9.2 million Americans receive social security disability benefits. 89% of those who receive benefits are disabled workers.
To receive benefits, the disabled person must first navigate the social security disability claim process, which is challenging and often frustrating.
Denials are common, and it’s recommended that social security lawyers get involved in a claim early in the process for optimal outcomes.
If you think you might be eligible for social security disability benefits or have made a claim that you’re now fighting, read on to learn more about the process and why getting a social security lawyer is critical to a successful outcome.
Types of Social Security Benefits
The US Social Security Administration is a branch of the US government. They’re charged with the distribution of benefits through social insurance.
Most people know about Social Security for seniors through retirement benefits. But Social Security provides more than just that type of benefit. The benefits are retirees, the disabled, and provide survivor benefits.
Let’s take a closer look at each of the types of Social Security benefits provided.
Retirement Benefits
Americans can be eligible for retirement benefits as early as 62 by paying FICA or Federal Insurance Contributions Act as a payroll deduction. Workers become eligible after ten years of work or 40 SS credits.
Your retirement benefits get based on the highest 35 years of income combined. A person can collect Social Security retirement benefits as early as age 62. Your monthly benefits increase if you wait beyond that age to as much as 70.
84% of all Social Security benefits paid out by the SSA are retirement benefits. If you’ve worked enough years, you’ll get this benefit if you’re the correct age when applying.
Disability Insurance Benefits (SSDI)
Social Security Disability Insurance or SSDI is a lesser-known benefit of Social Security. It’s a disability program intended to provide workers with benefits who have a disability before retirement age.
A worker is eligible for SSDI by also having paid into the system through payroll deductions like the retirement version of benefits.
13% of all SSA benefits paid out through the SSA are disability benefits. Unlike retirement benefits, a worker must apply for SSDI and prove their eligibility to receive benefits. More on eligibility and the making of a claim shortly.
Survivor Benefits
Another part of the program is for survivors of those eligible for Social Security benefits. Eligibility is for direct relatives of deceased workers who paid into the Social Security program through payroll deductions.
If a worker dies, those survivors can collect the Social Security benefits that would have gone to the worker. Survivor children, for example, can collect up to the age of 18 after an eligible parent dies.
About 3% of benefits paid out through Social Security go to underage survivors.
Supplemental Security Income (SSI)
Another arm of the Social Security benefits program is supplemental security income for SSI. SSI is a type of disability insurance coverage for low-income individuals who may not have met the work requirements of the other programs.
Like with SSDI, a claim must get made for SSI benefits. This claim will need to provide documentation and medical evidence of a permanent disability. It will also have to provide income or lack of it, documentation.
Applying for Social Security Disability
A Social Security disability requires you to apply to the Social security administration if you want government benefits. The application will require you to provide evidence and documentation of your disability.
First, the application will require a copy of your medical records. This includes past and current records that show both diagnosis and treatment information.
Part of this information should be diagnostic records from your medical team. These records will help provide important information about your diagnosis.
The SSA requires you to provide a list of past and current medications used in the treatment of your disability. An applicant also needs to provide information on all medical providers and their affiliate facilities.
Finally, the applicant needs to provide detailed work history information for the previous 15 years. The SSA wants to see the history to see how it compares to your current capabilities.
What Is SSDI?
Social Security Disability Insurance or SSDI is the disability insurance if a qualified US citizen suddenly finds themselves with a disability preventing them from working.
SSDI benefits might get paid for:
- A medical condition like diabetes
- A mental health condition like depression
- A long-term disability from a work-related injury
The two keys to SSDI benefits are showing you have a medical condition from objective medical evidence. The second is that the disability prevents you from the ability to work and earn an income.
Qualifying for SSDI
The SSA uses a five-step progressive process to decide if an applicant qualifies for SSDI benefits.
These steps include:
- The applicant’s substantial gainful employment or SGA can be more than $1,470 a month (2023).
- The applicant must show they have an impairment of a combination of them that prevents their ability to perform basic duties at work. The disability must last for at least a year or longer.
- The SSA has a Listing of Impairments that the applicant’s medical condition or combination of conditions must meet.
- If it doesn’t meet the Listing of Impairments, the applicant must show it prevented them from performing their work in the past.
- The impairment must prevent the applicant from doing any type of work based on their past work experience, transferable skills, age, equation, or, of course, their impairment.
SSDI Vs. SSI
It’s important to know about both SSDI and SSI programs if you have a disability. Depending on the history of the disability and the ability to work in the past, one of these programs might provide important benefits.
SSDI benefits come when the applicant has a disability and a qualifying work history.
SSI benefits are for seniors or the disabled with no work history or very low-income status.
The key difference between these programs is that the SSI program considers age and disability along with income status, whereas SSDI considers the disability and work history of the applicant.
SSDI Process
Applying for SSDI benefits can be a cumbersome and frustrating process. The amount of time it takes often depends on how quickly you get a lawyer involved and how many steps of the process your work through before getting approval.
The initial step of the application process is to submit your original application. You can do this online or by mail. You can do this without the help of an attorney. Although most data shows the more quickly you get a social security attorney involved, the faster you get the approval.
If your initial application gets denied, you can file an appeal, and your application is reconsidered by another SSA examiner. This step is called reconsideration.
If your application is denied again at the reconsideration level, then the case is appealed, and a hearing by an administrative law judge (ALJ) is held. If you haven’t retained legal counsel before now, you want a social security lawyer for this step in the process.
If your case gets denied with the ALJ, you can still appeal to the Appeals Council and District Court to seek a better outcome.
What Happens if Your SSDI Application Is Denied?
Many applicants feel discouraged if their claim is denied. It’s not uncommon for SSD applications to be denied.
Often it’s because there isn’t enough documentation or parts of the application aren’t thorough enough to get approval.
It can feel frustrating to get denied, but the SSA has many layers in the appeals process for this very reason. If you haven’t already, it makes sense to hire a Social Security lawyer to help with your case.
Mistakes to Avoid When Appealing Your Claim
One of the benefits of hiring a social security attorney is the experience they can bring to your case.
Here are some of the mistakes to avoid when filing an appeal on your case.
Giving Up Without an Appeal
It can be disheartening to get a denial of your claim. Some people even feel like giving up on their application.
You absolutely should not give up your claim without filing an appeal. Get an attorney who specializes in these types of cases and let them figure out what might have been missing from your application.
Failing to Hire a Lawyer or Waiting Too Long
It’s not uncommon for applicants to try to navigate this process on their own without an attorney. The problem is that most people don’t realize the depth of information you need to get approval.
The reality is that typically cases where an attorney is involved get approval more quickly than those that don’t have an attorney.
One mistake you can make with your case is waiting too long to hire an attorney or not hiring one at all.
Giving Up on Treatment
Some people suffering from a disability will want to give up their treatment protocols or get lax about their treatment.
Even if you feel like you’re not making progress with treatments, if a doctor prescribed it, you should continue.
When the SSA evaluates your case, they want to see you’re doing your part. If you stop seeking treatment, they could conclude you’re better or aren’t as bad as you’re suggesting.
Not Documenting Your Symptoms
Don’t be surprised when you file an appeal that there’s likely to be a long delay between when you file the appeal and when your case is heard.
You want to be able to go into the appeal with a mountain of evidence, so documenting all symptoms is critical. Don’t assume you’ll remember, as it can take a bit of time.
Keep a notebook documenting your symptoms daily and the impact of your disability on your life.
Prepare for Your Administrative Law Judge Hearing
Remember, the first appeal step is just a new SSA examiner looking over your original application. If you appeal again after that, your case will be heard by an administrative law judge (ALJ).
You should be well prepared to answer questions and provide information in the ALJ hearing. This is when having a Social Security attorney is critical, as they can help prepare you for this appeal hearing.
Let’s take a look at what you should prepare to address in your ALJ hearing.
Background and Personal Information
You will need to provide some personal information and background details for the record.
You will get asked:
- Full name
- Social Security number
- Mailing address
- Your age
- Date of birth
- Height and weight
- The extent of your formal education and any vocational training you have
All of this information is important because it can impact your ability to work.
Employment Background
The ALJ will want extensive information about your employment story. They will want to know if you’re currently employed, or your past employment.
The judge will want to know specifics about the type of work you’ve done and how your disability might impact that work.
Medical Limitations and Issues
In your appeal hearing, you will get asked to discuss your medical conditions and any limitations you have as a result. The ALJ will want to know how these impact your ability to work and the impact it has on your daily life.
You should expect the ALJ to want to know:
- Your disabling condition
- Your date of diagnosis
- Progression of disability
- Ability to work
- Impact on your daily life
It’s important to give significant detail to help the ALJ get a picture of the impact of the disability on your life.
Mental Health
It’s not uncommon for physical disabilities to also have an impact on your psychological condition.
This can impact your ability to concentrate, remember things, control anger, and manage your feelings, for example.
The ALJ will want to know if your mental health is part of the disability equation and how it is or might be impacting your ability to work.
Importance of Social Security Lawyers for Your Claim
Throughout the application and appeal process, a social security lawyer is critically important. The lawyer can ensure your application is well documented even before it’s submitted.
Their experience can better guide you through an appeal by making sure you have what you need and know how to answer any questions you’re presented with.
Getting an Approval for Your Social Security Disability Claim
Social security lawyers can be integral in getting approval for an SSD application. If you live in Tucson, AZ, and are in the process of a Social Security disability application, we can help.
Contact Sweet Law to get the assistance you need as you navigate the disability claim process.