In the unfortunate event you contract an illness or suffer an injury and are unable to work, Social Security disability benefits provide you with supplemental income during this difficult time. However, applying for Social Security Disability benefits can be a confusing process if you haven't done it before. Luckily, this guide will go in-depth to provide which conditions qualify for benefits, how to apply and even how to calculate your disability benefit if you receive approval.
How to Provide for Your Family When Disabled
If an illness, chronic condition or injury results in you not being able to work a full-time job, it can be crippling on your finances; this is why Social Security disability programs and SSI are available, to help you during these times. Not only can they supplement missed income, it helps recoup some of the costs brought on by family caregivers.
Informal care by family members is hard to measure in time and money spent. AARP conducted a study on how much families spent on informal care for disabled loved ones. This includes such services as meal preparation, taking your loved one to doctor's appointments, assisting in bathing and dressing and other duties. It concluded that in 2013, families spent approximately $470 billion. As you can see, this represents a tremendous expense; this is why having benefits from Social Security or SSI is so important because it helps you offset those expenses.
Now, let's take a look at which conditions qualify under these benefit programs.
Which Medical Conditions Qualify for Disability Benefits?
Since the application process can be tedious and confusing, it's important first to understand which conditions qualify for benefits either through Social Security disability or SSI. This will help you understand how Social Security approaches each case, whether you qualify and if so, how to prepare yourself for the application process. Even more important, time is of the essence in severe cases, where you need funds to care for a family member. Therefore, having this information handy can make it easier for you to fill out the application in a timely fashion.
Here is a checklist of the items the Social Security Administration looks at when reviewing your case:
- The first step is determining if you work. According to Social Security, if you are working in 2016 and earn more than $1,130 on average monthly, it won't consider you disabled.
- If you don't work, or you do but don't earn that much monthly, the next step is determining the severity of your condition. Does your illness or injury affect your ability to complete work-related activities?
- If your medical condition affects your ability to carry out your job's functions the next step is to find out if your condition falls under the Social Security list of disabling conditions. You can access the information on Social Security's website based on different systems within the body. It's important to note that Social Security keeps a list of serious medical illnesses, where once you receive the diagnosis you qualify for benefits right away. If you have a child under 18 years of age, Social Security has separate listings of medical conditions that would receive benefits under SSDI or SSI. In cases where the child has mental or physical impairments, resulting in functional limitations, the Social Security Administration will designate them as disabled. In turn, you would be able to receive benefits to pay for things such as treatment, personal care and other expenses.
- As part of its screening process, the Social Security Administration will also determine if you can do work functions as you did previously. This applies in cases where it determines you have a severe medical condition but it isn't on the same severity level as stated on its medical condition list.
- The last part of the evaluation concerns your ability to do other work functions. Determining factors it uses include your age, work experience, education and skills that might transfer well to another position. If it formulates the judgment you cannot work in any capacity your claim will likely receive approval whereas if it determines you can work in another position, your claim will likely face rejection.
This is a brief overview of how the Social Security administration approaches each case. By understanding what it looks for it makes you more aware of how it reaches its determinations. It will also better prepare you for the application process.
Applying for Social Security Disability Benefits
The application process for receiving disability benefits is involving and time-consuming. You can expect the process to take as little as a few months all the way up to a few years in some cases. A big reason for the long turnaround time concerns all the steps of evaluation the Social Security Administration takes as noted above.
It's important to note this can be a frustrating process. One, because there are so many steps applicants must do to even be consider for aid, and two, after jumping through a bunch of hoops, you still might not receive approval. At the same time, understanding the application process ahead of time gives you an advantage because you'll know what to expect; this aids you in gathering the documentation you need, which helps Social Security process your case in a somewhat timely fashion.
If you need assistance at anytime with applying, Social Security has a disability starter kit on its website. This kit contains a fact sheet, providing answers to the most common questions applicants have when applying for disability benefits. There's also a checklist of the documents Social Security requests. This alone is incredibly valuable because it gives you an idea of everything you'll need to supply. By providing all the information requested, it makes the application process smoother both for you and Social Security. The last part of the kit includes a worksheet, which helps you gather all the information you need to provide together. Social Security provides kits for both adults and children, depending on the type of benefit you request.
Along with this kit, Social Security provides ample resources on its website to assist you on learning more about disability benefits. Its publication on What You Need to Know When You Get Social Security Disability Benefits contains a wealth of information addressing benefits you might be eligible for, information Social Security requires you to report and more. Resources like this are informative and can answer many of the questions you have.
Now let's move on to applying for benefits. As you might imagine, there are different stages of the application process. However, it's important to note that depending on your medical condition you might not have to undergo all steps. This is a closer look at each step involved in the application process and what you can expect as you progress:
1. Application Process
You can apply for disability benefits on Social Security's website or by calling it at 1-800-772-1213. If you have hearing problems, you can use contact it at TTY 1-800-325-0778. At the time of application, you'll need to supply this information:
- Your personal information such as your Social Security number, date and place of birth, the same applies for your spouse-including dates of marriage and divorce-if applicable, your bank's routing number and account number for deposit purposes and the names and dates of birth for your children under 18 years of age.
- You'll also need to supply documentation supporting your medical condition. This can include the name, address and phone number of your doctor or specialist. You'll also want to provide your medical information pertaining to your current condition. Therefore, be sure to gather all the paperwork involving the doctors, tests, dates of treatment, who ordered the treatments and medications. This is incredibly important because this is the information that supports your claim when you request benefits, so be certain you have all the documentation required and you supply it in an organized fashion.
- Next, you'll want to give Social Security information about your work. For this, you'll first want to supply the amount of income you made this year and last year, the name and address of your employer(s) during this time, your Social Security Statement, any dates of active duty military service you had before 1968 and a list of your last five employers dating back 15 years before your condition prevented you from working. If you had to file worker's compensation or other occurrences as outlined by Social Security, it's important to provide them with this information.
As you can see, there's much information involved in applying for SSDI/SSI disability benefits. If you need assistance filing this initial application, an SSDI/SSI lawyer could be an excellent resource for you. While adding another expense doesn't seem desirable he or she could provide you with invaluable insight on how to file forms, gather documentation and other suggestions to alleviate the burden of filing the application. This could result in progressing to the next stage sooner.
The Social Security Administration reports only 28 percent of applicants receive approval after they submit their application. If you receive notification that Social Security denied your initial application, you have 60 days to appeal. This is where reconsideration comes in depending on where you live. If you live in Michigan, Louisiana, New Hampshire, Alaska, Alabama, Missouri, New York, Pennsylvania, parts of California or Colorado, you skip this step.
If you live in an eligible state for reconsideration this where you'll want to hire a lawyer to assist you. They can help you present a better case the next time around which might increase your chances of approval.
3. Administrative Council
If reconsideration fails, or the state you live in doesn't have it you move on to an administrative council. Again, you'll have 60 days from the date of rejection to appeal. During this hearing, a judge will examine your case and make an independent ruling. Since these hearings occur normally within 75 miles of residence you can attend to state your case or have an attorney present to do this for you. As part of this process be sure to bring updated medical documentation,which includes doctors/hospitals visited, tests conducted and any new medications prescribed.
4. Appeals Council
If your case still isn't approved you have 60 days to make your final appeal. In this final step, an appeals council reviews the administrative hearing to ensure the judge who reviewed your case adhered to the rules of the Social Security Administration. In this instance, the appeals council could reverse the judge's decision, send it back to the judge for further review or reject it outright.
Now, let's move on to the most important part of the process: payments.
Receiving Social Security Disability Payments
The Social Security Administration states that due to law, you won't be eligible for benefits until you have been disabled for five full months. If your case receives approval, this means you won't have your first payment until the sixth month. The Social Security Administration sends a notice if you will receive benefit payments. On this notice, it documents the amount of your payment benefit and when it will begin.
Once you receive disability benefits, they will continue as long as your/or your loved ones medical conditions don't improve. Social Security will review your case periodically to determine continued eligibility. This means there's a possibility your benefit won't last indefinitely. It's important to note that you are required to report to Social Security any changes in your medical condition that results in improvements, you return to work or your ability to work has progressed, as this might reduce or eliminate the benefit you would receive.
Overall, applying for Social Security disability benefits might seem like a daunting task. However, it's important to be organized, as this ensures you file the right paperwork and documentation with your application. By being accurate and diligently you make the process easier on you and those reviewing your case.