Understanding the Application Process for Social Security Disability Benefits
The Social Security Administration is a branch of the U.S. federal government that provides disability benefits to people who cannot work due to long-term disability.
The benefits are paid through 2 programs: Social Security disability insurance (SSDI), which pays benefits to people with disabilities who have worked long enough, and Supplemental Security Income (SSI), which provides benefits based on financial need. Applying to either program requires you to make a claim by filling out an application and providing the necessary documentation.
It can be a complicated process, so here are some things to keep in mind.
Apply as soon as possible
It is important to start your application as soon as possible so you do not lose benefits. Social Security will not pay benefits for time periods earlier than the effective date of your application, so it is best to get started as soon as you can.
You can apply online, by phone, or in-person
If you are applying for SSDI, you can apply online. This method allows you to complete the application in the comfort of your own home and on your own schedule. You can even save your application and come back to it later. Unfortunately, you cannot apply for SSI online. And, even if you are applying for SSDI, you may still want to apply in person so you can have the opportunity to ask any questions you may have.
To apply in person it is best to make an appointment by calling the toll-free number 1-800-772-1213. Getting through to Social Security on the phone can sometimes be a challenge, so it may be helpful to try calling first thing in the morning. Once you get through, you can make an appointment to visit your local Social Security office in-person or to be interviewed over the phone, whichever option is more convenient for you. Once you make an appointment, you will be mailed application materials.
Gather all the paperwork before your appointment
Before your appointment, make sure to have all the required documentation ready. Make copies of everything – 1 for your application and 1 to keep in your files – in case anything gets lost in the process. The documents you should have ready include:
- Your Social Security number
- Your birth certificate
- Contact information (names, addresses, and phone numbers) for doctors, caseworkers, therapists, hospitals, and clinics where you have been treated
- Names and dosages of all the medicines you take
- Medical records and lab results
- Dates you were seen, tested, and/or treated for your condition
- A copy of your most recent W-2 (or most recent tax return if you are self-employed)
- A summary of where you worked and what kind of work you did, including the dates you started and ended your employment, and the tasks you performed in each position
Check to see if your condition is listed
Social Security maintains a listing of medical impairments, often referred to as the “Blue Book” or “Listing of Impairments.” This list is divided into both adult and childhood impairments and includes specific criteria for each type of condition.
Meeting the criteria specified for your condition does not guarantee that you will be awarded benefits. However, if your medical condition does happen to be listed, it should help you determine the type of information you will need to help support your claim. If your medical condition is not listed, the reviewer will have to determine if you have an impairment that is equivalent to one that is listed in terms of medical severity.
Remember what you are trying to prove
Keep in mind that Social Security has a very strict definition of long-term disability. To qualify for benefits, you need to prove that you have a severe, medically proven impairment that limits your functioning to the point where you are unable to work. This includes the type of work you did previously and any other type of work.
If the reviewer believes there is other less physically or mentally demanding work that you would be capable of performing, your claim will be denied. The only exception to this rule is that Social Security regulations may not expect those over 50 to be able to adjust to new work, depending on your education and previous training.
Let your doctor(s) know early in the process
A disability claims examiner will likely need to be in contact with your doctor(s) to verify the medical issues in your claim. For this reason, it is important to try to make sure your doctors are willing to cooperate.
Try to inform your doctor(s) in advance that you are planning to file a claim for disability benefits and ask if there is anything you can do to make it easier for them to meet their requirements.
Remember your rights
Applying for disability benefits can sometimes be an overwhelming process, so keep in mind that you have several rights:
- You have the right to representation by a lawyer of your choice whenever you do business with Social Security. It is especially recommended that you seek legal advice if your initial claim is denied and you decide to appeal.
- You have a right to be notified in writing about any decision regarding your application. A copy will also be sent to your lawyer if you have one.
- You and your lawyer have a right to examine or get a copy of all the information in your case file
- You have the right to appeal if you do not agree with the determination made about your eligibility or benefit amount
Be patient, and follow up if necessary
How long a Social Security application takes to process depends on many factors, such as how many cases a reviewer has and how long it takes a reviewer to gather the necessary information.
You can help speed up the process by providing all of your own medical records instead of relying on the reviewer to contact your doctor. Still, there is really no way to know if your claim will be processed in a month or whether it will take several months.
If you need to follow-up on your claim, start by calling your state’s Disability Determination Services (DDS) office. Although you file your application through the Social Security office, it is DDS that will make the initial disability decision on your application.
Can you exercise with your PsA symptoms?