Are you seeking information and tips to help you maximize your chances of winning your Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) claim?
The information on this site is written by Nick A. Ortiz, a Social Security Disability Attorney in Pensacola, Florida. He represents Social Security Disability claimants across the United States.
Here he answers some of the most frequently asked questions about Social Security Disability claims, denials, and appeals.
Q: Why should I apply for Social Security Disability?
There are many reasons to apply for Social Security Disability. In addition to cash benefits, you also qualify for medical health insurance benefits. SSI recipients qualify for Medicaid right away, and SSDI recipients qualify for Medicare after two years of receiving benefits.
Q: When should I apply for Social Security Disability?
If you have a disability and are either (1) unable to work or (2) no longer able to work full time, you should file an application for disability with the Social Security Administration.
Q: Do you help claimants apply for Social Security Disability?
We help qualified claimants apply for Social Security disability, but we do not handle initial applications for Supplemental Security Income (SSI).
The SSA is required to consider your age, education level, work experience over the past 15 years, and the specific disabling conditions you are suffering from.
Q: Is there an age requirement for Social Security Disability?
There is no age limit to qualify for Social Security disability. In fact, under the right circumstances, one may qualify for Social Security disability from childhood until retirement age.
Q: What are my chances of winning my disability case?
A number of factors go into the decision, including your age, education, work history, type of disabilities, earnings record, medical evidence submitted, and the Judge assigned to your claim.
Q: What if there are no jobs due to high unemployment?
You must prove your condition keeps you from working, regardless of whether there are such jobs in your immediate area, and regardless of whether a specific job vacancy exists.
Q: How many different types of disability benefits are there?
There are at least five types of Social Security disability benefits claims: Disability Insurance, Disabled Widows or Widower’s, Disabled Adult Child, Supplemental Security Income, and Child SSI.
Q: How do I determine my Social Security earnings history?
You can use your My Social Security online account to get your Social Security Statement, to review estimates of your retirement, disability, and survivors benefits, plus your earnings record.
Q: What is proof of number holder name change?
This notice may mean that your records show a misspelled name, nickname, or alias. Be sure to respond to Social Security with any requested information so your application moves forward.
Q: What is the alleged onset date in my claim for disability?
Alleged Onset Date is more of a legal term than a medical one. What Social Security is really asking is, “When did you need to stop working full time due to your medical condition or disability?”
You, as a responsible US citizen, can use the SSA’s online form to report allegations of fraud, waste, and abuse in SSA disability programs.
Q: What is the Five-Step Sequential Evaluation process for determining whether a claimant is disabled?
The Social Security Administration (SSA) uses a step-by-step process involving five questions:
- Are you working?
- Is your condition severe?
- Is your condition found in the list of disabling conditions?
- Can you do the work you previously did?
- Can you do any other type of work?
Q: Do I need to have an empty bank account to apply for disability?
For Disability Insurance, Disabled Widow’s or Widower’s, or Disabled Adult Child benefits, it doesn’t matter how much money you have. For SSI, you will need to go through a financial screen.
Q: Can I Work and Receive Social Security Disability Benefits?
To be eligible for disability benefits, a person must be unable to engage in substantial gainful activity (SGA). The amount of monthly earnings considered as SGA depends on a person’s disability.
Q: Should I Apply for SSD, SSI, or Both?
If you don’t have enough work credits and have limited income and assets should apply for SSI. Anyone who has enough work credits (quarters of coverage) should apply for Social Security disability.
Q: What Is the Disabled Widow/Widowers Benefit?
Disability benefits may be payable to a widow or widower if they meet all of the requirements:
- They are between ages 50 and 60;
- They meet the definition of disability for adults; and
- The disability started before the worker’s death or within seven years after the spouse’s death.
Q: How Do You Qualify for Divorced Spouse Benefits?
A person can receive benefits as a surviving divorced spouse on the Social Security record of a former spouse who died fully insured if he or she:
- Is at least age 60, or age 50 and disabled;
- Was married to the former spouse for at least 10 years; and
- Is not entitled to a higher Social Security benefit on his or her own record.
Q: What Other Benefits Will I Qualify for If I Win My Case?
You may also qualify for a “lump sum” back payment and Medicare (however, there may be an additional wait time before Medicare starts).
Q: Is There a Statute of Limitations in a Social Security Disability Claim?
There is no time limit to file an application for SSD or SSI benefits, but any appeals must be filed within a certain amount of time, usually 60 days.
Q: Will Social Security Help with my Medical Bills?
If your application or appeal for Social Security Disability is approved, then you may be eligible for state or federal health insurance, which may pay some of your medical bills.
Q: What Are Special Extra Earnings Credits for Military Service?
Under certain circumstances, special extra earnings for your military service from 1957 through 2001 can be credited to your record for Social Security purposes.
Q: Should I Hire a Disability Attorney to File a Claim for Disability or Go It Alone?
Even after scouring the internet and reading up on claims, the vast majority of SSDI and SSI claimants will have no idea how to thoroughly and properly prepare a disability claim for a hearing.
Q: Should I Request Reconsideration Using a Lawyer If My Disability Claim Is Denied?
A lawyer may be able to help you turn things aground if you left out important information in your application; however, there is no guarantee.
Q: How Much Are the Attorney Fees in Social Security Cases?
For Social Security lawyers, the fee is only 25% of the “past-due” benefits you are awarded. The maximum fee is set at $6,000. The attorney will be paid only out of your back pay, or past-due benefits.
Q: What Can I Do to Help Win My Social Security Disability Case?
Submit any and all medical records you have in your possession to Social Security when you first apply, continue to get ongoing medical treatment and try not to go more than 3 months between visits.
Q: How Do You Apply For Social Security Disability Benefits?
When you file a claim in person or by phone, an SSA representative will interview you and complete the application for disability benefits and the Adult Disability Report. You can also file online.
Q: How Do You Qualify for Social Security Disability Benefits?
You must have earned a certain number of work credits and meet Social Security’s definition of disability to qualify for SSD benefits.
Q: What Are The Steps In The Social Security Disability Application and Appeal Process?
The steps in the SSD application and appeal process are:
1. Apply for Benefits
2. File a Request for Reconsideration
3. File a Request for Hearing
4. Request a Review by the Appeals Council
5. File a Lawsuit in Federal Court
Q: What are Common Abbreviations in Social Security Disability Claims?
The most common abbreviations in Social Security Disability claims are SSD/SSDI, AOD, and CE: Social Security Disability Insurance, Alleged Onset Date, and Consultative Exam
Q: Should I File for Social Security Disability Benefits and Early Retirement?
You can collect early retirement while applying for the disability income. Once found disabled, you can collect disability pay until full retirement age when you will collect full retirement.
Q: Can I Collect Social Security Disability, Long-Term Disability, and Workers’ Compensation Benefits?
You can collect these benefits at the same time, but there may be set-offs of each other where the total benefit amount typically cannot exceed what you were made before you went out on disability.
Q: What is the Five-Month Waiting Period for Social Security Disability?
SSD claims are subject to a 5-month “waiting period” wherein the Social Security Administration (SSA) does not pay the claimant any disability benefits until the 6th month after the onset date.
Q: How Do You Win Your Social Security Disability Claim?
The first tip to help give you the absolute best chance of winning is to make sure you submit ALL relevant medical records to Social Security or give them to your attorney to give to Social Security.
Q: What Are the Time Requirements for Social Security Disability Benefits?
Generally, you have 60 days after you receive the notice of our decision to ask for any type of appeal. The SSA presumes you received the letter 5 days after it is mailed.
Q: How Much Work is Required for SSDI?
Generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year you become disabled. However, younger workers may qualify with fewer credits.
Q: What is Supplemental Security Income (SSI)?
The Social Security Administration manages the SSI program. SSI makes monthly payments to people who have low income and few resources and are:
- Age 65 or older;
- Blind; or
- Disabled.
Q: How Do You Qualify for Supplemental Security Income (SSI) Benefits?
Supplemental Security Income (SSI) benefits are available to anyone who is disabled and has limited income, limited resources, files an application, and meets certain other requirements.
Q: SSI Income Assets Limits: What Does and Does Not Count?
Under SSI, income includes cash, checks, and other things you get that can be used for food or shelter. A single person can have resources worth up to $2,000 and still get SSI.
Q: Can a Surviving Spouse Get SSI Benefits?
If you are the surviving spouse, you may be eligible to pursue the claim and receive payments. For an adult SSI claimant, only the claimant’s spouse is eligible to receive payments.
Q: How Long Does a Social Security Disability Claim Take?
Social Security advises that it may take up to 180 days to issue a decision on a Social Security Disability Insurance (SSDI or SSD) or SSI claim.
Q: Why Is My Social Security Claim Taking So Long?
Social Security has a backlog of cases. There are so many open disability cases, it takes a long time for the SSA to process all of the claims.
Q: How Do I Speed Up A Social Security Disability Claim?
You can request a quicker decision with a “dire need letter.”
Q: How Do I Check The Status of a Claim?
You can check the status of your claim at www.ssa.gov. If you do not have online access or are otherwise unable to check the status of your application online, you may also call the SSA.
Q: Who Makes the Decision in my Social Security Disability or SSI Claim?
Most SSD or SSI claims are initially processed through your local Social Security Administration (SSA) field office and State agencies (usually called Disability Determination Services or DDS).
Q: Who is the Social Security Disability Examiner?
Social Security Disability claims examiners make the initial decision on an applicant’s medical eligibility for Social Security Disability (SSD) and Supplemental Security Income (SSI) claims
Q: What is a Claims Representative (CR) in a Social Security Disability Claim?
A Claims Representative (CR) works in the District Office and assists individuals in establishing entitlement to disability benefits under the SSA’s SSDI and SSI programs of benefits.
Q: What are Disability Determination Services?
Most Social Security Disability claims are initially processed through a network of local SSA field offices and State agencies usually called Disability Determination Services (or DDSs).
Q: What is the Virtual Screening Unit?
The Virtual Screening Unit is a stage between Reconsideration and a Hearing. A Senior Attorney will review the claim and determine whether a decision can be made “on the record” without a hearing.
Q: What Do I Do If My Claim Was Denied?
The number-one mistake claimants make is failing to appeal in a timely manner as you only have sixty (60) days from the date of the denial to appeal. You can appeal by mail or on the SSA website.
Q: How Do I Appeal a Denial of Social Security Benefits?
You can appeal online at https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp or you can request the appeal paperwork by mail by calling 1-800-772-1213.
Q: How Long Does a Social Security Appeal Take?
There is no set time limit to process an appeal and there is no way to know exactly how long a Social Security disability appeal will take.
Q: What Are the Three Levels of Appeal?
The SSA’s three levels of administrative appeal are Request for Reconsideration, Request for Hearing Before an Administrative Law Judge, and Request for Review by the Appeals Council.
Q: What Happens at a Social Security Hearing?
The judge, and then your attorney, will ask you questions about your limitations. If a medical or vocational expert is present, the judge or your attorney may ask questions of the expert as well.
Q: What Do I Testify About At My Disability Hearing?
You and your lawyer may discuss ways to demonstrate your abilities and limitations. You might also examine medical records and work history to prepare for the hearing.
Q: What Happens If I Lose After A Hearing?
You have the right to file an appeal with the Appeals Council or to start a new claim.
Q: What Happens When You Disagree with the Appeals Council’s Decision?
If you disagree with the Appeals Council’s decision you would then have to go to the last level of the appeals process which would be to file a civil suit in a federal district court.
Q: When Is A Person Considered Disabled by Social Security?
Your impairment must have prevented you from doing SGA for at least 12 months or will be expected to prevent you from doing SGA for at least 12 months.
Q: Will Social Security Grant Disability Benefits to Applicants with My Particular Illness?
There are no “automatic” wins in disability. Some conditions are more likely to win than others, and some conditions are more likely to win earlier in the disability review process than others.
Q: What is Residual Functional Capacity (RFC)?
Your residual functional capacity, or RFC, is the most you can still do despite your limitations. Social Security will assess your RFC based on all the relevant evidence in your case record.
Q: Why Are Mental Disability Claims Denied?
It is common for mental health specialists to make notes about office visits that are not very detailed, or there may be a lack of medical records altogether if you don’t see a mental health doctor.
Q: How Is Your Claim Evaluated If You Have Multiple Conditions?
As a matter of fact, Social Security must evaluate all of your conditions in making a disability determination, including those that are not categorized as severe.
Q: Can I Get Social Security Disability for Diabetes?
Having diabetes by itself usually will not qualify you for Social Security Disability, but most diabetic applicants suffer from related medical problems and symptoms that limit their ability to work.
Q: Can I Get Social Security Disability for Cancer?
Cancer claims are often denied based on the “one year rule”, which states that the condition must be expected to remain severe enough to prevent work activity for at least 12 continuous months.
Q: Can I Get Social Security Disability for Migraines?
Social Security continues to uphold that a migraine headache disorder will rarely prevent a person from working for a continuous 12 months but that there are exceptions.
Q: Can I Get Social Security Disability for Lyme Disease?
If Lyme disease keeps a Social Security disability claimant from being able to work eight hours a day, five days a week, such individuals may be eligible for Social Security disability.
Q: Can I Get Social Security Disability for Fibromyalgia?
Because you cannot see Fibromyalgia on an X-Ray or MRI, many judges (and doctors for that matter) are skeptical as to the existence and severity of the impairment.
Q: Will Failure to Follow Doctor’s Orders Hurt My Case?
Failure to follow a doctor’s orders or prescribed mode of treatment is an easy way for your claim to be denied. Your non-compliance will be noted in the medical records.
Q: What is a Medically Determinable Impairment?
A medically determinable impairment results from anatomical, physiological, or psychological abnormalities which can be shown by medically acceptable clinical and laboratory diagnostic techniques.
Q: What Evidence is Required by Social Security Disability?
Documentation of impairment must come from medical professionals as defined by SSA regulations as “acceptable medical sources”, then other evidence is considered in assessing impairment severity.
Q: What Are Acceptable Medical Sources?
Per CFR § 404.1513, subsection (a), acceptable medical sources are licensed physicians, licensed or certified psychologists, licensed optometrists, licensed podiatrists, and qualified speech-language pathologists.
Q: Why is My Attorney So Concerned About Drugs and Alcohol in My Disability Claim?
Drugs and alcohol are a problem because the Social Security Administration may deny benefits where it finds such use is a “material contributing factor” to the disability.
The Baker Act provides legal procedures for mental health examination and treatment, including voluntary admission, involuntary examination, and involuntary inpatient or outpatient placement.
The SSA is not bound by the VA determination and has separate rules and regulations as to how to qualify for SSD benefits.
Q: How Much Will I Receive if I Win My Disability Claim?
The best place to find an estimate of your monthly benefit would be to download your personal Social Security Statement. You can go to SSA.gov to download a copy of Your Social Security Statement.
Q: Do I Have to Pay Income Tax on Social Security Disability Benefits?
If you file an individual federal tax return and your total income is greater than $25,000 or you file a joint return and the income of you and your spouse is greater than $32,000 then yes, you must pay federal income taxes on your Social Security Disability benefits.
Q: Can My Social Security Disability Be Garnished?
There are a number of circumstances in which the Federal government can garnish “regular” Social Security benefits. SSI benefits can never be garnished.
Our list of acronyms and abbreviations used by the SSA may also help you understand key terms in a Social Security Disability claim.