Many who are unable to work because of a physical or mental disability are eligible for Social Security Disability Benefits. If you are elibible, there are ways to speed up the process and improve your chances of being approved.
Introduction
If you have worked for the better part of your life and have recently become incapacitated and unable to work, you may be frustrated and scared. You may even wonder if you will be able to support yourself and your family. If you wonder if there is any help for you, you may be in luck as help is available, if you qualify.
Social Security Disability Benefits are designed to help people who have become disabled and are not able to work. However, to reduce the chances that people who are able to work will abuse these benefits, the Social Security Administration has set the qualification criteria for disability benefit programs very strict and specific. This article discusses when, where, and how to apply for Social Security Disability Benefits and offers some suggestions on how to improve your chances of qualifying for these benefits.
Quick Facts About the Process
SSA Definition of Disability
In order to ensure that abuse of the program does not occur the Social Security Administration has defined disability, for the purposes of determining eligibility, as:
"You must be unable to do any substantial work because of your medical condition(s); and
Your medical condition(s) must have lasted, or be expected to last, at least one year, or be expected to result in your death." (Social Security Administration).
When and Where to Apply
Social Security disability benefits are not available until you have been disabled for six full months. After this period you are able to apply for benefits. You can apply online or at your local Social Security Branch Office. If you are unable to travel other options may be provided such as a phone interview or a home visit.
How Long It Takes
It will take anywhere from three to five months to determine if you are eligible for assistance. However, if it is decided that you do qualify for Social Security Disability Benefits then you will be paid from the first full month after you filed your claim. You will receive back payments for the months that you were eligible for benefits, once it is decided that you are eligible.
Other Disability Insurance
Many people wonder how qualifying for benefits under a private disability insurance differs from qualifying for benefits from a Social Security Disability Program. The main difference is that private insurance companies will pay benefits to you even if you are only partially disabled, or only disabled for a short period of time. Social Security Disability benefits, on the other hand, require you to be completely disabled for at least one year in order to receive benefits. Also, even if you qualify for long-term disability benefits from your private insurance, it does not guarantee that you will qualify for Social Security Disability. Furthermore, if you do qualify for Social Security Disability benefits, once you start receiving payments from this agency, the amount will reduce how much your private insurance company will pay you.
What Programs Are Available
There are two programs available for people who qualify for Social Security Disability benefits. The first program is Social Security Disability Insurance (SSDI), and the second program is Supplemental Security Income (SSI) for people with little or no income and resources.
Applying For Adult Disability Benefits – What to Gather Before Your Interview
The application process involves a lot of legwork. You can help speed up the process by gathering all the information that will be needed during your intake interview ahead of time. Below is a list of items that you will need to have documented.
Medical Information - You will need to have the names and contact information of all of the doctors that you have seen because of your disability including: name, address, and phone number of doctors and clinics you have visited; patient ID number(s); dates of visits; list of medications that you are currently taken or have taken; and any medical records that you have in your possession. You will also need to fill out and sign medical information release forms so that the Social Security Administration will be able to access your medical history.
Citizenship - An authorized copy of your birth certificate. You can get this from you town hall in the records department. Make sure you get a "certified" or "authorized" copy and not just a photocopy. An authorized copy will most likely be on special colored paper with embossing or a raised seal. If you were born in another country you will also need to bring with you proof of your citizenship or legal residency like a green card.
Military Service - If you served in the military you will need to bring with you the original or certified copy of your Form DD 214 (military discharge papers) for all of the periods of time that you were on active duty. Again photocopies are not acceptable.
Income Verification - You will also need to bring in proof of your income such as your W-2’s, 1040s, 1099s, Schedules C and SE from the previous year or two years.
Workers’ Compensation Information – Bring copies of all of the workers’ compensation paperwork that you filed when you first got injured including: date of injury, claim number, and proof of payment amounts.
Social Security Information – Have ready the Social Security numbers of you, your spouse, and your children (if applicable). This can be simply a list of names and numbers, but you may also want to have a photocopy of everyone’s Social Security cards available as well, especially your own Social Security card. If you have lost these cards you can fill out a form to request a new one. The form is available both at the Social Security office and online.
Financial Information – The Social Security Administration will also need to know about all of your financial accounts like checking accounts, savings accounts, retirement accounts, stocks and bonds, real estate etc. Have a list of account types, locations, and amounts available as well as the monthly statements from these accounts from at least the last three months prior to your application.
Alternative Contact Information – Have a list of one or two people that the Social Security Administration can contact in case they are unable to reach you for some reason.
Work History – You will also need to list your work history for the last fifteen years with as much detail as you can remember. You will, at the very least, need to list the types of jobs that you did and the dates that you did them before becoming disabled. This will help determine the impact your disability really has had on your ability to do work.
Applying For SSDI or SSI – The Intake Interview
You will want to arrive about fifteen minutes before your scheduled appointment to allow yourself enough time to check in and fill out any preliminary paperwork. Dress comfortably and have your documentation neatly contained within a folder in the order listed above. Once the intake person is ready for you, you will be taken back to his or her office.
The interview process really is just to go over all of the information that is listed above. You will also need to sign forms and printouts to verify that the information that was entered is correct and accurate to the best of your knowledge, and that you did not falsify any documents or statements simply to qualify for benefits.
After entering you information into the computer system, you may be told that you will need to get medical tests and examinations done by specific doctors. You don’t have to pay for these visits so keep all appointments made to ensure that your application will be given a chance for acceptance.
After your interview you will start the long period of waiting. It will take anywhere from three months to five months for a decision about your case to be made. During this time you may receive phone calls from the Administration requesting more information, requesting that you sign additional consent forms, or requesting that you see another doctor or specialist. Complete each request as quickly as possible, following the instructions given to you by the SSA to the letter.
Tips For Applicants
Keep a copy of every piece of information you submit to the Social Security Administration during this process as well as a copy of every form you fill-out, sign, and submit. Many people who file for Social Security Benefits are frustrated by misplaced documents and records. If you mail off a large packet of paperwork, purchase a delivery confirmation tag to have proof that the Administration received your paperwork. Also make a follow up call to the Administration to confirm receipt of your paperwork.
Don’t call the Social Security Administration’s 800 number for information about your case. This call center most likely won’t have access to up-to-date information about your case. Instead call you local branch for information related to your claim.
When you first get injured have regular doctor’s visits to document your progress or lack there of. This will help establish a history of disability that the Social Security Administration will be able to use when determining your eligibility.
Keep a log of incidents, physical pain experienced, days of work missed, doctor visits, therapy sessions, when you stopped working, and daily activity from the day you are first injured. You can use this to help support your case by showing how your disability has affected your ability to do work related activities as well as how it has affected your general mobility and ability to function.
Follow your doctors’ orders and medical advice. This means take your medications, follow mobility restrictions, and keep doctors appointments. The Social Security Administration will see that even when you follow prescribed treatments your impairment is still severe enough to limit your abilities. This will be good for your case. On the other hand, if you do not follow your doctor’s advise, the SSA may see your impairment is because of your lack of compliance with medical advise and not because you are disabled. This would be bad for your case.
Even when you are frustrated with the process remain friendly and polite with your caseworker. Your patients and friendliness may help your file be completed sooner.
To help speed up the processing of your claim have your physician complete an RCF form for you. An RCF form is an evaluation of your residual functional capacity, and it is required before a final decision can be made in regards to your case.
Also have your doctor fill out a statement that details why you are disabled and why this disability prevents you from working.
If You Are Denied
70% of all people who apply for SSDI or SSI are denied the first time that they apply. At this point the applicant has three choices: (1) don’t pursue the issue further, (2) file a new claim, or (3) appeal the denial. The best choice to make is to appeal the denial. To make an appeal you will have 60 days to file a Request for Reconsideration. This form is available both at the Social Security Office and online. After this form is filed the Social Security Administration will re-evaluate the case. Again the claimant will need to wait while this re-evaluation occurs.
If you are denied again then you will need to appeal again, this time by filing a Request for Hearing. Again this form is available at the Social Security Office and online. Once your Request for Hearing has been received and processed a hearing date will be scheduled so that your case will be heard before an Administrative Law Judge. You will receive a Notice of Hearing with the time, place, and date of your hearing, and the name of the judge that will be listening to your case. You will be given about 30 days to prepare your case for the hearing. If you haven’t done so already, you will want to get legal representation at this point of the processes. Without professional help, you really don’t have a fair chance at winning your case.
When the day for your hearing arrives you will want to arrive a few minutes before you are scheduled to go over the details of your case with your attorney or legal representative. You should dress neatly, but not too formal. The hearing itself will not last more than an hour. After hearing all of the information, the judge will adjourn and will consider the matter. It will take a few weeks or even months before a final decision on your case will be made. The good news of this stage of your application for benefits is that 50% of cases that are heard before a judge are approved.
If your case is finally approved then you will receive two letters. The first letter will be a Notice of Decision letter from the judge that states the judge’s opinion on your case. This letter may state an opinion that is either fully favorable or partially favorable. The difference between these two letters is when the Date of Onset is determined to be. The fully favorable opinion will mean that back pay will be calculated starting the first full month after the claimant first filed for disability. If the opinion is partially favorable the Date of Onset may be set closer to the hearing date reducing the amount of back pay that the claimant will receive. This issue is why it is important to have legal representation to ensure that you get the most favorable Date of Onset as possible.
The second letter will be from the Social Security Office, a Notice of Award. This letter will discuss what benefits you will be receiving including how much back-pay you qualified for, what your monthly check will be for, when you will get your checks each month, your payment options, medical coverage, etc. With any luck, you will start receiving payments the following month on the 1st or 3rd, depending on where you live and what program you qualify for.
If your hearing results in another denial of benefits you will receive a letter from the judge, a Notice of Decision – Unfavorable. At this point in the process you may be fully discouraged and ready to give up, however, you still have one option left for appealing your case. You can still appeal to the Appeals Council. The Appeals Council is a review board that reviews the cases denied by the ALJ. While chances are this appeal will not result in approval, it does give you one last chance at acceptance