How do I apply for Social Security Disability?
Applying for Social Security disability benefits can be a confusing and frustrating experience. There are many forms to fill out, deadlines to meet, and difficulty communicating with the Social Security Administration (SSA).
The SSA manages two distinct disability programs: Social Security Disability (SSD) and Supplemental Security Income (SSI). Participants may be eligible for one program or both, depending on the circumstances. SSD is funded through Federal Insurance Contributions Act (FICA) deductions from employee paychecks. To qualify for SSD, participants must have worked long enough to be “insured” for disability. Upon being found disabled, participants may also be eligible for Medicare after approximately 29 months.
SSI is generally for people who have not worked long enough to qualify for SSD, or who qualify for only minimal benefits. It is a federal welfare program and participants must meet financial eligibility criteria to qualify. Under SSI, participants are eligible for Medicaid immediately upon being found disabled.
Applying for SSD is a reasonably easy process and can be done by:
- Calling the SSA at 800-772-1213
- Going to a local Social Security office
- Filing online at www.ssa.gov. The website is designed to be user-friendly and SSA prefers that applications be filed online
To evaluate a claim, SSA will pull medical records and send the applicant forms to fill out regarding work history, medical condition, and activities of daily living.
Appealing a Denial
There are three levels of appeal within SSA if the application is denied: reconsideration, hearing, and appeals council review. Under some circumstances, further appeals can be filed in the Federal Judicial system. All appeals must be filed within 60 days of the date of the last denial. Failure to file an appeal within 60 days may result in loss of the ability to appeal or decrease the amount of retroactive benefit to which the applicant would otherwise be entitled.
Statistically speaking, claimants have the best chance of winning at the hearing level. Nationwide, the statistics show about 35 percent of claimants win at the application stage, 12 percent win at reconsideration, and nearly 50 percent win at the hearing. It is very important to retain an attorney who specializes in SSD law. All Social Security attorneys must take cases on a contingency basis — no attorney fee is owed unless the claimant wins benefits. Attorneys are allowed to charge 25 percent of past due benefits or $6,000, whichever is less.
There are non-attorney representatives who will agree to represent claimants, however, they may not be as knowledgeable about the law and cannot represent claimants in federal court. Furthermore, although the hearing is designed to be non-adversarial, the judge is not there to advocate for the claimant. Claimants also have the burden of proving four of the five steps of the analysis used to determine whether they are in fact disabled (go to www.ssa.gov for the disability analysis). Providing the proof necessary to persuade a judge that a disability exists can be difficult. Finally, the judge will almost always call one or two expert witnesses to testify at the hearing. Claimants have a right to cross-examine those witnesses, but knowing what to ask to help – not hurt – the case also can be complicated. A loss at the hearing results in all future appeals being dependent on the hearing judge’s analysis of the evidence. It is critical to have all relevant evidence in the record by the hearing, including appropriate testimonial evidence, to provide the best chance of winning any future appeal.
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