Things to know about applying for SSDI

On Behalf of | Oct 10, 2022 | SSD Benefits

Seeking disability benefits can be complicated. Knowing several facts may help you in this process.

Eligibility

The eligibility process for Social Security disability benefits is difficult. Applicants had to have been employed for a specific number of years and paid FICA taxes. However, a deceased worker’s spouse, divorced spouse and children may also be eligible.

The Social Security Administration reviews an applicant’s age, salary and work history to determine if they are fully insured after paying FICA. Over time, a worker earns credits or quarters of coverage.

In 2022, an individual had to earn $1,510 annually while paying taxes to earn a credit. The number of credits needed depends on the person’s age when the disability began. A worker who is at least 62 must earn 40 credits or the equivalent of 10 work years. Younger workers need fewer credits. Six is the minimum.

SSD, unlike workers’ compensation, does not pay benefits to individuals with partial disability. Workers must be totally disabled and unable to do their job or most any other work. The physical or mental impairment must be expected to last at least 12 months or cause death.

Benefits

Monthly benefits depend on work and salary history. In 2022, the average monthly benefit is $1,358. Most monthly benefits range from $800 to $1,800. The maximum monthly benefit is approximately $3,100.

Application

Applicants must provide family member names, educational background, any vocational training, and the jobs they held within the last 15 years. Detailed medical records, treating doctors’ names, hospitals, clinics, patient identification numbers, examinations, treatments, diagnosis, medications and the date that medical condition affected work are important.

Each state’s office of Disability Determination Services reviews applications to assure there are enough credits. DDS and their physician and vocational experts review medical records, tests, treatments, and work limitations. They contact treating doctors.

Between 75 and 80% of initial applications are denied. Reasons usually include insufficient credits or failure to meet the SSA’s disability definition.

Appeals

Denials may be appealed. The first appeal is reconsideration where the applicant’s entire record, and additional medical information, is reviewed.

If reconsideration is denied, applicants may request a hearing before an administrative law judge. The odds of success are generally 52% but there is usually a six-to-16-month hearing wait.

Denials can then be appealed to an appeals council, which reviews whether the ALJ made a mistake. It can reverse the ALJ decision or return the case to the ALJ.

Applicants can sue the SSA if the Appeals Council rejects a claim. There were 13,000 federal cases filed in 2021.

Attorneys can help applicants gather the right information and follow procedures. They can also assist them in SSA proceedings.