If you have a serious illness or debilitating injury that is making it impossible for you to work, you may be panicking wondering how you will be able to make ends meet. Luckily, this is why Social Security Disability Benefits exist. On the other hand, the system has some tough requirements for eligibility. So just because you have a serious medical condition and meet other criteria for the benefits, the system still does not always make it easy to get the benefits to which you are entitled. This process can be long and complex, and often requires the assistance of an experienced social security disability benefits attorney. If you have started this process, or are looking for options, you likely have a lot of questions. We will do our best to answer some of those here. Of course, if you have questions that are specific to your case, it is always best to speak with an Arizona social security disability attorney directly.
What is a Qualifying Disability?
To qualify for social security disability benefits, you must have a disability that meets the government definition. It is necessary to have medical records supporting the fact that you have a disability, so just having a doctor’s statement that you are disabled will rarely by itself suffice to meet the eligibility criteria. To be found disabled by the Social Security Administration (SSA), you must meet the following criteria which are required by law:
- You are unable to do any substantial Full-Time work because of your medical condition; and;
- Your medical condition must have lasted or be expected to last at least one year or to result in death.
These are two of the basic rule requirements, but there are more rules and requirements than these. And if you have a disability that makes doing your job more difficult but can be done with reasonable accommodations, that alone will usually not qualify as a disability entitling you to SSDI benefits because you are still able to do work. To receive SSDI benefits, you must be unable to do any substantial work at all. This should be supported by medical records and often functional records also. Unlike other programs, the SSA does not make payments for partial disability. This means that if you are receiving disability payments from your employer, workers’ compensation, or another program, the threshold may be different for those benefits than that required by the Social Security Administration. You should therefore not assume that because you are already receiving disability benefits from another source that you will also qualify to receive SSDI benefits from the SSA.
When Should I Apply for Social Security Disability Benefits?
You can apply for social security disability benefits as soon as you are injured or become disabled. The process for receiving disability benefits is not a fast one, so one way to look at it is that the sooner that you can get the ball rolling, the better. On the other hand, there is a 12-month retroactive look-back for a benefit award, so in that respect there is not a penalty to wait to apply, and that is important because there may be situations where it is advantageous to wait a bit on the application, such as if there are mistakes in your medical records, or if you are receiving unemployment benefits, or if your name is still connected to a business receiving passive income; although even if you have one or more of those less than ideal circumstances, you may still need to get your SSDI application filed right away if your insured status ‘Date-Last-Insured’ (based on your paid-in earning credits) is about to expire! If you have any of those situations, it may be best to talk to an attorney about those situations prior to making the application.
When you do apply, the Social Security Administration will determine if you have an eligible disability and, if so, when it occurred. If the SSA determines that you do have a disability that qualifies you for coverage, then you may be able to start receiving social security disability benefits 6 months from the date of the injury or disability, which may or may not line-up with the date you are claiming. But your receipt of SSDI funds will include a five-month waiting period, which begins one month from the date that the SSA determines that your disability began. There is an exception that allows you to skip the waiting period if you have been diagnosed with amyotrophic lateral sclerosis (ALS) and were approved for SSDI benefits starting on or after July 23, 2020.
How Do I Apply for Social Security Disability Benefits?
You can apply for social security disability benefits by calling or visiting your local social security field office. You can also access and complete the application online at SSA.gov. And finally, you can call the SSA main number at 1-800-772-1213 and make the application over the phone. If you do go down to one of the local State Agency offices to start the claim, it will generally last about one hour for the interview, but you can reduce the time by more than half by completing the application before you go. There is a checklist of documents and information that you will be required to bring to your appointment so that it can be reviewed.
After your application has been submitted, it had usually been taking three to five months for the State Agency office to process the claim. But with Covid-19 delays, the processing time has been doubling or even tripling that time as the State Agency offices continue to work through the back-log caused by the office closures from the pandemic. In general though, the faster that all of your medical records, supporting evidence, and any other requested documents are provided, the faster and more streamlined the process will be. For this reason, having an experienced attorney who can help you seamlessly navigate the process and ensure that your circumstances and medical records are in order and supporting your clam from the beginning, as well as correctly handle the functional forms and often tricky questions that the State Agency offices will send to you when processing your claim, can make a huge difference when it comes to getting a positive outcome as quickly as possible, and will also help develop the claim if a Hearing before an Administrative Law Judge becomes necessary.
How is Eligibility Determined for Social Security Disability Benefits?
After you have submitted your application, your materials will be sent off to a State Agency office that is responsible for ordering medical records and setting up medical consultative examinations and arranging with other local offices to process functional questionnaires. The State Agency offices and analysts then review all of the information and materials gathered to determine eligibility. In this process, the Agency may reach out to doctors who have treated you as well as places where you have received treatment to verify your condition. The State will usually require that you complete additional questionnaires or attend a medical appointment. If you are given a medical appointment, you will be informed of the location, date, and time of the appointment. It is important that you do not miss this appointment and make every effort to go. Failing to attend the appointment could result in a denial of your claim.
What if My SSDI Claim is Denied?
If you receive a denial of your SSDI claim, you can file an appeal online or at your local State Agency office. Your claim will be reviewed by someone who was not involved in evaluating your claim the first time. An attorney can help you with this process and ensure that you are more likely to secure approval. If that appeal is also denied, the next step will be to file a Request for Hearing, which can also be done on-line or at your local State Agency office.
Contact the Law Office of Paul J. Dombeck in Phoenix, Arizona
If you need help getting the social security disability benefits that you are entitled to, contact the Law Office of Paul J. Dombeck today to schedule a consultation and find out how we will fight for you.