 SSDRC What is the Application Process for Social Security Disability and SSI? How do you Win Benefits under Social Security Disability or SSI? If I am determined disabled, how far back will Social Security pay benefits? How do you prove your disability case if you have a mental condition? What Can I Do to Improve My Chances of Winning Disability Benefits Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits How to File for Disability - Tips for Filing If You Get Approved For SSDI Will You Also Get Medicare? How much does a Social Security disability attorney get paid? Social Security Disability SSI Criteria and the Evaluation Process How long does it take to be approved for SSI or Social Security disability? What do you Need to Prove to Qualify for Disability Benefits? Social Security Disability SSI and Fibromyalgia Social Security Disability SSI and Degenerative Disc Disease Can I Qualify For Disability and Receive Benefits based on Depression? Answers to questions about SSD and SSI disability What Disabilities Qualify for SSI and Social Security Disability Benefits? Social Security Disability Status Social Security Disability Tips — how a claim gets worked on Social Security Disability, SSI Disability - Terms, Definitions, Concepts |
What Happens When You File an SSI or Social Security Disability Application?How to prove you are disabled and win disability benefits Generally, you file a Social Security application or SSI application with a claims representative either in person at your local Social Security office or through a telephone interview. Regardless of the format chosen, the claims representative will ask questions about your: A) Disabling conditions. B) Medical treatment C) Work history. Medical History Information You should be able to provide the claims representative with your medical treatment sources and make sure the information is complete and detailed. Keep in mind that this information will be used by a disability examiner to request your medical evidence and that if you fail to include a particular treatment source, or provide incompete information, it could significantly delay your case, or, worse, result in the examiner being unable to gather the evidence needed to approve your claim. In accordance with this, the information you provide regarding your medical treatment history should include the names of facilities (hospitals, clinics, etc), the names of your physicians (names of treating physicians are doubly important if at some point, your disability representative or disability attorney will be attempting to obtain a medical source statement on your behalf: this usually occurs at the level of a disability hearing before an administrative law judge), the addresses for your treatment sources, their phone numbers, and the dates, or date ranges, during which you received treatment. Additionally, you should have a list of your current medications, which medical professional prescribed them, and any side effects you are experiencing. Many individuals fail to disclose side effects that occur as a result of prescribed medication; however, this is important to include since medication effects can have a profound influence on an individual's ability to persist at work tasks (for example, some pain meds and muscle relaxants can significantly impair concentration and alertness). Lastly, you need to provide a list of the medical tests you have had along with who referred you for the test and where it was done. Work History Information When you file a Social Security disability application or SSI application, you should also be able to give the claims representative (a CR, or claims representative, is not to be confused with a disability representative who provides legal representation. The CR, by contrast, is a social security field office employee who takes both disability and retirement claims) information about the various kinds of work you performed prior to becoming disabled. Social Security considers all work activity you performed in the fifteen years prior to filing for disability. This fifteen year period is known as the relevant period. However, a job can only be relevant to your disability determination if you performed the job three months or more, had time to learn the job, and your earnings were considered to be what is considered substantial gainful activity (SGA). To be considered SGA, you simply needed to have made a certain amount or more (The social security earnings limit) each month for the time that you held the job. Disability examiners will use your relevant work history to make their disability determination, meaning that they will compare what you did in your past jobs to the residual functional capacity that you currently possess to determine if you have the ability to go back to one of those jobs. The Processing of your Disability Claim The Social Security definition of disability mandates that you must have a medically determinable mental or physical impairment and that the impairment has prevented you from performing work activity that earned SGA-level income for the past twelve months, or can be expected to prevent SGA for twelve months. After each claim is initiated and a disability interview has been conducted, claims representatives at social security offices gather the medical and work information for your disability claim and then send the claim to a state disability agency (DDS, or disability determination services) for a medical determination. Once your disability file is received at the state disability agency, or DDS, it is assigned to a disability examiner, who then sends for your medical records. Ordinarily, the wait for your medical records will constitute the bulk of the time that it takes to process your case. In some instances, your records will be gathered within a couple of weeks. Very often, however, it can take months if the medical provider is very slow in responding to the medical record requests. Once the medical records have been received, the disability examiner will review them to look for signs of physical and mental functional limitations that would A) prevent the individual from going back to one of their past jobs and B) prevent the individual from doing some type of other work. In many cases, the claimant will not have been treated for one of the conditions that has been listed on the disability application, or will not have received medical treatment recently (within the last 90 days). In such cases, it may be necessary for the disability examiner to schedule one or more consultative examinations, if needed. Social Security uses consultative examinations to provide clarification of information found in your medical treatment notes, or to get a current status on your medical condition if you have not had medical treatment in the past ninety days. Disability examiners must have current medical treatment information to make their disability decision. Once the disability examiner has enough medical information from your treating medical sources and/or consultative examination reports, they will make their medical determination. They consider the limitations imposed upon you by your disabling condition. Means of Approving your Disability Claim If your limitations are so severe that they meet or equal the disability criteria of an impairment listing (see What is the Social Security Disability List of Impairments? ), you may be approved for disability. If this is not the case, however, there is still the possibility of being approved via a medical vocational allowance, a type of approval that is far more common than being approved on the basis of a listing. In this type of determination, the examiner evaluates your ability to perform any of your past work. If they determine that you are unable to do your past work, they must then consider your ability to perform other types of work. If you are not able to do past work, and the disability examiner determines that you are unable to do other work, you may be approved for disability benefits. Medical vocational allowance decisions rely heavily on the information provided by the claimant and, once again, highlight the importance of supplying detailed and accurate information. This is because the disability examiner will identify the claimant's past jobs according the description of the job made by the claimant. Proper identification of jobs (delivery truck driver versus tractor-trailer-truck drive, for example), of course, can easily make the difference between being approved for benefits, or being denied on the basis of the ability to return to past work, or using one's education and skills to perform other work. Additional information: What happens if my SSI or Social Security Disability Application is denied? How to File for Disability - Tips for Filing 
Return to: SSDRC, or the Questions, Answers, Tips, and Advice page Topics and Questions SSD and SSI are Federal Programs The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming Recent approval and denial statistics for various states can be viewed here: Social Security Disability, SSI Approval and Denial Statistics by state Special Section: Disability Lawyers and unnecessary claim denials |