Sunday, March 01, 2009

Appyling for SSD - Disability Application Information

In order to be approved for benefits, those who file disability applications must be eligible for either Social Security Disability Insurance (SSD) or supplemental security income (SSI), the two programs from which government disability payments are drawn.

SSD is available to disabled individuals who have worked enough in recent years to qualify, and who due to their impairment are unable to earn the current SGA (substantial gainful activity) amount. SGA is determined annually by social security, and adjusted as needed to reflect the current cost of living. The idea behind SSD is that it functions as a national disability insurance that anyone can draw on if needed, provided they have paid enough into it. Those who are employed pay into the system in the form of social security, or FICA, taxes deducted from their paychecks.

SSI provides disability coverage to those who are severely impaired but not covered by SSD, and who can demonstrate financial need. SSI is funded by U.S. Treasury general funds rather than social security taxes, so past employment is not a requirement. Those who file applications under the SSI programs must show that they have an impairment that prevents them from earning the current SGA, and that they have no more than $2,000 in total assets, including checking and savings accounts, with the exception of a primary residence and one car.

When it comes to actually making a decision on your claim, it makes no difference to a disability examiner or judge if your application will be approved under SSD, SSI, or both. The federal Social Security Administration office determines the program for which you are eligible based on information you initially supply.

Disability examiners work for state disability determination services (DDS) agencies, and their sole purpose is to review your medical records to decide if your impairment is truly disabling, or if you are still capable of working. They are in charge of all decisions on disability applications and request for reconsideration appeals. It takes about 3 to 4 months on average to receive a decision from DDS on your claim, although some claims are decided more quickly, and some will take longer to process.

If your physical or mental impairment is beginning to have a negative impact on your work performance and your ability to go to work, you should file an application for SSD as soon as possible. It takes a while for a disability application to work its way through the system, and only 30% of them are approved at the initial level, without the claimant having to go through at least one level of appeal (though it is unlikely to be approved on the first appeal, the reconsideration, and generally a second appeal, a request for a disability hearing will be necessary). This means it may be many months or even a year or two--or longer--before someone that files a disability application actually receives benefits.

Claimants that are turned down for disability should consider speaking with a representative, either a disability attorney or a non-attorney rep (in either case, it is often best to choose who you initially speak with based on a referral from someone who has actually used the services of the rep), to secure assistance on their claim.

On this point, it should be said that many claimants wait too long before seeking representation. However, a good rule of thumb is this: if a claim is denied at the reconsideration level, get representation because the next step will be a hearing before a federal judge and "self-representation" is never a wise choice.

Additionally, most disability representatives offer free consultations, even for those who have not yet filed an SSD or SSI application but are just thinking about it.

If DDS (disability determination services) turns down your initial application, it will probably turn down your reconsideration appeal as well (only about 15% of reconsideration appeals, on average, are successful), at which point you will have to either give up or file a second appeal.

The second appeal (as indicated in the prior paragraphs) is decided, not by DDS, but by a federal disability judge, and at this point the adjudicator, an administrative law judge, is more likely to approve a disability applicant who has representation than an applicant who tries to argue their case themselves. Psychological factors surely play into this (it is worth betting that most judges look dimly upon claimants who forego representation); however, it is also a fact that a qualified representative will have a detailed grasp of the disability determination process while the average claimant will know practically nothing about the system, even including how to interpret their own medical records.

Return to the Social Security Disability SSI Benefits Blog

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