- How To Apply For Social Security Disability Benefits
- What Is The Difference Between Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)?
- Who Can Apply For Social Security Disability Benefits?
- 3 Ways To Apply For Social Security Disability Benefits?
- Documents Needed To Apply For Social Security Disability
- Next Steps After You Apply For Disability
- How The Social Security Disability Process Works
- 1. Your Application Goes To A Disability Examiner
- 2. Disability Examiner Contacts Your Doctors And Past Employers
- 3. You May Have To Complete A Daily Living Questionnaire
- 4. An Initial Claim Is Made
- 5. Your Disability Application Goes To The Office of Disability Adjudication and Review
- 6. Your Disability Hearing
- How Long Does It Take To Get Disability Benefits?
- How To Expedite Your Social Security Disability Claim
- Appealing A Social Security Disability Denial
- 4 Steps Of The Social Security Appeals Process
How To Apply For Social Security Disability Benefits
Social Security disability benefits are monthly payments to individuals who qualify based on a disability that limits their ability to work.
These monthly payments are crucial to the health and well-being of many Americans because for some it is the only income they receive.
If you have an injury or illness that is preventing you from working and you’ve considered applying for disability benefits this guide will teach you some of the basics of this process. In addition to explaining how to apply for benefits you will also learn:
- The difference between SSI and SSDI
- Who is encouraged to apply for disability
- The 3 ways to apply for Social Security benefits
- Documents needed to apply
- The 6 step process of a disability claim
- How long it takes to get disability benefits
- How you can expedite your Social Security claim
- 240 medical conditions that Social Security has a history of approving
- The cost of hiring a disability lawyer
- What to do if you are denied disability
As you can see, there is so much to discuss so let’s start the discussion!
What Is The Difference Between Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)?
Supplemental Security Income (SSI) and Social Security Disability Insurance are similar in the fact that they are federal programs that provide a monthly income to individuals who have a disability. Outside of this fact, these federal programs differ in 3 main ways.
1. The Ways You Qualify For SSI and SSDI Differ
To receive the Supplemental Security Income benefit you must qualify based on your age, being blind or disabled. The attained age to receive an SSI check is 65 years old. You can also qualify based on a combination of you having a disability and having little to no work history in the past.
To qualify for Social Security Disability you must have a history of paying into the Social Security system for at least 10 years and have a medical condition or disability that prevents you from working.
The main difference in how you qualify for SSI and SSDI comes down to…
SSI is for individuals who are considered low-income, with limited work history, and they now have a disability.
SSDI is for individuals who have an extensive work history, have paid into the Social Security system for at least 10 years, and also now have a disability.
2. TYPICALLY…SSI Beneficiaries Receive Medicaid While Those With SSDI Have Medicare
An easy way to tell if someone under 65 years old is receiving SSI vs SSDI benefits is to look at their government health insurance plan.
If someone under 65 years old is receiving Medicaid this is a sign that they may be considered to have a low-income therefore they would likely have Supplemental Security Income benefits.
Anyone under the age of 65 who has Medicare benefits likely has it because they have received Social Security Disability benefits for at least two years.
Editor’s note: After receiving SSDI benefits for 2 years you will qualify for Medicare benefits.
3. The Monthly Incomes Of SSI And SSDI Are Different
The last way that SSI and SSDI benefits differ is the amount of money a recipient receives each month. Let’s start with how much the standard SSI check is.
In 2020, SSI beneficiaries received a monthly amount of $783 per month. Compare that with the average SSDI payment of $1,258 per month.
Your standard SSDI check is typically more than that of an SSI check because it is based on your earnings. Essentially the more money that you paid into the Social Security system over the years will result in a greater SSDI check.
Who Can Apply For Social Security Disability Benefits?
Applying for disability can be a lengthy process which it is best to confirm that you are eligible before spending starting the process. If you meet each of the following below then you could potentially qualify for disability benefits:
- 18 years or older.
- You are not currently receiving Social Security benefits.
- You cannot work due to a medical condition that is expected to last for at least 12 months or result in death.
- Have not been denied Social Security disability benefits in the past 60 days. If this is your situation you will need to request an appeal.
3 Ways To Apply For Social Security Disability Benefits?
No matter which method you choose, when applying for disability benefits you must go through the Social Security Administration. Below you will find 3 ways to apply for disability benefits :
- Apply online at the Social Security website.
- Call the Social Security Administration phone number at 800.772.1213.
- Visit a local Social Security office to apply for benefits.
Editor’s note: The Social Security Administration states that applying online is the most convenient way to apply for disability. To learn more about the process of applying online refer to their 7 paged pdf that explains How To Apply Online For Disability Benefits.
Documents Needed To Apply For Social Security Disability
To apply for disability benefits you will need to provide the following documents:
- Birth certificate
- Proof of citizenship
- Documents related to military service, especially any discharge paperwork if you served in the military before 1968
- W-2 forms ore self-employment paperwork for the last year
- Worker’s compensation information, date of injury, claim number’s, etc
- Medical records like doctor’s reports, list of medical conditions, test results, and any evidence to prove your disability
- Names and dates of birth of children under 18 and the same information for your spouse
- Dates of any marriages and divorces
- Direct deposit information
- An emergency contact
- Medical release form SSA-827
Obtaining disability benefits will not be an easy win. It’s not enough to simply say you are disabled, because if it’s not on paper it does not count. For this reason, you want to provide as much evidence as you can to support your case. Don’t just assume that your disability hearing judge will understand and agree with you, convince them through your paperwork. I cannot stress this enough.
The checklist in this section is just a summary of the documents that you will need. Use the links below to educate yourself more about documents that you will need to apply for benefits:
- Adult Disability Interview Checklist
- Adult Disability Starter Kit
- SocialSecurity.gov Guide To Understanding Disability Benefits
You are encouraged to refer to the Social Security disability checklist to see specific details about the information mentioned above.
Next Steps After You Apply For Disability
After applying for disability benefits you can expect to receive confirmation that they received your application via email or mail. The Social Security Administration will review your application and follow up with you if more documentation is needed.
How The Social Security Disability Process Works
As I have mentioned before, applying for Social Security disability and be a lengthy process. In this section, we will talk about that process, and each step that goes into determining whether your application is approved or denied.
- Your application goes to a disability examiner
- The disability examiner contacts your doctors and past employers
- You complete a daily living questionnaire
- An initial claim is made
- Your disability application is sent to an ODAR
- Attend your disability hearing
Next, we will go into the specifics of each.
1. Your Application Goes To A Disability Examiner
The very first step is sending your application to a disability examiner in your state. This examiner is also known as Disability Determination Services (DDS).
During this process, you will be assigned a disability examiner. Their job is to collect information from you that is relevant to your case and make an initial determination about your disability case.
2. Disability Examiner Contacts Your Doctors And Past Employers
Your disability examiner will speak to your doctors and employers to learn more about your medical and work history. During this process, Disability Determination Services may also request you to do a consultative examination (CE) which is essentially a short physical or mental exam.
3. You May Have To Complete A Daily Living Questionnaire
The examiner wants to know how your current medical condition impacts your daily living activities. Your daily living activities consist of things like:
- Grooming, bathing, hair care
- Continence management
- Dressing yourself
- Manage your medications
- Manage your money
- Prepare meals
4. An Initial Claim Is Made
Your disability examiner decides what type of activities you can and cannot perform despite your medical condition.
5. Your Disability Application Goes To The Office of Disability Adjudication and Review
The Office of Disability Adjudication and Review (ODAR) does two things which are schedule and hold disability hearings.
One major reason why the disability process can take so long is waiting on a hearing with an ODAR. The limited number of judges and ODAR offices play a huge role in why it takes a long time to receive your disability benefits.
Editor’s note: If you visit the website Disability Judges, you can see a listing of judges available at each ODAR office. In addtion this site also provides information on how long it takes to receiving a hearing, % of cases approved and those that are denied.
6. Your Disability Hearing
You will be scheduled for a hearing where an ALJ or administrative law judge will review the facts and evidence of your disability claim and then make a determination.
The ALJ will come to a decision based on factors like:
- What kind of health problems you have?
- How severe your medical problems are?
- In what ways your medical conditions limit you?
- How these limit your ability to work their pas job and sustain any other forms of work?
The video below will provide you with a basic understanding of what happens during a hearing with an ALJ. Watch it to prepare yourself for any upcoming disability hearings you may have.
How Long Does It Take To Get Disability Benefits?
According to the Social Security website, it typically takes 3 to 5 months to receive a decision on your disability.
That being said, the 3 to 5 month estimate is not an established timeframe. In fact, the Social Security Administration does not have a deadline for making a decision. For this reason, the actual time it takes to receive a determination on your disability is 6 months to 2 years.
If this timeframe is too long to wait there are two ways to expedite your Social Security claim that we will discuss in the next section.
How To Expedite Your Social Security Disability Claim
There are two ways to have your Social Security disability claim expedited and they include having a terminal illness or having a condition on the Compassionate Allowance List (CAL).
If you have a terminal illness the Social Security Administration could faster track your disability claim.
Social Security’s Compassionate Allowance List (CAL)
Another way to have your disability claim expedited is by having a medical condition that is on the Compassionate Allowance List (CAL). Currently, there are about 240 medical conditions on that list.
Compassionate Allowances Conditions (CAL)
Adult non-Hodgkin Lymphoma
Adult Onset Huntington Disease
Alexander Disease (ALX) Neonatal and Infantile
Allan Herndon Dudley Syndrome
Alpha Mannosidosis Type II and III
ALS and Parkinsonism Dementia Complex
Alveolar Soft Part Sarcoma
Amyotrophic Lateral Sclerosis (ALS)
Anaplastic Adrenal Cancer - Adult with distant metastases or inoperable, unresectable or recurrent
Astocytoma Grade III and IV
Atypical Teratoid Rhabdoid Tumor
Beta Thalassemia Major
Bilateral Optic Atrophy Infantile
Bladder Cancer - with distant metastases or inoperable or unresectable
Breast cancer - with distant metastases or inoperable or unresectable
CACH - Vanishing White Matter Disease - Infantile and Childhood Onset Forms
Carcinoma of Unknown Primary Site
Cardiac Amyloidosis - AL Type
Caudal Regression Syndrome - Types 3 and 4
CDKL5 Deficiency Disorder
Cerebro Oculo Facio Skeletal (COFS) Syndrome
Child Lymphoblastic Lymphoma
Child Neuroblastoma - with distant metastases or recurrent
Chondrosarcoma - with multimodal therapy
Chronic Idiopathic Intestinal Pseudo Obstruction
Chronic Myelogenous Leukemia (CML) Blast Phase
Coffin Lowry Syndrome
Congenital Myotonic Dystrophy
Cornelia de Lange Syndrome - Classic Form
Creutzfeldt Jakob Disease (CJD) Adult
Cri du Chat Syndrome
Degos Disease Systemic
DeSanctis Cacchione Syndrome
Desmoplastic Small Round Cell Tumors
Early Onset Alzheimers Disease
Edwards Syndrome Trisomy 18
Endometrial Stromal Sarcoma
Ependymoblastoma (Child Brain Cancer)
Erdheim Chester Disease
Farber Disease (FD) - Infantile
Fatal Familial Insomnia
Fibrodysplasia Ossificans Progressiva
Follicular Dendritic Cell Sarcoma - metastatic or recurrent
Friedreichs Ataxia (FRDA)
Frontotemporal Dementia (FTD) , Picks Disease - Type A - Adult
Fucosidosis - Type 1
Fukuyama Congenital Muscular Dystrophy
Fulminant Giant Cell Myocarditis
Galactosialidosis - Early and late infantile types
Gaucher Disease Type 2.
Editor’s note: If you do not see your medical condition on the list above you can submit a new condition to the Social Security Administration for consideration.
The medical conditions on the Compassionate Allowance List are used to quickly identify applicants who clearly meet the standard for disability benefits. If you have a condition on this list be sure to provide medical documents as proof because this will help your case.
Get A Disability Lawyer
In 2018 the Social Security Administration approved roughly 20% of first-time applicants. This underscores the difficulty of getting approved for disability benefits. Because of this, you are encouraged to consult with a lawyer as soon as possible if you want to receive your benefits sooner.
An experienced lawyer will improve the chances of you being awarded disability benefits since they know exactly what documents and evidence is needed to satisfy the strict Social Security requirements.
The good thing about Social Security attorneys is that they only collect a fee if you win your disability claim.
What this means is that you pay nothing out of your pocket for a lawyer to represent you. If you do win, then your lawyer would be paid out of the backpay that you receive from Social Security. The fees that disability lawyers typically charge is 25% of your settlement, however, this amount cannot exceed $6,000.
Appealing A Social Security Disability Denial
All is not lost if your first attempt at getting disability benefits is denied. Remember only 20% of first-time applicants received their benefits in 2018.
If your case is denied you have 60 days from the day you receive your denial letter to file an appeal. It is important to appeal within those 60 days because if you miss this deadline you will have to start the process all over again. On top of that re-applying for disability benefits lowers your chances of being awarded Social Security.
Editor’s note: If you want to know how long it takes to have an appeal hearing the Disability Approval Guide website has an interactive map that provides a timeframe for each state. In my state of Texas, the wait time for an appeals hearing is about 10 months and there is a 41% approval and a 40% denial.
4 Steps Of The Social Security Appeals Process
If you have arrived at this point in the process it could be due to a disability examiner or a Social Security employed doctor not feeling that your medical condition was severe enough to award you benefits. When winning a Social Security appeal, sometimes all it takes is a new set of eyes on your case.
In this section, we will go over the 4 stages of a disability appeal. At any of the following stages your claim could be approved:
- Hearing with an administrative law judge
- Review by the appeals council
- Federal court review
Let’s first start with the reconsideration review.
Reconsideration is the first level of a disability appeal. This is essentially a second look at your disability claim to determine if the initial denial was the right or wrong decision.
You can start the reconsideration process by visiting the Social Security website’s Disability Appeal page.
During reconsideration, expect to repeat many of the same steps that you did during your initial application like:
- Having your Social Security disability application sent to DDS or disability determination services
- Another disability examiner reviewing your claim
- Providing medical records or participating in a consultative examination (CE)
The reason that many reconsideration cases are denied is that the reviews are performed by the same agency that denied your disability claim in the first place. Despite the low likelihood of your claim being approved in reconsideration, you should still apply, because the next stage of appeals (hearing with a judge) offers much better chances of approval.
2. Hearing With An Administrative Law Judge
If your claim was denied during reconsideration, a hearing with an administrative law judge provides another chance at being awarded disability benefits. At this level you are looking at a 40% chance that your disability claim is approved if you do not have a lawyer, however, your success rate jumps to 60% if your case is presented by a lawyer.
To start this process, you will have to visit the Social Security website and request a hearing. You have the option of scheduling a hearing with a judge at a hearing office or meeting with them online via video.
3. Appeals Council Review
If the administrative law judge denies your disability claim your next option is to request that an appeals council review your case.
At this stage the appeals council can do three things:
- Deny to review your case if they feel the administrative law judge made the correct ruling. Your next option would be a federal court review which we will talk about in the next section.
- Review your case and kick it back to the administrative law judge for another look.
- Approve your disability claim.
Like the previous two stages of appeals, you can visit the Social Security website to request an appeals council review.
4. Federal Court Review
The last stage in the appeals process is a federal court review. This is the only appeal that you can not start by visiting the Social Security website. Instead, you will have to file a civil suit in the judicial district where you live. You have 60 days to file your civil suit after you receive notice of the appeals council’s decision.
To locate a district court you can visit the United States Courts website and select the state that you live in to see the courts that are available to you.
I stated this earlier in this guide and I will say it again…
Applying for Social Security disability benefits will not be an easy win.
Social Security requires you to REALLY prove your case by showing medical documentation to support your claim, you need a good relationship with your doctors, being extremely organized is helpful, and so is hiring a Social Security attorney!
Even if you do all these things there is still a chance that you could be denied. If this happens, pick yourself up and try again because this happens to many people.
My last bit of advice is to study everything you can about how the process of applying for Social Security disability benefits works because the better you understand the process the greater chances of your claim being approved.
Nick Bryant is a Counselor with 11 years of experience working in community health. He enjoys concerts, walks with the doggo and wife, mocking Dallas Cowboy fans, and sharing community resources. Jump on the Houston Case Managers email list to receive weekly community resource guides delivered directly to your inbox.