Obtaining benefits series: The Initial Application

People often come to me for help within a few months or weeks of becoming unable to work because of a medical disability, and for the most part people don’t know where to start. Why would they?  This stuff isn’t common knowledge, and it’s not taught in school, unless you happen to go to law school and take an obscure elective.  So I’m writing this with the assumption that you know nothing at all about Social Security Disability Benefits, except maybe you’ve heard of it.  

 

What is Social Security Disability?  Social Security Disability Insurance, often referred to as SSDI or just SSD, is the Federal Government’s main benefit program for people unable to work because of disability.  It is complementary to the Americans with Disabilities Act, the law which provides requirements for employers and others to provide reasonable accommodations for the disabled.  Social Security picks up where the ADA leaves off, in that if your disabilities can be reasonably accommodated in the workplace, you are covered by the ADA and not Social Security, but if your limitations go beyond what the ADA is meant to cover, you may qualify for SSDI.  SSDI pays a monthly cash benefit, similar to the cash retirement benefits available at age 62 and up.  The benefit amount is partially proportionate to what you earned over your work career and the taxes you paid into the system.  You become eligible for SSDI benefits if you are unable to sustain full-time work of any kind, including unskilled work that isn’t physically strenuous. The standards are slightly relaxed over age 50, but in general you need to prove that you can’t do any full-time job that exists in the economy.  There is a waiting period of 5 full calendar months before you are eligible after you stop working, and you can only be granted benefits if your disabling condition last or is expected to last at least 12 months or until death.  

 

If you feel that your condition meets the basic definition above, then you should consider applying for benefits.  Applying for SSDI is actually fairly straightforward.  You can apply online at ssa.gov (full link: https://www.ssa.gov/benefits/disability/), or by phone at the SSA’s main number (1-800-SSA-1213), or by walking in to a Social Security office.  The application is somewhat lengthy and detailed, and in most cases takes around an hour.  You will need to provide complete information about your current and recent medical treatment, as well as various information about your work history and education. Most of the information that is required is stuff you’ll know by memory, but often I observe that people need to consult their records for things like doctor and clinic contact information, visit dates, and details about past jobs. 

 

Here’s a checklist of the topics covered in the application:

 

  • Your identifying and contact information, such as name, Social Security number, date of birth, address, and phone number

  • The date you became disabled – This is generally the date when you stopped working due to your condition.   

  • Citizenship status, including green card or naturalization information if relevant

  • Information about your marital status, including start and end dates of all of your marriages, and the names and identifying information of current and prior spouses, marriage date and location, and if relevant divorce date and location. 

  • Military history if relevant

  • Names, ages, and disability status of your children

  • Information about your workers compensation or no-fault claim if involved

  • Direct deposit information for eventual payment of benefits

  • Your education level and date it was attained

  • A third-party contact person

  • A list of all of your disabling medical conditions

  • The names, contact information, and dates of first and last visits for all of the doctors, clinics, and hospitals relevant to your disability claim

  • The start and end dates, wages, hours, rate of pay, and job title for your last five jobs.

 

I have prepared a form that contains all of the application questions in a Word document that you can print to fill in by hand or fill in on the computer to copy and paste into the application form.  If you can’t find the link, contact me to request a copy.  

 

So that’s the application form.  You can fill that all out on your computer or smartphone, or you can have an attorney go through it with you.  Once you’ve completed the application, though, there is more to do.  First, you will need to sign or electronically sign a medical release form, authorizing Social Security to pull your medical records. This is critical, because the claim analysis is based almost entirely on your medical records.  

 

After your application is submitted, the Social Security Administration (SSA) will mail you first an application confirmation, which you must sign and return, and then a detailed 22 page questionnaire about your activities and daily life, work history, and medical treatment.  Some of this is redundant to the application, but it’s still a required part of the process – if you don’t complete the forms, they will deny your claim without even reviewing the medical.  This is also when a particular analyst is assigned to your claim, and the forms will have a cover letter with that person’s last name and phone number.   

 

After you’ve completed and returned these forms, the government will send you for an examination with one or more of their own consulting doctors.  These examinations are often a bit of a joke – many of my clients report being seen by the doctor for only a few minutes and not being given a chance to talk about all of their conditions.  But this examination is usually a critical factor in determining whether the claim is granted, so you’ll want to review our consultative examiner information sheet before the appointment.  

 

Once the consultative examination (CE) is completed, the government analyst will then request records from all of the medical sources you told them about in the application, and will then review all of the records and make a decision.Understand that most cases are denied at this stage, even very strong cases, so don’t be shocked if you receive a denial letter shortly after the CE appointment.Unfortunately, this is routine.Now is the time to start your appeal, and to retain an attorney if you haven’t already.