The Social Security Disability Process
If you suffer from an injury or illness and cannot work, and your prospects for returning to work are not good, you may have considered seeking benefits through the Social Security Administration. Here’s an overview of how that process works:
Qualifying for Social Security Disability Insurance (SSDI) Benefits
To be eligible for SSDI benefits, you must be unable to work for at least 12 months, due to injury or illness. You must also have either been out of work for 12 months OR have a disability that is EXPECTED to keep you out of work for 12 months or longer. In addition, because SSDI benefits are paid from Social Security taxes, you must have earned Social Security credits in at least five of the last 10 years before your disability. This means that you must have earned income on which you paid a FICA tax.
It is also important to keep in mind that 84% of the initial SSDI applications are denied.
Filing for Social Security Disability Insurance Benefits
You initiate the process by filing an application for benefits with the Social Security Administration. Employees of the SSA will obtain medical information to verify that your condition will keep you from working, and will also determine whether you have enough qualifying credits to entitle you to payments. If your application is approved, you will receive monthly cash payments based on your prior income. The more you have paid into the FICA system in the past 10 years, the higher your payments will be. In addition, after two years, you will be entitled to health insurance benefits under Medicare, regardless of your age.
If your initial application is denied, you can still appeal the decision. Some estimates indicate that as many as half of all initial SSDI applications are denied.
As soon as your claim is denied, you want to begin the appeal process. The first step is a Request for Reconsideration, filed with the Social Security Administration. This is an informal review in the local Social Security office.
If your request for reconsideration is rejected, you can request an independent review by an administrative law judge. This review is typically done outside the local Social Security office.
If the administrative law judge denies your claim, you can file an appeal to the Social Security National Appeals Council in Washington, D.C. If that appeal is denied, you may still file a lawsuit in federal district court.