How to Qualify for Social Security Disability Insurance

If you’re disabled and cannot work, and you’ve previously paid Social Security taxes (at least five years over the last 10 years), you may want to know how to qualify for Social Security Disability Insurance (SSDI) income benefits. This federal benefit program is designed to support workers when they cannot earn an income due to disability. Employers and employees are required to contribute to this program. Employers and their employees pay into SSDI via FICA taxes. FICA taxes are withheld from earnings to ensure that each employee pays into Social Security.

In theory, every disabled person who pays into Social Security for the required period is eligible for SSDI but, in practice, you must prove that you’re unable to perform work, or Significant/Substantial Gainful Activity (SGA), in the past. You must demonstrate to SSA that you can’t be retrained to perform another type of work. Your current age, degree of physical/mental capacity, and education level are considered to this end.

Qualifying for SSDI

If you’re less than 50 years old and become disabled, SSA first checks to determine the number of years you’ve worked and paid FICA taxes. If you’ve worked five years over the past decade, you have met the first qualification needed for SSDI approval.

Apply for SSDI as soon as possible if your doctor or other medical treaters believe the condition or illness will last at least 12 months or result in death. You should let SSA know about your intention to file an SSDI as soon as possible because, even if you don’t complete the file at that time, the protective filing date is determined at that time.

Filing a written “Intent to Claim” (described by GN 00204.010 ‘Protective Filing’) with Social Security can help you claim more backpay if you request and later receive SSDI income. If you get better and don’t file, you lose nothing but the time it took to advise Social Security of the intention.

Process Required to Apply for Social Security Disability Insurance Benefits

Before submitting an application for SSDI, it’s important to know that the process can take a long time. Up to two-thirds of initial applications for benefits are rejected by SSA. Assume that your request for disability income benefits will be denied on the first try and prepare for the appeal.

File a Social Security “Request for Reconsideration” or appeal if your initial request is denied. SSA reviews evidence you previously presented along with additional evidence submitted to rule on your case.

Take the time to organize the information you’re presenting at the initial stage and, if required, at the SSA appeal. Many applicants have an extensive medical record for SSA to review. To help reviewers understand the key information, plan to “keep it simple:”

  • Prepare a time line that indicates as precisely as possible when the onset of your disability or multiple medical/mental health issues began.
  • Provide a chart that shows names and contact information of your medical providers. Include medical appointment information to show when and how often you visit the doctor, hospital, clinic, etc.

Administrative Law Judge Review

SSA appeals for reconsideration of your case may be denied. If that’s the case, you will present information about your disability at a disability hearing. An Administrative Law Judge, or ALJ, will preside.

The ALJ hearing allows you to tell the judge, a SSA representative, why you need SSDI income. Although you must have documents to support your case, the judge doesn’t rely on a dry document review to arrive at a decision. You can also ask medical treaters and others to testify on your behalf.

If your request for SSDI income is denied at the hearing, you can take an additional step by asking SSA’s Appeals Council to review your claim. The Appeals Council performs fact-checks to ensure that the ALJ properly considered evidence you presented at the hearing according to the law. When the Appeals Council believes the Administrative Law Judge should review the decision, they either return the case file back to him or her for review or even overturn the decision reached at the hearing.

Federal Court Review

The Appeals Council may decide to agree with the ALJ’s ruling on your case and, if this happens, you have a last step to take. You may file your case with Federal Court and request a review. Although few denied SSDI applicants take this step, it’s important to know you have this recourse.

Social Security Administration says that, after receiving an original denial of SSDI benefits, many claims are later accepted at a hearing. It’s your decision at that time to engage an experienced Social Security lawyer to help you prepare for the hearing or take special care to organize and present the facts of the case yourself.

Social Security Legal Specialist

You might consider hiring a Social Security lawyer or law firm if you’re discouraged or concerned about getting approved for SSDI.

SSA allows you to engage an attorney at any stage of the SSDI applications process. Some people assume their chances of approval are better if they engage an SSDI-experienced attorney at the start. Others decide an attorney may improve their chances at an ALJ hearing.

It’s possible to hire an attorney on a contingent basis. In other words, your attorney agrees to be paid a fee only if you’re approved for SSDI or other Social Security benefits.

  • Preparing the initial SSDI application can be the most challenging part of the process, and you shouldn’t assume that an attorney has magical solutions. He or she can’t help you gather required paperwork or help you get required medical treater paperwork signed. Although the attorney can help you request medical records, it’s still up to you to get your doctor, hospital, or clinic to prepare SSA-required documents and submit them on time.
  • Ask lots of questions before engaging an attorney in your Social Security SSDI application process. It’s possible for you to complete the SSDI application process for free. Once you assemble the required information, SSA representatives can also assist you.
  • Some larger Social Security Disability law firms operate on a virtual basis. They offer assistance to individuals in all U.S. states over the Internet. You might never meet the attorney and, after you sign the fee agreement, you might find it difficult to get information or assistance during the lengthy SSDI qualification process. Know that if you disengage the attorney after you’ve signed them at any point before you receive approval for SSDI benefits, SSA will require you to initiate the SSDI application process from the beginning!

Social Security attorneys can be very expensive. If you receive SSDI benefits, your lawyer can receive up to USD 6,000 of your backpay. Even if you receive a generous backpay settlement, you probably might not believe that the lawyer earned his or her share of your disability benefits at that point.

You can obtain a free consultation with most Social Security disability attorneys. If you contact virtual SSDI law firm, you will probably interact with a paralegal at first. Before agreeing to sign up for help, ask to speak with an attorney. Ask questions about how and when he or she is available to you and what you can expect in terms of paperwork assistance.