Filing for SSI Benefits - What you need to know

If you intend to seek Social Security Disability benefits or SSI disability benefits, you must first contact SSA (Social Security Administration) to initiate your disability claim.

You can file for disability by contacting a local Social Security office. This will result in an appointment being set for a disability interview. The interview may be done in person or, if you have medical mobility or transportation issues, it may be done via a telephone interview. This may also be requested for claimants who simply prefer a phone interview.

Social Security does offer an online filing process. However, this is for title 2 Social Security Disability benefits only. SSA does not currently offer an online SSI disability application process.

The reason for this is that SSI is a need-based program, meaning that a person's resources (assets and income must be throughly evaluated to determine if they are eligible to file a claim. This necessitates that a person-to-person interview (which, as stated, may be done at a local office or over the phone) be conducted versus filing online.

Since individuals wishing to file for disability will not know in advance if their claim will be for SSI, SSD, or will involve both programs in the form of a concurrent benefit claim, it may simply be more productive to call or visit a local field office which will sort out which program, or both, the claimant is eligible for.

Additionally, contacting a local office will guarantee a face-to-face interview with a field office claims representative (CR) who can directly answer questions regarding the application and appeals process. This may minimize future confusion regarding paperwork, filing deadlines, and correspondence received from the Social Security Administration and also reduce the potential for making mistakes during the claim process.

Who may file for SSI disability?

SSI disability is intended for A) individuals who have not worked, or worked enough, to become insured for title 2 SSD benefits (such as minor-age children) and B) individuals who were once insured for SSD but have lost their insured status due to a prolonged absence from the workforce.

SSI disability may also be available to individuals who are eligible to receive Social Security Disability benefits, but may only be eligible to receive a small monthly disability benefit check. In such cases, the claimant may be eligible for concurrent benefits.

Who is eligible for SSI Disability?

Like Social Security Disability, to qualify for SSI disability a person must have one or more medically determinable medical conditions (which may be physical or mental in nature) that affect their ability to engage in work activity.

To satisfy the Social Security definition of disability, the condition, or conditions, must last for at least one full year and be severe enough to either A) prevent the claimant from engaging in substantial and gainful work activity or B) satisfy the SSI or SSD disability requirements of a listing in the Social Security list of impairments.

Most claims that are approved are not approved on the basis of a disability listing, but, rather on the basis of a medical vocational allowance. A medical vocational allowance is granted when Social Security determines that the claimant's medical condition imposes functional limitations that are severe enough to prevent a return to work activity, either performing their past work or performing some form of other work while earning a substantial and gainful income.

Filing for SSI at a Social Security Office

When you file your SSI disability application with a CR, or claims representative, at a local Social Security office, be prepared to provide the claims representative with your medical information: This includes:

1. The names of all sources of medical treatment sources, such hospitals, doctor's offices, and clinics. You will want to supply full addresses to ensure that the disability claims examiner who is assigned to determine your case will not have any difficulty obtaining your records (the time it takes to obtain medical records usually signifies the single largest delay on a case).

2. The names of all treating physicians who are familiar with your condition and who have provided medical treatment to you. The names of your doctors may be very important later if your case goes to the hearing level: your disability lawyer or disability representative will probably attempt to secure a medical source statement in support of your from one, or more, of your treating physicians

Remember, Social Security has to be able to obtain your medical information and they can only do this by gathering medical treatment records from your various medical providers.

Since SSI is a need based disability program, you should also be prepared to answer questions about your financial situation. All need-based programs are based upon two things: resources (assets) and income. When you complete your application for SSI disability benefits, a claims representative will ask you questions about the following:

1) Your wages if you are still working,

2) Income from property,

3) Retirement benefits you might have,

4) Property that you own,

5) Bank account balances,

6) Vehicles, and

7) Recreational vehicles.

For SSI disability purposes, the highest valued vehicle and the home you live in are exempt from the resource limit. However, any additional vehicles, homes, land, 401Ks, stocks, etc, are counted against a $2000.00 limit for single individuals and a $3000.00 limit for couples. Income limits are a little bit different in that they are somewhat variable depending upon household composition.

If you are under the income and resource limits of the SSI disability program, the claims representative will gather your medical information for your disability folder. Once you complete the interview, your disability claim will be sent to the state disability agency for a decision.

Who makes the decision on an SSI disability application?

Although your SSI claim is filed at a local Social Security office, the SSA office does not actually render the decision. All states have disability agencies of one name or another that process medical decisions for Social Security. When your claim reaches the disability agency, usually designated as DDS, or disability determination services, it is assigned to a disability examiner.

The examiner will review all of your medical records (after they have been obtained - requests for records are usually made the same day that an examiner receives a case from the Social Security office) and schedule additional examinations if needed (Social Security uses physical and mental consultative examinations when disability applicants have no current medical information or their medical information is out of date).

How long does it take for an SSI decision?

Once there is enough medical information and work history information in the disability file, the disability examiner will make a disability decision. The decision may, in some cases, take just a few weeks. Ordinarily, in most cases, the decision on an SSI claim will be made within 90 to 120 days. When cases take much longer than this, it is usually because the disability examiner has had difficulty getting the medical records from the treatment sources listed by the claimant.

The chances of being denied or approved for SSI

Statistically, approximately 70 percent of all claims for disability (SSI or SSD) are denied at the disability application level. Statistics will, vary, of course from state to state and from year to year. Despite this, the national average of 70 percent of disability applications being denied has been very consistent over the last two decades. The high rate of denial will, for the majority of claimants, make it necessary to consider using the disability appeal process.

The disability appeal process

The appeal process begins with a request for reconsideration appeal. Reconsiderations are handled in an identical fashion to disability applications, therefore it should not be surprising that a high percentage of these appeals are denied as well. However, the second appeal level, the request for a disability hearing, may offer more than a 60 percent chance of receiving a disability award.

The odds of approval at this level favor claimants whose cases have been properly prepared in terms of medical evidence, statements from treating physicians, and a knowledge of SSA disability rules and regulations, as well as proper presentation at the hearing, which may include interaction with any expert witnesses (such as a vocational or medical expert witness) that has been called to appear by the judge.

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These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?

What happens if I file a disability application and it is denied by a disability examiner or Judge?