Social Security Disability Claims - Who is Eligible and How to Apply

Social Security Disability Insurance Benefits (DIB) are available to disabled workers who paid enough earnings into the Social Security system. The Social Security Administration (SSA) determines if you are eligible for DIB, based on your work history during the years before you became totally disabled. As a general rule, you probably have enough work credits to qualify, if you worked for 5 out of the last 10 years.

The following factors determine eligibility for DIB:

• Whether or not you have enough work credits to qualify for disability benefits.
• Whether or not you have an impairment that has lasted, or is expected to last, for at least 12 months, or is expected to result in death.
• The nature and extent of your impairment.
• Your ability to engage in substantial gainful activity since your impairment began.
• The date your disability began.

Do I Qualify for Social Security Disability Benefits?

You must be totally disabled from employment and meet the Social Security Administration requirements for prior earnings.

As defined by the Social Security Act, a disability means:

Inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to last for a continuous period of not less than 12 months or result in death.
Therefore, you may be eligible for Social Security Disability benefits if you can answer yes to one or more of the following questions:

• Do you have a severe physical or mental impairment that prevents you from participating in any type of gainful employment?
• Do you have a disability that prevents you from working at any job, rather than just your previous employment? Has your disability lasted, or is it expected to last, for at least one year?
• Is your disability life threatening?

The Social Security Disability Application Process

The Social Security Administration requires evidence of the extent of a disabling condition before awarding benefits. To succeed in obtaining benefits, you must have a severe impairment that is shown by "medically acceptable clinical and laboratory findings." Unfortunately, many illnesses may completely disable an individual, but remain difficult to diagnose. In these cases, an attorney can analyze your medical records to try to find the evidence necessary to prove that you have a serious disability.

Can I apply for Social Security Benefits on my own?

Yes, you can file your own application for Social Security Disability Benefits or SSI, and represent yourself in seeking benefits. However, statistics indicate that claimants who have legal representation, especially on appeals, win their benefits much more often than those who represent themselves.

The Initial Application

You can apply for SSA benefits at a local Social Security Branch Office. To obtain the address and telephone number of your nearest Branch Office, call the SSA Hotline telephone number at 1-800-772-1213. (Deaf and hard of hearing individuals can reach SSA on its TTY number at 1-800-325-0778.)

The SSA application form requests a lot of information. In addition, the claim review process can take a long time. Some people simply give up and go away, even if they are genuinely entitled to their benefits. Often, SSA takes several weeks or months to review your initial application. Many individuals are denied at this stage, even though they meet all the requirements for benefits.

Do not be intimidated by the application process. If you are disabled, you have the right to seek benefits.

If SSA denies your application for Social Security Disability Benefits at the initial stage, you only have 65 days from the date stamped on the denial letter to appeal the decision and ask for a hearing to present your claim to an Administrative Law Judge.

The Social Security Hearing

An individual who files a proper appeal before the 65-day deadline will be scheduled for an Administrative Law Judge hearing. Usually, SSA takes between 6 months to 18 months to schedule your hearing date.

• The Administrative Law Judge who conducts your hearing will evaluate the following factors, to decide if you should get benefits: Whether or not you accumulated enough SSA earnings (work credits) to be insured for disability benefits.
• If not, whether or not you qualify under the SSI income limits.
• Whether or not you have an impairment that has lasted, or is expected to last, for at least 12 months, or is expected to result in death.
• The nature and extent of your impairment.
• Your ability to engage in substantial gainful activity since your impairment began.
• The date that your disability began.

Appeal of a Denial at the Hearing Level

If you are denied benefits at a hearing before an Administration Law Judge (ALJ), you have a right to appeal your decision further, to the Appeals Council. However, you only have 65 days from the date of the ALJ denial to file for that appeal.

Therefore we recommend that you contact a lawyer immediately, if an ALJ denied your claim. A lot is at stake when you are unable to work and wrongfully denied Social Security Disability Benefits or Supplemental Security Income (SSI). Families often depend on the income that was denied. A professional, experienced Social Security lawyer will work hard to obtain all relevant medical and employment records, review all documentation, and aggressively pursue a claim on your behalf.