determinations because they only issue permanent rulings on those who are applying for Social Security Disability Insurance benefits within the agency. Those who cannot qualify for SSDI may be eligible for Supplemental Security Income, or SSI, but the program is actually handled by Washington state after a ruling from the SSA following the appeals process unless the case is automatically awarded using the Blue Book of prior approved claims.
The SSA typically denies most Social Security Disability applications during the first round. Claimants must prove that they are unable to work due to a verifiable medical condition or multiple conditions that impact the ability to maintain substantive gainful employment, also known as SGE. SSDI is more a claim that the applicant cannot work instead of a claim that they are disabled. This puts the case in the appeals phase of the SSA decision, which begins with the first appeal or “reconsideration” of the claim.
The next step in Social Security Disability appeals following the case reconsideration is a hearing before a SSA administrative law judge. This provides the claimant an opportunity to present testimony regarding how the disabling conditions impact their ability to work. Even when the applicant or their legal counsel is successful in supporting the evidence presented in the filing, the ALJ will often still issue a denial.
The final step in being approved for SSDI is a review of the total claim by the SSA Appeals Council. The agency will evaluate the claim based on the medical record of the applicant along with their personal testimony regarding employment maintenance due to the disability before issuing a final ruling.