How Long Does the SSA Claim Reconsideration Process Take in Florida?

The SSA’s data shows that it takes roughly 213 days to process a claim reconsideration, a little over 30 weeks. Unfortunately, that is only an average. The entire SSA claim process will take months or even years for a Florida resident.

Why does it take so long, and why does Florida have particularly long waits for its applicants?

How an SSA Claim Works

Social Security pays disability benefits under two programs, serving different needs. SSDI (Social Security Disability Insurance) applies to workers who become disabled after acquiring enough Social Security credits to qualify. It also applies to their disabled surviving spouses or children who became disabled in youth. SSI (Supplemental Security Income) is available to people with few assets or resources who are disabled, blind, or over 65.

Claiming SSDI involves the following steps:

• An individual submits their application.
• “State Disability Determination Services (DDS) checks to see if the customer’s medical condition meets the disability requirements,” then the SSA field office “approves or denies the claim and issues the decision letter.” (Source)
• Since the SSA denies most initial claims—over 70%—the applicant can request reconsideration of their denial. 
• If a reconsideration ends in another denial, the applicant can request a hearing before an administrative law judge (ALJ).
• The applicant has a further right to appeal to the Appeals Council.
• Finally, if this appeal does not succeed, the applicant may be able to sue in federal court.

What Is Taking So Long?

Each state and region has its own set of field offices and DDS offices. Due to staffing difficulties and COVID-related backlogs at Florida offices, Social Security disability claims have a particularly long processing time. Even so, no SSA claim is exactly speedy. According to SSA’s own data, New York City applicants currently have the shortest average wait for a decision letter, which is still 148 days. Although the government is working to improve efficiency, the process has always been time-consuming.

After the claimant’s non-medical qualifications are verified, the state’s DDS reviews the claimant’s medical status. To meet the definition of disability, “you must have a severe impairment(s) that makes you unable to do your past relevant work … or any other substantial gainful work that exists in the national economy.” 20 CFR § 416.905. The DDS will examine work closely to decide whether it qualifies as substantial gainful activity (SGA), but it generally applies to any compensated physical or mental activity.

The Five-Step Process

The DDS uses a sequential five-step process for determining an adult claimant’s qualifications for disability:

1. Does the claimant engage in SGA? If so, the claimant is not disabled enough to qualify. If not—
2. “Does the claimant have a medically determinable impairment (MDI) (or combination of MDIs) that is both severe and meets the duration requirement?” A disability must either be expected to result in death or “to last for a continuous period of not less than 12 months from the onset of disability.” See DI 25505.030. 
3. Does the claimant have an MDI listed as an impairment “that we consider to be severe enough to prevent an individual from doing any gainful activity?” 
4. Does the claimant have enough residual functional capacity (RFC) to perform any of their past relevant work (PRW), either as they actually did or as it is currently performed in the national economy?
5. “Does the claimant have the ability to make an adjustment to any other work, considering the claimant’s RFC, age, education, and work experience?”

This evaluation process will end at any step where the answer is not a clear “yes” or “no,” as required.

When a claimant requests a reconsideration, that process is a “de novo review,” which means that the whole evaluation starts from scratch. See DI 27001.010. They claimant may need to take more questionnaires or a new consultative exam (CE). Nonetheless, if the claimant does not present new evidence of worsening about their condition, they are free to affirm the first evaluation as written. 

An SSA disability attorney knows how to prepare a strong reconsideration request, including new medical evidence and a strong appeal that helps you express how much you have struggled. Although many reconsideration claims are denied, you may have an even better chance if you follow this with an appeal and request for a hearing, as ALJs are not involved with previous rulings. Your attorney can prepare a clear argument for the ALJ, presenting your case at its strongest.

Don’t Go Alone

You should never face this long and baffling process without guidance. Our firm works only on getting retired and disabled Florida workers the help they need. We have personal experience with the red tape and unfairness of the system, and we want to be on your side. Call 727-477-3263 to schedule your free initial consultation.