How to get Social Security benefits - Part 1, the Initial Application.

Potential clients often ask me what it is that I will do for them, and in a lot of ways the main answer is that I know how to win Social Security benefits, and I take them through the process. It's true that, if the steps are followed carefully, you may not need help from a lawyer. If you decide to go it on your own, then maybe this will serve as a helpful guide. If you choose to get the help of a lawyer, I hope to help you understand what your lawyer will do.

So here is how to get Social Security Disability benefits.

 

Step 1: Be disabled.

Believe it or not, this is the step that trips up a lot of would-be applicants. It all stems from the legal definition of the term "disabled."  The term means different things in different contexts, such as the Americans with Disabilities Act or Worker's Compensation, or even an insurance policy. For Social Security, it is a very narrow definition that most Americans will hopefully never meet. You are disabled if (and only if) due to a medical condition or combination of conditions, you have functional limitations which so seriously impair your daily functioning that you cannot sustain unskilled work at any level of exertion. There are actually a few exceptions to this definition, and a lawyer can explain them, but in general, thats the Social Security "standard of disability."

 

Step 2: Stop working.

Now really, I could list this as step 1, as that's where the government puts it in the evaluation process. You can't collect Social Security disability benefits (or SSI) if you are working full-time or earning more than about $1100 monthly. Even part-time work that exceeds that dollar amount can exclude you from getting benefits, as can volunteer work or an internship that isn't paid.

Now if either step 1 or step 2 isn't already the reality of your life, proceed no further down this article. I've had people ask me if they should stop working in order to pursue Social Security benefits, and with few exceptions the answer is usually no. Most people will have less money on Social Security benefits than working, even working part time. So if you're capable of working, you're probably better off in the work force - or even on unemployment benefits which are often higher than Social Security benefits. Nobody applies for Social Security because it's an easy way out. You apply because you're out of options.

 

Step 3: Apply for benefits

There are three ways to apply: by phone with the Social Security Administration, at a local SSA office,or online at SSA.gov. The application requires a lot of information, and it's good to get that information together before you apply. You'll be asked questions about:

  • Your basic demographic information including social security number, date and place of birth, address, and phone number
  • Your work history, including the names and addresses of your last five employers
  • Your recent medical treatment, including the names and contact information of every medical provider you've seen since becoming disabled

Again, it's best to have this information handy when you start your application, but if you don't, it's a good idea to get the application started as soon as you can even with incomplete information. The most important part of the application is identifying your medical sources, so that the government can gather your medical records.

 

Step 4: Follow up on your application.

Once your application is completed, it's the government's responsibility to gather your medical records, and they will also send you and your doctors some questionnaires. It's important that you complete each of the questionnaires they send you, because if you don't, they may deny your claim without even looking at the medical evidence. But it's a good idea to consult an attorney for guidance while completing these questionnaires. Generally, I will help my clients complete the questionnaires so that we know that the answers correctly address your condition and limitations.

The government will usually send you to see their doctor, an appointment called a Consultative Examination. It's important that you attend this appointment and that you provide that doctor with a complete picture of your symptoms. If you have recent objective reports such as an MRI, it's a good idea to bring those with you. I provide my clients with an info sheet to prepare them for the CE appointment.

Once you've completed the questionnaires and gone to the CE appointment, your application is considered complete, and this is where most people stop - and where some initiative might mean the difference between winning now and having to wait for a hearing.

 

Step 5: Get a medical opinion.

The earlier you can do this, the better. While the rules for evaluating a treating physician's opinion have recently changed, one upshot of the change is that nurse practitioners and physician assistants are now considered "acceptable sources" for medical opinions. The government is required to consider the professional opinions of your physicians. Now, it's important to note that an opinion saying "my patient is disabled" isn't worth much at all, because of the rules. But an opinion stating the physical and mental limitations that stem from your condition, especially if the opinion makes specific references to your medical records, is very helpful. Most competent Social Security attorneys have a library of forms to solicit detailed medical opinions, and if you hire an attorney early in the process getting a medical opinion is one of the things we will do for you. If you don't have a lawyer, some internet research may help you find a helpful form to get an opinion from your doctor, but keep in mind that there may be more bad information than good on the web, and it's important to know that you've got the right information.

That's pretty much it for the initial application process. Oh, I forgot the most frustrating part.

 

Step 6: Wait.

Once all the information is in, including the CE report and hopefully your own doctor's opinion statement, the evaluators at your local Disability Determination Service (DDS) will evaluate your case and make a decision. If they like what they see, they'll grant your case and you'll start receiving your benefits soon. Bear in mind, though, that fewer than 30% of initial claims are approved, and you are likely to need to proceed further through this process.

Tune in for my next post for information on the process of getting and winning a hearing with an administrative law judge.