A Brief Overview Of SSDI And The Application Process
If you are considering applying for Social Security Disability benefits, or if you are in the midst of appealing a denial of benefits, it is important to understand the Social Security Administration’s approval process. In addition to meeting the definition of “disabled” and fulfilling the earnings requirements that the Social Security Administration dictates, you must present a convincing and organized claim. An experienced Social Security Disability attorney from Thomas & Thomas Attorneys At Law in Easton, Pennsylvania, can offer insight and guidance in your pursuit of benefits.
An impairment that qualifies as a disability under Social Security Administration (SSA) guidelines must be quite serious. The impairment must render the applicant unable to perform substantial gainful activity — that is, the applicant must not be able to earn more than a minimum amount of money, determined each year by the SSA.
The impairment must prevent the applicant from working on a full-time, continuous basis and earning income at a substantial gainful activity level. It must be expected to last for a year, have already lasted a year or be expected to cause the applicant’s death. But this is not the end of the qualifying tests.
The Social Security Administration also requires the applicant to have a sufficient work history to qualify for Social Security Disability benefits. Based upon the applicant’s age, he or she must have worked for a specified number of years. The applicant also must have worked at least some of those years recently. This is because Social Security Disability Insurance (SSDI) benefits are “earned” with the contributions applicants have made through their Social Security taxes. Some blind applicants do not need to meet the recent work test.
Supplemental Security Income (SSI), on the other hand, is a needs-based program that helps disabled people with low income and few resources.
When To File
To qualify for benefits, a person must meet the Social Security Administration’s definition of disability or be expected to meet that definition for a minimum of 12 consecutive months. Thus, it may not be a good idea for a person to file an application for benefits as soon as he or she becomes unable to work because it may be difficult to prove that the disability will last for at least one full year. The initial decision can take a number of months. If your claim is denied — which happens in a large majority of cases — the time it takes to appeal can last a year, two years or longer, depending on where you live and the hearing office. It is often wise to start early, depending on your individual circumstances.
The Decision Process
Following the receipt of the application, a federal Social Security Administration representative will review the information. If the representative is satisfied that the application meets certain basic criteria, the application and evidentiary materials will be forwarded to a state agency that is charged with making a decision regarding the disability benefits application. The state agency may develop the file further by gathering more medical or vocational evidence.
Social Security uses a five-step process to determine whether the applicant should receive benefits, asking:
- Whether the applicant is working at substantial gainful activity level
- Whether the medical condition is severe enough to render the applicant “disabled”
- Whether the impairment is on a government list of impairments granting automatic disability status (if the impairment is not on the list, that does not necessarily disqualify the applicant)
- Whether the applicant can do the work he or she did before
- What other types of work the applicant can to do
The state agency will return the file to the federal Social Security Administration with its recommendation. The SSA almost always adopts the state agency’s disability determination.
After considering all other eligibility questions, the SSA will mail the applicant a notice of its decision.
The applicant has the right to appeal the decision. The first appeal, in many states, including New Jersey, is a reconsideration of the initial denial, typically a review by a new person of the written evidence and any additional evidence. Under a pilot program in some states, including Pennsylvania, the reconsideration step has been eliminated and applicants go right from an initial denial to a hearing with an administrative law judge. After reconsideration, the next appeal goes to an administrative law judge for a hearing. Following this stage, the applicant has a right to appeal to the Social Security Appeals Council. Finally, the applicant may appeal to the federal courts. An attorney can offer valuable assistance in the appeals process.
Speak With An Attorney
Each step of the Social Security Disability benefits application process can be time consuming and complex. An attorney from Thomas & Thomas Attorneys At Law in Easton, Pennsylvania, can answer your questions and help you through the qualification and the appeals process. Contact us online or call 610-559-9271 to schedule your free consultation.