Applying for disability benefits can be a crucial step for individuals facing health challenges that impact their ability to work. Navigating the application process involves understanding eligibility criteria, gathering necessary documentation, and presenting a compelling case. 

Let’s explore the essential steps in seeking disability benefits and the support available to make this process more manageable.

Phase 1: Applying For Disability Benefits

Not everyone contending with a health condition qualifies for disability benefits. To be deemed a disability by the government, your condition must be linked to a diagnosed illness or injury, endure for at least 12 months (or lead to death), and hinder your ability to work in your current job or other occupations. 

Certain conditions, such as terminal cancer, Chronic Heart Failure, Parkinson’s, Blindness, and Dementia, are classified as “listing-level conditions,” expediting the disability application process for those facing these severe health challenges.

Phase 2: Which program to apply for

The majority of individuals will fall under one of two government programs: Supplemental Security Income or Social Security Disability Insurance. SSDI hinges on your employment history, and your earnings determine the payouts. In contrast, SSI payouts are less substantial and carry more restrictions. For further details on both programs, refer to our Disability Claims 101 guide.

Phase 3: Gather documentation and medical evidence

Review the application thoroughly and identify the necessary paperwork, records, and documentation required by the SSA to substantiate your disability claim. It’s essential to have all these materials prepared before submitting your application. 

The SSA may request documents such as medical records, educational records, work history, your doctor’s contact information, and financial details. Maintaining a symptom diary and asking your doctor to include your entries in your medical records can serve as valuable documentation during the later stages of the process.

Phase 4: Fill out the application form accurately and submit

The application forms for SSI and SSDI are extensive, often spanning over 30 pages and requiring hours to complete. Being thoroughly prepared with all the necessary information and materials before starting the application is crucial. 

An attorney can assist in ensuring the forms are filled out correctly, adding to the benefits of having legal assistance early in the application process. You can submit your application through the SSA website, in person, or over the phone.

Phase 5: Provide additional information

After submitting your application, the SSA may request additional evidence or documentation to gain a deeper understanding of your situation. Don’t be alarmed; this is a standard process part. Collect and submit the requested information diligently, which may involve providing more records and documents. The SSA might also ask for an examination with one of their medical experts.

Phase 6: Wait for the SSA’s decision

Hooray! Your application is now complete. Now, it’s time to patiently await the SSA’s decision and be prepared to navigate the hearings and appeals process if your application isn’t initially approved.

Some Essential Tips For Medical Examination By The SSA

Facing a medical examination can be stress-free if you remember a few tips. 

  • When discussing your symptoms, focus on how they typically feel on most days rather than your current state. 
  • If necessary, guide the doctor to ask pertinent questions by reminding them of the purpose of the examination. 
  • For instance, if your condition is mental, clarify if they primarily conduct a physical exam. 
  • Lastly, review your medical record after the exam to ensure your reported information is accurately documented.

Hearings and Appeals Procedure

Receive your decision:

Request reconsideration:

  • If you lose, you can appeal the denial by requesting reconsideration.
  • It is critical to appeal within 60 days of receiving the denial letter.
  • Often, it results in another denial, moving the case to the next stage.

Hearing:

  • If your reconsideration is denied, you can request a hearing with a judge.
  • The request must be made within 60 days of the second denial during reconsideration.
  • In the hearing, you submit additional evidence, speak to the judge, and cross-examine government experts.
  • Approximately 50% of people win at this stage.
  • Scheduling a hearing can take 1-2 years.

Appeal:

  • If you lose at the hearing stage, further appeals are possible.
  • The process may involve multiple stages of appeal.

Get approved — and get paid!:

  • If you win your case at any stage, you receive retroactive benefits for the time you should have been getting benefits.
  • These back payments provide financial support for the period your application was under review.
  • This phase is crucial; working with a lawyer increases the likelihood of success.

How Can A Disability Lawyer Help You?

A Social Security disability lawyer plays a crucial role in hearings and appeals by gathering evidence. They compile all relevant medical and supporting evidence for a strong case. Moreover, they will understand the intricate legal processes, improving your chances of success in the appeals phase.