When you’ve become ill or injured and are unable to work, applying for Social Security Disability Insurance (SSDI) should be high on your list of things to do. The process can seem daunting, and having your application rejected the first time you apply is practically par for the course.
Don’t give up hope. Here’s our guide to help you get started with the application process.
Starting your SSDI Claim
To begin your claim, you’ll need to contact the Social Security Administration (SSA), usually through a local office. There are three ways to reach the SSA to get started:
- In person. You usually do not need an appointment to be seen on a walk-in basis, but be sure to arrive early, because the wait is likely going to be long. You can also call ahead to schedule a visit.
- By telephone. The SSA phone queue can be lengthy, too, so try to call right when your local office opens.
- Over the Internet. This option is becoming more popular for self-guided applications, but you lose the benefit of speaking directly to an SSA representative during the process.
Once you’ve decided how you want to apply, you’ll need to gather all of the information and evidence that the SSA will want. Be prepared to fill out the following forms or supply supporting data for your…
- Disability report. This form is used to gather information about your disability. Be prepared to explain your medical condition and how it limits your ability to do the work that you were doing, or that you have done in the past.
- Work history report. The SSA will want to know about what kind of work you have performed in the past fifteen years. Be as detailed and specific as possible in the tasks that you performed, and the physical or mental effort needed. In order to have a successful application, you will need to demonstrate that not only are you unable to do the work at your last job, but also at every other job that you’ve had in the past.
- Supporting medical documentation. This is a critical part of your application, in which you provide information from what the SSA deems “acceptable medical sources” pertaining to your disability. This includes records from licensed physicians, psychologists, optometrists, podiatrists, or speech-language pathologists. The SSA also maintains a list of “other sources” that you may also use, such as chiropractors, naturopaths, educational personnel, welfare agency personnel, and other non-medical sources. You will want to include as much evidence to support your claim as possible.
After you’ve supplied the required information to the SSA by submitting your application, it’s time for the determination process. This process will likely take at least 90 days (three months), but bear in mind that if you are approved, you will likely be eligible for benefits that date back to the beginning of your disability.
The SSA’s Five-Step Evaluation Determination Process
The Social Security Administration now uses a simplified five-step process to determine who is eligible for disability benefits. Every application goes through the steps sequentially, and a determination of ineligibility at any step will halt the process and cause a denial. Here’s what happens during your evaluation:
- Financial screening. The SSA will determine whether you meet the “substantial gainful activity” (SGA) limit based on how much income you currently have, if any. If you exceed the SGA limit, your application will be denied.
- Severity of impairment. The SSA will then determine whether your impairment is considered severe enough to warrant continuing the evaluation process. If your condition is not considered severe, your application will be denied.
- Medical listing requirement. The SSA maintains the “blue book” of listed impairments which automatically qualify an applicant for benefits, but if your condition is not listed in the book, it’s not grounds for a denial—your application will proceed to step four for further analysis.
- Capacity for past work. The SSA will look at whether you have the capacity to do any of the work that you have done in the past. If so, your application will be denied.
- Capacity for any work. The SSA will look at factors such as your prior experience, education, or training to determine whether or not you are capable of performing any other work. If so, your application will be denied.
If your application is denied at any step of the process, it’s not necessarily the end of the line. You can ask for a reconsideration, during which your application will be re-evaluated from top to bottom by someone new. You may also submit more evidence to support your claim.
If reconsideration fails, the next step is to ask for a hearing. Unless the situation is able to be filed as a critical case for time-sensitive issues such as homelessness or lack of medical care, a hearing could take up to a year. You will need to appear before an administrative law judge, and you may call witnesses or present additional evidence.
Get Legal Help After Your SSDI Claim Denial
First-round denial of a Social Security disability claim can be frustrating, but it’s extremely common. To maximize your chances of a successful claim in as little time as possible, it’s wise to consider hiring either a Social Security attorney or an SSA-certified advocate who can help you. A representative can guide you through appeals process and help you build the best case possible for your hearing.
If your application has been denied and you’re not sure what to do next or would like professional help with your appeal, Wayne Wright LLP would like to hear from you. Our experienced team of lawyers, advocates, and support staff will bring a wide range of talents to bear, tailored to the specifics of your case. Contact us today at 800-237-3334 for a free case evaluation.