How do I Obtain Social Security Disability Benefits?
File an Initial application online, on the telephone or in person at your local Social Security office. The Social Security Administration's website is found at www.ssa.gov.
What can I do if the Social Security Administration denies my initial claim?
Appeal your denial within 60 days. There are many reasons why an initial disability claim gets denied, and many denials have little to do with the merit of your claim. Sometimes there is no logical reason for a denied claim. Try not to get discouraged by the denial of your application for disability benefits.
By appealing, you will ultimately have a hearing with a U.S. Administrative Law Judge (ALJ). The hearing level is your best chance to have your claim for disability benefits granted.
A common mistake made by disability applicants is that, instead of appealing a denied claim, they reapply later. Then they are denied again. You should not make that mistake! Improve your chances of receiving benefits by appealing your denied claim, rather than reapplying for benefits later.
How long should I expect to wait for a hearing?
Unfortunately, a hearing by administrative law judge takes at least a year in most parts of the country. That time begins on the day you request a hearing by ALJ. There is not much that can be done to speed up the hearing process in most cases. However, there are "critical case" exceptions to the rule.
A critical case request asks Social Security to expedite a claim at the hearing level. Critical cases get priority because they are the most serious claims. There are three situations that constitute critical cases: 1) the claimant's illness is terminal, 2) there is an indication that the claimant is suicidal or homicidal, and 3) dire need.
How does the Social Security Administration evaluate disability claims?
The Social Security Administration uses a 5-step sequential evaluation process to determine whether or not you will receive disability benefits. Knowledge of the 5-step sequential evaluation is critical to assessing the merit of your Social Security disability claim.
Step 1: Are You Working?
Step 1 determines if a person is "working", according to the Social Security Administration definition. The work must be "substantial gainful activity," which is currently $1,000 a month as an employee. Earning that amount is enough for disqualification from receiving Social Security disability benefits. The judge will simply stop the inquiry at this step, and will not consider you impairments. If you are working at the SGA level, you are not disabled under Social Security's rules.
Step 2: Is Your Condition Severe?
Step 2 evaluates whether your medical condition is severe enough to significantly limit your ability to perform basic work activities. In addition, the impairment must last, or be expected to last, for a continuous period of not less than 12 months or result in death.
Step 3: Is Your Condition A Listed Impairment?
Step 3 asks if the impairment meets or equals a medical "listing." The Social Security Administration uses more than 150 categories of medical conditions, called "listings." These conditions are deemed to be severe enough to preclude a person from working. If you "meet or equal a listing" you will be granted benefits. If you do not meet a listing, the SSA proceeds to Step 4.
Step 4: Can You Do Work You Did Previously?
Step 4 explores your ability to perform your past relevant work, despite your physical or mental impairments. If the Social Security Administration finds that you can still perform this past relevant work, benefits are denied. Social Security considers the past work both as you performed it, and as it generally performed in the national economy.
It does not matter at step 4 if your former employer would not hire you, or if the place where you worked is no longer in business, or if all those jobs are now done in China. All Social Security does at this step is match your physical and mental residual functional capacity with the requirements of your former job.
If you cannot perform your past relevant work, then the process proceeds to the fifth and final step.
Step 5: Can You Do Any Other Type Of Work?
Step 5 determines what other work, if any, the person can perform. Social Security considers your age, education, work experience and physical/mental condition to make this determination. If Social Security finds that you cannot make the transition to other work, you will be granted benefits.
Because Social Security considers your age at this step, there are special rules for claimants over the age of 50.
What is "Residual Functional Capacity"?
Disability is functionality. The judge will determine your residual functional capacity (RFC), which describes your work capacity that remains after the effects of your impairments are considered. Your Residual Functional Capacity (RFC) is the cornerstone of your Social Security disability claim. Unless you meet a listed impairment, the administration's assessment of your RFC will decide the outcome of your disability claim. The RFC is used to determine whether or not you can return to your past relevant work (step 4 of the sequential evaluation process) or do other work (step 5 of the sequential evaluation process).
The RFC is Social Security's assessment of your abilities to do sustained physical and mental activities on a regular and continuing basis in a work setting. The RFC considers only those functional limitations resulting from medically determinable impairments.
Should I continue with my regular medical treatment while waiting for my hearing?
Ongoing medical treatment is important both for the management of your health conditions and for your disability claim. Over time, the medical record of your impairments will become stronger, and will provide a better basis for a favorable disability determination. By the time your claim gets to a hearing by an administrative law judge, well over a year will have passed since your initial denial, and the medical picture is often much clearer by that time. One reason more claims are won at the hearing level is that there is often more complete medical evidence, including medical opinion evidence, by the time a hearing is held.
Be sure to tell your doctor about your symptoms, and how they affect your daily activities. Your doctor should enter these limitations into your treatment notes, so that it will be apparent to the judge reviewing your medical records that you are experiencing significant functional limitations.
Do I need an attorney to assist me with my Social Security Disability claim?
The most important quality that a lawyer offers is perspective and judgment about the weaknesses and strengths of your claim. This judgment comes from experience, knowledge, and seeing how the judge reacts to a particular claimant and particular medical evidence. There are several ways that a disability lawyer helps you:
1. Develops a winning theory for your claim. The most important task for a lawyer is to develop a winning theory for your claim. Based upon your impairments, work history, age, education, and the Social Security disability evaluation process, a lawyer will seek the legal path that leads to an award of benefits.
2. Obtains the necessary evidence. The key to winning a Social Security disability claim is proper development and presentation of medical evidence demonstrating disability.
3. Helps you tell your story. Every disability claim has a unique story. Each person reaches the point of being unable to work in a different way. Your personal story about your struggle with your medical condition is often the most powerful evidence at the hearing for your disability claim.
4. Represents you at the hearing. A lawyer will represent you at the administrative hearing, and explain to the judge why your impairments prevent you from sustained employment. Prior to your hearing, a lawyer will explain the issues that are important to your claim, and will prepare you for your hearing testimony. Each administrative law judge conducts a hearing a little bit differently, and you should hire a lawyer who is familiar with the judges in your state.
5. Ensures that you are paid correctly. When your claim is approved, having a lawyer can ensure that you are paid correctly by the Social Security Administration.
6. Acts as your guide. Applying for Social Security disability benefits can be difficult and frustrating. An experienced disability attorney can be your guide throughout the process, and can help you to understand Social Security's unique administrative procedures.
7. Lastly, it does not cost one penny to hire an attorney to help you right away. Attorney fees for a Social Security disability or SSI claim are contingent on winning the claim. That means that you pay a fee only if you win, and when you are awarded benefits. You pay no fee if your claim is denied. The attorney fee is 25% of the retroactive benefits awarded in your claim. Attorney fees for Social Security claims are regulated by the Social Security Administration. The SSA must approve any fee that is charged in a Social Security case. Further, the fee is subject to a "cap" imposed by Social Security. The current fee cap is $6,000 for fees awarded at the administrative level. As a result, the fee is 25% of the back benefits or $6,000 - whichever is less. The ongoing benefits you receive are not subject to any attorney fee.
