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10 tips for applying for Social Security Disability: What to do, what to know

Where to apply

The quickest way to file for Social Security Disability Insurance is online at https://www.ssa.gov/benefits/disability/. You can also apply by telephone at 1-800-772-1213 (TYY 1-800-325-0778) or by making an appointment at a nearby Social Security office. Offices can be found by typing in a zip code at https://www.ssa.gov/locator/.

Who is eligible?

You have to have been employed for a certain number of years and paid Social Security taxes (FICA) to be eligible for SSDI, although there are exceptions. For example, if a person who has worked and paid Social Security taxes dies, certain members of their family including their spouse, divorced spouse and children may also be eligible.

What if you have never worked?

People who have never worked mostly are not eligible for Social Security Disability benefits, although they may be eligible for another government program known as Supplemental Security Income, or SSI. SSI is a program for low-income individuals. It is given to people who are 65 and older, blind or disabled and have limited resources, whether they worked or not.

To quality for SSI, a person or couple can own a house, car and items like furniture, but otherwise have a very low income and, in most states, can’t have assets of more than $2,000 as an individual or $3,000 as a couple. In most states, the maximum SSI payment in 2022 was $841 each month for an individual and $1,261 for a couple.

How does the Social Security Administration determine if you are eligible for Social Security Disability benefits?

The Social Security Administration looks at your age, salary and work history to see if you are “fully insured.” You become fully insured by working and paying Social Security taxes (FICA). As an individual works and pays Social Security taxes, they earn what are called Social Security “credits” — also known as “Quarters of Coverage,” or QCs.

The amount an individual needs to make in salary to earn a single Social Security credit is very little, even as it has changed year-by-year. In 1990, for example, workers had to make $520 a year in salary (while paying Social Security taxes) to earn a single credit. By the year 2000, that amount was $780. Now, in 2022, it is $1,510 annually. The number of credits one needs depends on the age at which they become disabled. A person age 62 or older must earn 40 credits to be eligible, which is the maximum number, the equivalent of 10 years of work. The younger one is, the fewer credits are needed, with six being the minimum.

How much is the monthly benefit?

It depends on your work and salary history. The average in 2022 is $1,358, with most benefits ranging from $800 to $1,800 per month. The maximum monthly benefit is about $3,100. To find out precisely, create a My Social Security account at https://www.ssa.gov/myaccount/.

What information do I need to apply?

The Social Security Administration publishes a checklist. It includes basic information such as name, address, family members, your educational background, any vocational training, and also the types of jobs you’ve held in the last 15 years. Central to the application is detailed medical records: names of doctors, hospitals, clinics, your patient I.D. numbers, dates of medical tests, examinations, treatments, diagnoses, prescriptions and the date your medical condition began to affect your work.

What happens after I apply?

Social Security Disability is a federal program, but it is administered by each state through a special office known as DDS, for Disability Determination Services. The Social Security Administration looks at your application to see if you have enough credits to receive benefits. If you do, your application goes to your state DDS office for an initial determination.

The DDS workers go over your medical records and contact your doctors. They do not ask your doctors to determine if you are disabled. DDS does inquire about your medical condition, when it began, what the tests show, what treatments you’ve received, medications you’re on and, most significantly, how your condition may limit your abilities. Physicians and vocational experts working for DDS go over your records to help make an initial determination. If your medical documents are incomplete, DDS may ask you to get more records or set up an appointment for a consultative medical exam.

Getting approved at the initial level is hard. Between 75% and 80% of initial applications are denied, often because of missing information or because the applicant’s medical problem does not fit Social Security’s definition of a disability or because the applicant did not have enough credits to receive benefits.

What is Social Security looking for?

The bar to receive disability benefits is high. Unlike worker’s compensation or private insurance, Social Security Disability does not pay benefits to individuals who are partially disabled. One must be totally disabled, unable to do their past job as well as pretty much any other job in the U.S. economy. Social Security Disability has a strict definition of disability which reads, per the Code of Federal Regulations:

“The law defines disability as the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. To meet this definition, you must have a severe impairment(s) that makes you unable to do your past relevant work or any other substantial gainful work that exists in the national economy.”

Can I appeal if I am turned down and what are my chances?

You can absolutely appeal a decision and millions of people do. You can first appeal to DDS for something called reconsideration, in which an applicant has their entire record looked at again, sometimes with added medical information. If you’re turned down again, you can request a hearing before an administrative law judge, or ALJ. That process can take months. The wait for a hearing ranges from six to 16 months, depending on where the hearing office is, with the average being just less than a year.

Nationally, the odds of getting one’s claim approved at the ALJ level are about 52%, just better than half. But those numbers are deceiving. Much depends on the judge you get, with some approving 70% to 80% of cases, while others deny 70% to 80%. If you fail at the ALJ level, you can then appeal to the Appeals Council in Falls Church, Virginia, which considers if the administrative law judge possibly made a mistake. The Appeals Council can approve a case outright, which rarely happens, or can send the case back to the ALJ for another hearing.

As you can tell, this entire process can take years. If the Appeals Council rejects a claim, applicants then have the right to sue the Social Security Administration for benefits in federal court. Thousands of federal cases are filed annually, including 13,000 just last year.

Do I need an attorney?

Ideally, no, but trying to get disability can be a struggle. The practical reality is that an attorney that practices in the specialized area of Social Security law is often recommended to make sure that an applicant, from the beginning, has the paperwork they need and is following all the right steps. The attorney will also represent the client through what can be a years-long appeals process.

Most reputable Social Security disability attorneys work on contingency, meaning they do not get paid up front or charge retainers. They typically only get paid if they are able to obtain benefits for their client, and receive a percentage of those benefits in return.

Have issues with getting Social Security disability?

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