The Social Security Disability Insurance Claims Process

If you’ve watched any daytime television, whether or not you’re disabled, you might have seen the ads for the mega-law firms specializing in Social Security Disability claims. What is it that they do and do you really need a lawyer to help you?

Having any injury, illness or chronic disease that makes it impossible for you to earn an income could mean that you’re eligible to benefits under the Social Security Disability Insurance program (SSDI). The process can be confusing and take a long time to finally get benefits, and a well-versed lawyer on your side could make a big difference in your case .

Qualifying for SSDI Benefits

There are some general rules to qualify for disability benefits. You must:

• Be under normal retirement age
• Have insured status for disability, which means that you have earned enough money in the required number of three-month periods (known as quarters of coverage) before the disability began
• Have a disability now or in the 12 months before the month in which the application is filed
• File an application for benefits
• Establish a waiting period of five consecutive months, beginning with a month in which you were both insured for disability and disabled

You must also prove you’re unable to sustain activity for any length of time hindering your ability to hold a job.

How to Apply for SSDI

There are three ways to apply for SSDI benefits:

• You can complete an online SSDI application Be sure to make sure you are within the time-frame to receive benefits. If you don’t follow their guidelines and miss filing dates, you won’t get a chance to apply for benefits. Even if you think you might qualify, start the process immediately.
• You can apply via phone at 1-800-772-1213 or via TTY 1-800-325-0778 if you are deaf or hard of hearing
• You can apply at your local Social Security office

Before beginning the application process, take the time to collect several pieces of information that you’ll need to apply. A complete list is available on the Social Security Administration‘s website, but includes:

• Proof of your age
• Your Social Security Number
• Contact information for all healthcare providers and dates of recent visits
• Information about all medications you take
• Medical records, including test results
• Your work history
• Recent W-2 forms or federal tax returns (if self-employed)
• If applying for benefits for family members, proof of their ages and Social Security Numbers, as well as proof of your marriage, if your spouse is applying for benefits

In addition to the application form, you’ll also have to complete the Social Security Adult Disability Report.

Appealing a SSDI Denial

It’s important to know that SSDI applications are routinely denied, so you shouldn’t be discouraged if your initial application for benefits is turned down. Most people are denied because the Social Security Administration feels they are not disabled under the SSA’s rules. There are a few cases that get automatic benefits, though, so it’s worth it to do your research.

You can appeal the SSA’s decision online. There are several steps to the appeals process. These include:

• Complete a request for appeal and disability report, as well as a medical release form allowing the SSA to request and review your medical records
• Your appeal is then sent to the appeals office
• The appeals office requests any new and recent medical records, and reviews all new and old medical records
• You have the opportunity to meet face-to-face with someone from the office reviewing your appeal
• You’ll be notified of the office’s decision

If the agency still denies your appeal, you can request a hearing before an administrative law judge (ALJ), who will either approve or deny your application. If the ALJ denies your application, further appeals are possible to the Social Security Administration Appeals Council and the US District Court.

Although you don’t need to hire a lawyer to help with your initial application, you may want to consider using a lawyer to prepare your paperwork. You’ll almost certainly want legal representation if your appeal goes to an ALJ, the Social Security Administration Appeals Council or US District Court. A lawyer familiar with the judges and procedures can take away a lot of the anxiety you may be feeling, which could make your condition worse.

In the standard social security disability case, the attorney is entitled to 25 percent of the back pay up to a maximum, which right now is just over $5,000. In an extraordinary case the attorney can file a fee petition to be awarded additional fees.

Even after you win, there are administrative duties that need to be taken care of, such as contacting your insurance company and other offices to make sure they know you’re being covered.

Related Resources on Lawyers.com^sm

- Contact a Social Security lawyer in your area for specific legal advice, and read about Selecting a Lawyer
- Access more information about Social Security Disability law
- Visit the Social Security law forum
- Follow us on Twitter and become a Fan on Facebook to join the conversation about Lawyers.com topics online