Will I Qualify For Disability Benefits in Wisconsin?

If you live in Wisconsin, you may qualify for Social Security or Supplemental Security (SSI) disability benefits if you have been unable to perform substantial gainful activity (work) due to a severe mental or physical impairment for twelve months, or you expect to be unable to work for twelve months or more.

The Wisconsin Social Security Disability and SSI disability qualification process is much the same as it is in other states in that you must first file a disability application. There are 26 local Social Security offices across the state of Wisconsin. And filing does not require physically visiting an office. The inteview and application process may be done via telephone.

Qualifying for disability in Wisconsin

The approval rate of initial disability claims in Wisconsin is 35.6 percent compared to a national average of 31.2 percent.

Statistics will vary from year to year; however, the denial rate of approximately 70 percent for all initial claims filed (disability applications) means that the majority of individuals seeking disability benefits in Wisconsin will need to follow the appeal process before eventually being awarded benefits.

Typically, this involves two appeals, a request for reconsideration, and a request for a disability hearing. The odds of approval at the reconsideration level are very low, and only 10-20 percent of reconsideration appeals are normally approved in a given year.

However, the majority of claimants who appear at a hearing and present a well-documented case will be approved for benefits, particularly if representation is involved and their treating physician has provided a supporting medical statement on their behalf.

Filing for disability in Wisconsin online

You can file your disability application with your local Social Security office either in person or by phone. You may also use the Social Security online disability process.

If you use the online disability process, make sure you complete the necessary online disability forms and medical release form along with your disability application. If you do not do so, you will still have to receive a contact from a local Social Security office and, if for whatever reason, the Social Security office fails to establish contact with you, your claim may be denied and you may be sent a close-out letter.

For this reason, filing for disability through the Social Security office (as stated, the disability interview can be conducted in person or over the phone) may be more practical--and potentially less risky.

However, another reason for avoiding the online process is that it does not allow for an online application for SSI. Since most claimants will not know in advance if their claim will be for SSD, SSI, or will be concurrent and, therefore involve both SSD and SSI disability, it may, again, be more practical to simply initiate a claim with a local SSA field office.

Finally, the online system does not allow for a disability interview. The interview with a CR, or claims representative, can be beneficial because it allows a claimant to get answers to specific questions which, otherwise may be difficult to learn. This can minimize confusion and the potential for mistakes during the claim process.

Filing for disability in Wisconsin through a Social Security office

If you file your application with your local Social Security office, you will have a disability interview during which a claims representative will determine if you are eligible for Social Security Disability and/or Supplemental Security Income disability (SSI).

If you meet the criteria of both disability programs, your claim will be a concurrent disability case, otherwise your disability claim will be sent to a state disability agency as a Social Security Disability or SSI disability claim only.

After filing, your disability claim is forwarded to the Wisconsin Disability Determination Bureau in Madison, WI. This agency is responsible for making all of the Social Security Disability and SSI determinations for the state. Disability examiners at the Disability Determination Bureau are responsible for making both initial disability claim and reconsideration appeal disability determinations.

Once your disability claim arrives, it is assigned to a disability examiner for a medical determination. The examiner reviews your disability file and requests medical records from all your medical sources. If they determine you do not have current medical information (medical treatment notes that are less than ninety days old), have insufficient medical information, or have no medical information, they will schedule one or more consultative medical examinations. They do this because Social Security must have sufficient current medical evidence to address all of your disabling conditions.

When the examiner has enough medical information to make their decision, it is their responsibility to deny or approve your disability claim. If your disability claim is denied, your will receive a denial notice from the Disability Determination Bureau. If your initial disability claim is denied, you have sixty five days to appeal the decision.

Disability appeals in Wisconsin

If you decide to appeal your initial disability claim denial, you must file a reconsideration appeal. This appeal is just a review of the initial disability determination. If there was no decisional error made on your initial disability claim, or you have not provided new evidence that supports a finding of disability, it is unlikely your reconsideration appeal will qualify you for disability benefits. The reconsideration appeal has the highest denial rate of all levels of the Social Security Disability process.

If your reconsideration appeal is denied, you can keep your disability claim going with a request for hearing appeal. If you have to appeal your disability claim to the disability hearing level, you have your best chance of qualifying for disability. Administrative law judges are able to be more flexible when making their disability determinations and this allows more disability applicants to qualify for Social Security Disability in Wisconsin.

Reconsideration and hearing approval rates in Wisconsin

The reconsideration appeal approval rate is 17.6 percent compared to the national average of 11.6 percent. The disability hearing approval rate was recently recorded as 46.5 percent, versus the national average hearing approval rate of 57.8 percent.

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