You may qualify for Social Security Disability Benefits if:
- You can’t work due to a medical problem or serious injury, and
- You have worked long enough and paid enough work credits into the Social Security trust fund
Our law firm can help you:
- Improve your chances of getting benefits
- Get the maximum benefits you are due
- Obtain medical records
- Complete your application and supporting documents
- File your Appeal if you get denied benefits
- Prepare for and attend any hearings
What is the difference between Social Security Disability (SSDI) and Supplemental Security Income (SSI)?
- The Social Security Disability Insurance (SSDI) program pays monthly benefits to you and certain family members if you have worked long enough to earn sufficient work credits and paid Social sufficient Security taxes.
- Supplemental Security Income (SSI) is a Federal income supplement program which is designed to help aged, blind, and disabled people, who have limited income and resources provide for basic necessities such as food, clothing, and shelter. Click here to access the Benefit Eligible Screening Tool to determine if you qualify for SSI benefits.
- The biggest difference between SSDI and SSI is that SSDI is available to workers who have accumulated a sufficient number of work credits which is paid through social security taxes deducted from their paychecks, while SSI disability benefits are available to low-income individuals who have either never worked or who haven’t earned enough work credits to qualify for SSDI.
Disability Process Stages
1. Initial Application
The process of applying for Social Security Disability benefits, starts with you filing claim with the Social Security Administration. This can be done by visiting the local office, by phone or online. Each method has benefits. Applying online or by phone may be more convenient and allow you to avoid waiting for an appointment at the disability office. By applying online, you can start your application and save your progress if you want to take a break and finish the application later without starting over. The average time frame for a decision on your initial application is approximately 3-5 months. While the initial approval rating is below 50%, this should not mean you are not entitled to benefits. There can be many reasons why you are not initially approved. You may have a legitimate claim for disability benefits, but insufficient medical documentation to prove your condition, or that the condition is expected to last at least a year. Whatever the reason, don’t give up if your medical condition and symptoms are severe enough to prevent you from working.
2. Request For Reconsideration
If you get denied on a reconsideration, you need to immediately file a request for hearing, which is the second stage of the process. Just because you receive a denial letter, it doesn’t mean you are not disabled. Many people get frustrated and give up. Don’t let that be you. The deadline to file this appeal is 60 days of getting the denial of your initial application. Don’t waste time. Get your paperwork filed immediately.
3. Administrative Hearing
This third step involves requesting a hearing before an Administrative Law Judge. In most social security cases, this will be your only opportunity to meet face to face with the person who will decide if you are disabled. You will be able to explain your case and give testimony about your medical conditions. You will be allowed to provide live testimony at the hearing, including witnesses who can provide information about your medical conditions and their effect on your ability to work and/or complete everyday work tasks.
If you don’t have an attorney by this point, get one. It doesn’t guarantee approval, but helps your chances at this critical stage in the disability process, where many cases that were initially denied are approved at this stage.
It may take up to 24 months or more to get from the initial application to a hearing before an Administrative Law Judge, so it is important that you don’t miss a step.
4. Appeals Council
If you are denied or disagree with the hearing decision, you may ask for a review by Social Security’s Appeals Council.
The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an administrative law judge for further review.
Because the Appeals Council reviews cases for several different states, it can take up to 18 months or more to get a decision from their office.
5. Federal Court
If you disagree with the Appeals Council’s decision or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court. Once in District Court you can continue to appeal the case all the way up to the Supreme Court, which is an extremely lengthy process of up to 3 years or more. Most people can’t wait that long for benefits to start and will often start a new application.
What can we do to help you?
The Social Security Disability application process is very long and complicated. If you are suffering from a physical or mental condition, the wait can be excruciating. With family depending on you, this long process can add to your family stress and financial hardship. You and your family need the back pay and monthly benefits paid by Social Security, and these are benefits you have earned through years of hard work.
Considering how long this process takes and the toll that it can take on your life, don’t try to do it alone. And most importantly, don’t give up. There is no cost to you to see if we can help and help is just a call or click away.
- Guide you through all steps of the Social Security Disability application process, including the Initial Disability Application, Reconsideration, Hearing Requests, and Appeals
- Focus on your case and make sure that any information that supports your claim is provide, file you paperwork quickly
- Obtain copies of all medical records and help you find referrals for first and second medical opinions
- Help develop the best legal argument for your case following the regulations and guidelines regarding disability eligibility requirements
- Prepare your case for hearings, including a Pre-hearing Brief for the Administrative Hearing to help increase you chances of winning Social Security Disability
- Provide legal advice and counsel throughout the process, answering any questions you may have, while helping you fight for your benefits.
Ways to Win Your Case
Below are 3 very important ways to prove your eligibility for Social Security Disability benefits. Proving one of these methods makes you eligible for benefits.
1. You may win by proving a condition on the SSA Listing
The Social Security Administration has Impairment Listings which describe, for each major body system, impairments or medical conditions that are considered severe enough to prevent an individual from doing any gainful activity (or in the case of children under age 18 applying for SSI, severe enough to cause marked and severe functional limitations). Most of the listed impairments are permanent or expected to result in death, or the listing includes a specific statement of duration is made. If you have one of these impairments, you are eligible for disability benefits under the Social Security guidelines. For all other listings, you must show that your impairment has lasted or is expected to last for a continuous period of at least 12 months. These criteria apply to the Social Security Administration’s evaluation of claims for disability benefits.
Part A of the Listing of Impairments (included on this site to the right) contains medical criteria that apply to the evaluation of impairments in adults age 18 and over.
The Listing of Impairments criteria apply to one step of the multi-step sequential evaluation process. At that step, the presence of an impairment that meets the criteria in the Listing of Impairments (or that is of equal severity) is usually sufficient to establish that an individual who is not working is disabled.
The lack of a listing-level impairment does not mean the individual is not disabled. Rather, it requires the adjudicator to move on to the next step of the process and apply other rules in order to resolve the issue of disability.
2. You may win by proving Limited Capacity to Function
hinders or reduces your capacity for work. The Social Security Administration refers to this as “residual functional capacity.” Residual means that which is left over. Functional refers to your ability to perform in a work or work like environment. Capacity describes your ability to perform in a competitive work environment. So, if your residual functional capacity is less than sedentary, it means that you do not have the ability to perform even a simple, sit down, unskilled job 8 hours a day, 5 days a week.
If you have medical records and physician opinion evidence sufficient to prove that your residual functional capacity is less than sedentary, you are eligible for disability benefits. Judges give medical opinion evidence (especially if the physician has been treating the claimant on a long term basis) lot of weight if it supported by the medical records history.
A residual functional capacity evaluation form or RFC can be completed by your medical for use with your disability application. Your doctor will be asked to comment about your exertional capacity and your non- exertional limitations. Exertional capacity has to do with your physical abilities – things like standing, walking, lifting and carrying. Non-exertional impair- ments have more to do with things like pain, endurance and concentration. You can download a RFC form from this site for completion by your medical care providers. This form can also be customized and amended for you as needed.
3. Prove a “Grid Rule”
This involves the effect of age and education on your ability to work.
The third way to win your disability case is by proving that you meet the “grid rules,” as they are referred to by the Social Security Administration. These rules apply when you are 50 or older and have a physical type of impairment. These rules do not apply to claimants with non-physical impairments like depression or pain.
The grid rules take into account your age, education, work skills and physical capacity for work. You can line up each of these elements on the grid chart to determine whether you meet one of the rules and thereby qualify automatically. SSA recognizes by use of these “grid rules” that workers who are older and less education will have a harder time finding an entry level job. Realistically, fewer jobs are offered to workers over 50, even if those jobs are simple and unskilled.
Workers between the ages of 18-49 are considered to be younger individuals. Workers between the ages of 50-54 are considered closing approaching advanced age. Workers over 55 are considered by Social Security to be in advanced age.
Sedentary: Sedentary work means that you are able to sit for up to 6 hours in an 8 hour day, and lift up to 10 lbs. occasionally during a day
Light: Light work means that you can stand and walk for up to 6 hours in an 8 hour day, lift 10 lbs. frequently and 20 lbs. occasionally
Medium: Medium work means that you can stand and walk for up to 6 hours in an 8 hour day, lift 25 lbs. frequently and 50 lbs. occasionally
For example: Grid rule 201.01 provides that a worker between the ages of 50 and 54, with limited or less than a high school education whose has no transferable work skills or performed unskilled work will be considered disabled.
The older a worker becomes, the more Social Security accepts that simple, entry level work really does not exist in significant numbers in our economy to consider that the worker is able to find work.
Click on the link to see the grid rules. Use of the grid rules may be beyond the knowledge of the average disability claimant. Therefore, it is very important to seek information about any element that may help prove your eligibility for Social Security Disability benefits and win your case.
Social Security Disability Benefits FAQs
Step One -The first step involves determining if you are working. The amount of money you make if you are working is limited. If you make more than allowed, you will not be considered disabled. (See Publication No. 05-10003 for current figure Update )
Step Two – The second step is to consider the severity of your medical condition(s) if you make less than the current guideline amount. This involves determining whether your medical condition(s) significantly affect you ability to perform basic work activities, i.e. sitting, standing, walking, for at least one year.
Step Three – If the condition is severe enough to limit basic work functions, the agency will determine if the medical condition(s) are on a List of Impairments for adults and children developed by the agency. The impairments described are considered so severe by the agency that you can automatically be defined by law as disabled. If your condition is not on the list, the agency can determine that you are disabled if your condition(s) are as severe as those on the list of impairments.
Step Four – If your medical condition(s) are not on the list of impairments or meet or exceed the severity of an impairment on the list, the agency will then consider whether you medical condition(s) prevent you from doing the type of work you did before.
Step Five – If the agency decides that you can do the type of work you did before, then it will decide you are not disabled. If not, then the agency will evaluate your medical condition(s), age, education, past work experience and skills learned from that work, to determine if you can do any other type of work. If you can, then the agency will decide that you are not disabled.
Your spouse, if he or she is 62 or older; Your spouse, at any age if he or she is caring for a child of yours who is younger than age 16 or disabled; Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be under age 18 or under age 19 if in elementary or secondary school full time; and Your unmarried child, age 18 or older, if he or she has a disability that started before age 22. (The child’s disability also must meet the definition of disability for adults.)