The Social Security Disability Insurance (SSDI) program can provide the money you need for living expenses if you become disabled and can no longer work. Due to the program’s limited resources, the Social Security Administration restricts eligibility to individuals with qualifying disabilities and work histories.
The SSA operates another disability program called Supplemental Security Income (SSI) for individuals with minimal or no income or assets. However, this article will focus on eligibility requirements for SSDI benefits.
If you have questions about qualifying for SSDI benefits, contact Disability Law Group for a free initial case evaluation. Our SSD lawyers can answer your questions and help you determine your eligibility to apply for Social Security Disability Insurance benefits.
Role of a Lawyer in SSDI Applications
SSDI applicants may obtain legal assistance in filing a benefits application. A lawyer can help an applicant with each step of the application process, including gathering personal, work history, and medical information and filling out the SSDI application form. A lawyer can help ensure an applicant has a complete application, giving them the best chance of approval.
When an application is denied – as many initial applications are – a lawyer can guide an applicant through the appeals process, including explaining the basis for the denial, obtaining additional information to supplement the application, and advocating for the applicant during reconsideration or an appeals hearing. Many initially denied applications are approved during the review and appeals process, especially when the applicant has help from an experienced attorney.
Understanding SSDI: An Overview
The Social Security Disability Insurance program can pay financial benefits if you have a qualifying disability that renders you unable to work. The SSDI program provides benefits for people who have accumulated enough work history to qualify for benefits from the Social Security system.
Basic Eligibility Requirements for SSDI
The SSDI program has two major eligibility requirements. First, an applicant must have a medical condition that qualifies them as “disabled” under Social Security regulations. Second, an applicant must have a sufficient work history in jobs that require the applicant to pay Social Security taxes.
A person has a qualifying disability when their medical condition has lasted or will last at least 12 months or result in death. The medical condition must prevent an applicant from engaging in substantial gainful activity. The Social Security Administration defines “substantial gainful activity” as earning more than a specified monthly income from work. That number changes annually according to inflation. An applicant’s medical condition must severely limit their ability to perform basic work tasks. The applicant must also have a condition found in the Social Security Administration’s Listing of Impairments or one as severe as a listed impairment.
An applicant must have a sufficient work history to qualify for SSDI. The amount of work history needed depends on the applicant’s specifics. Generally, an applicant needs 40 work credits with at least 20 credits earned within the 10 years before the onset of disability, although younger workers may need fewer credits. A person earns a work credit if they earn a specific amount of wages or self-employment income. Workers can earn a maximum of four work credits per year.
Disabled surviving spouses or children of a worker with a qualifying work history may also qualify for SSDI under certain circumstances.
The SSDI Application Process
The SSDI application process begins with collecting information you must submit with your application. Examples of information that the SSA will need to process your application include:
- Your name, date of birth, and Social Security number
- The names, dates of birth, and Social Security numbers of your current or former spouse(s), and dates of marriage and divorce or death
- The names and dates of birth of your minor children
- Details about your medical condition, including names, addresses, phone numbers, patient IDs, and dates of treatment for all your medical providers
- Names and doses of your medications and the names of the prescribing providers
- Names and dates of your medical tests and the ordering physicians
- The work income you earned this year and last year
- The name(s) and address(es) of your employer(s) from this year and last year
- The beginning and ending dates of any active U.S. military service since 1968
- Up to five jobs you held in the 15 years before your disability and the dates you worked in those jobs
- Information about any workers’ compensation or similar benefits you’ve applied for or intend to apply for
You must also supply your birth certificate or other proof of your U.S. citizenship or lawful permanent residency, your discharge papers if you served in the military, your most recent W-2 or self-employment tax forms, and your medical and workers’ compensation records.
The SSA has a network of local field and state agency offices called Disability Determination Service centers that make initial eligibility determinations. DDS centers can take SSDI applications online, by mail, over the phone, or in person. Centers verify applicants’ work history and review medical evidence to determine whether applicants have a qualifying disability. Sometimes, a DDS center will require an applicant to undergo a consultative examination to obtain additional medical evidence. An applicant who receives a rejection notice can appeal to obtain reconsideration of their application or an administrative appeals hearing.
Common Mistakes in SSDI Applications
According to the Social Security Administration, most applicants’ SSDI applications are denied on initial review. Denials more commonly occur for technical reasons than because an applicant does not have a qualifying disability. Many initial denials are overturned on reconsideration or in an administrative appeal or lawsuit.
Denials may occur because of mistakes on the application. Some of the most common mistakes include:
- Not including all required biographical and family information
- Not including information to establish a sufficient and recent work history
- Employment history shows you continue to earn enough income to meet the substantial gainful activity threshold
- Failing to include information about workers’ compensation or other disability benefits you have applied for or intend to apply for
- Not providing sufficient medical evidence to demonstrate that you have a qualifying disability
- Refusing or failing to submit to a consultative examination if requested by a DDS center
- Not responding to the DDS center’s request for additional information or documentation
Fortunately, you can rectify these mistakes by updating or supplementing your application and requesting reconsideration or an appeals hearing.
Contact an SSD Lawyer Today
If you need to apply for SSDI or appeal a denial, our SSD lawyers can guide you through obtaining benefits. Contact Disability Law Group today for a free, no-obligation consultation to discuss your SSD benefits eligibility and get SSDI application assistance that can improve your chances of securing the benefits you need.
