If you are considering applying for Social Security Disability benefits, or if you are appealing a denial of benefits, it is important to understand the SSA’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 Fletcher Van Gilder LLP can offer insight and guidance in your pursuit of benefits.
How do I know if I qualify for disability?
An impairment that qualifies as a disability under SSA guidelines must be quite serious. The impairment must render the applicant unable to perform any 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 completely disable the applicant from working. 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.
What is the difference between Social Security disability and Supplemental Security Income (“SSI”)?
The SSA also requires the applicant to have a sufficient work history to qualify for Social Security Disability Insurance (“SSDI”) 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 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 should I file for disability?
To qualify for benefits, a person must be disabled 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 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. It is often wise to start early.
How does the Social Security Administration evaluate my disability application?
Following the receipt of the application, a Social Security Administration (“SSA”) 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 (within the state where you live/filed the claim) charged with making a decision regarding the disability benefits application. The state agency may develop the file further by gathering more medical records or vocational evidence.
Social Security uses a five-step process to determine whether the applicant should receive benefits, asking:
- Is the applicant working?
- Is the medical condition severe enough to render the applicant disabled?
- Is the impairment on a government list of impairments granting automatic disability status? (If the impairment is not on the list, that does not disqualify the applicant.)
- Can the applicant do the work he or she did before becoming disabled, either as he or she performed it or as it is generally performed?
- What other types of work can the applicant do?
The state agency will return the file to the federal SSA 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.
Should I appeal the denial of my claim?
Every applicant has the right to appeal the decision. An appeal must be made within sixty (60) days of the denial letter. The first appeal is a reconsideration of the initial denial, typically a review by a new person of the written evidence and any additional evidence. 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.
Why should I hire an attorney?
Each step of the Social Security Disability benefits application process can be time-consuming and complex. An attorney from Fletcher Van Gilder LLP can answer your questions and help you through the qualification and appeals process.
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