What Is Social Security Disability?
The Social Security Administration offers benefits for disabled individuals who are unable to work due to their injuries or illnesses. There are two types of benefits available: Social Security Disability (SSD) Insurance or Supplemental Security Income (SSI).
Depending on your work history, income level and severity of disability, you may qualify for either one of these. This page discusses how to qualify for Social Security Disability (SSD) benefits.
Do I Qualify for Social Security?
In order to qualify for Social Security Disability Insurance, a person must:
- Have a condition that is expected to last at least 12 months or result in death
- Be under the age of 65
- Have worked five of the last 10 years from the determined date of disability onset
- Live in the United States or one of its territories
- Have a physical or mental disability (or both) that prevents them from engaging in substantial gainful activity.
Substantial gainful activity is a standard that the Social Security Administration uses to measure whether or not a person is earning enough to support themselves. It is measured in terms of monthly earnings, and changes each year to keep up with economic factors.
What Disabilities Qualify Me for Benefits?
There are many ways that a person can become injured or sick enough to lose the ability to work. The Social Security Administration has a list of ailments that qualify a person for disability benefits, including:
- Respiratory conditions
- Cardiovascular conditions
- Autoimmune disorders
- Endocrine disorders
- Neurological conditions
- Mental health disorders
- Musculoskeletal issues
There are many ailments included in the Blue Book, but yours does not have to be listed in order to qualify. If you can demonstrate that your unlisted disorder keeps you from working and earning enough income for yourself or your family, you can apply for benefits.
When Should I Apply?
The best answer is as soon as possible. Once you meet the requirements to apply--go do it. The approval process can be long and complicated, so you want to make sure that you get your application in as soon as you can. Many people can begin the application for Social Security Disability from the date they are first unable to work. If your appeal for disability is successful, you might be able to claim back benefits, which start from the date of your determined disability.
How Do I Apply for Social Security?
To apply for Social Security, you have two options:
- File a Social Security application at ssa.gov (recommended)
- Call and schedule an appointment at your local SSA office (not recommended as this can sometimes take weeks)
Applying online can save you time and money. However, you must be 18 or older to apply online, as well as meet the other SSD eligibility requirements.
Information You Need to Apply Online:
- Name, address, and phone number of someone who can verify your disability.
- Names, addresses, phone numbers, patient ID numbers, and dates of treatment for any doctor, clinic, or hospital you've used.
- Names of prescriptions and the doctor who prescribed them.
- Names and dates for any medical tests completed and the doctor who ordered them.
- Dates and types of jobs you have worked for the last five years.
- Insurance claim information, such as workers' compensation or auto insurance.
Documents You Need to Apply Online:
- Military service discharge information (Form DD 214)
- W2 form or IRS 1040 from last year
- Social Security numbers for family members (spouse and minor children)
- Bank account numbers (optional: needed if you want your benefits directly deposited into your account)
Once you've gathered these materials, you can complete the online application!
What Happens After I Apply?
After you have completed the initial application, you can proceed to the Adult Disability Report, which gives the SSA a profile of your disability and work history.
The SSA requests that you mail or bring the completed "Authorization to Disclose Information to the Social Security Administration" form to their offices. This grants them permission to get information from your doctor's office and other treatment sources.
What If My Application Was Denied?
Here's the truth: Social Security denies about 70% of all disability claims on the first application.
If your application has been denied, don't accept that as a final answer. You have the right to appeal a denied disability claim, and an experienced disability attorney can help you in doing that.
Appealing a denied claim can be complicated and intimidating, but know that the Social Security Administration works with disability attorneys, as well as applicants. This ensures that you are not blindsided in the appeals process.
Just know that your chances of being approved are much higher if you have an experienced disability attorney working on your case.
In Order to Properly Preserve Your Disability Claim, You Should Do the Following:
- Contact an experienced Florida disability attorney.
- Continue to treat with your doctor.
- Gather contact information of doctors who treated you, including names, addresses, and telephone numbers.
- Make sure that you have a good relationship with doctors who are aware that you have applied for disability.
How Do I Appeal a Denied Application?
What Are the Stages of the Appeals Process?
There are four stages in appealing a denied disability claim, but if you are successful at any of them, the process stops.
After you receive a denial letter, you will need to notify the Social Security Administration that you would like to file a Request of Reconsideration.
You have 60 days from the date of denial to file an appeal for disability benefits. The SSA accounts for mailing time, but in some circumstances you may be able to prove that you got it later than normal. If you cannot meet this deadline, provide the SSA with a valid reason in writing and your deadline may be extended.
Online resources can begin the appeals process. If your claim has been denied because of:
- Medical reasons: fill out the Appeal Request and Appeal Disability Report.
- Non-medical reasons: the SSA requests that you discuss a review with a regional office near you.
The Reconsideration Stage
To file an appeal, you must first go through reconsideration. In this stage, a representative who has no familiarity with your case will consider all of the evidence and aspects of the case. If there are any new developments or pieces of evidence in your case, be sure to submit them. If your reconsideration is approved, then you will receive a letter in the mail saying so. If your reconsideration is denied, then you move onto the next stage of the appeals process, which is a hearing.
The Hearing Stage
Applicants appealing a denied Social Security disability claim can request a hearing if reconsideration doesn't turn out the way they had hoped. Again, a person who knows nothing about your case will make the decision. That person in this case will be an administrative law judge (ALJ). You can expect to see them and the following people at your hearing:
- Your attorney
- Vocational experts (to testify about the person's work history)
- Medical experts (to testify about the person's health or disability)
- Other witnesses
In most cases, the ALJ will hold the hearing within 75 miles of your home. Video-conferencing can sometimes be done in place of a traditional hearing. You need to provide the judge with any new evidence or developments in your case before the trial starts. Once the judge makes a decision, it will be sent to you (the claimant) in the mail.
Appeals Council Review
As the appeals process progresses, it becomes even more difficult. Most denied SSD claims don't go past the hearing level. This is mainly because the time and money needed to do so aren't worth the potential benefits. However, there are two more levels in the appeals process.
The Appeals Council is a part of the Social Security Administration, and consider a case if an appeal is filed past the hearing stage. They may deny requests for appeal if they agree with a prior decision, decide upon the matter themselves, or send it back (remand) to an ALJ for further review. No matter their decision, the Appeals Council will send you a notification in the mail.
The final step in the appeals process is to file a formal lawsuit in federal court. Claimants rarely reach this final step in the appeals process, but it is an option if you disagree with the decision. You will certainly need a disability attorney at this stage of the appeals process, but hiring one as early as possible will help save you the time, money, and stress that accompany a lawsuit.
Visit the Social Security Administration's website or call them at 1-800-772-1213 to learn more about filing and resolving an appeal.