According to a front page article in the July 30, 2007 issue of USA Today, the Social Security Administration (SSA) has a backlog of 745,000 cases pending appeal for the denial of disability benefits. The article states that the average wait time for a hearing on an appeal is 17 months, with waits that can exceed 2½ years in some parts of the country. For people with limited financial resources to see them through lengthy waiting periods these kinds of delays in receiving benefits can be ruinous.
To boost the prospects of getting a disability application approved on the first try, and perhaps eliminate the need to appeal, a number of actions can be taken. First, understand that the Social Security Administration will consider benefits only for people who are totally disabled with a condition that will last or is expected to last at least one year or results in death. A short-term injury or illness or a partial disability will not qualify for benefits.
There are two programs available to individuals with disabilities: Social Security Disability Insurance (SSD or SSDI), also referred to as Disability Insurance Benefits (DIB), and Supplemental Security Income (SSI). The Social Security Administration administers both programs and under both programs individuals must meet the medical criteria to be deemed disabled.
Social Security Disability Insurance: SSD is a credits based benefits program. Basically, benefits are paid to those individuals who are found disabled and are “insured” through the program by having worked and paid Social Security taxes. Generally, applicants for SSD will need to have worked 5 out of the last 10 years (although for applicants under age 31, there are different criteria). You will be required to submit information about all of your work for the past 15 years (or longer depending on when you are last insured for benefits). It is helpful if you have kept track of your past earnings. Your benefits will be based on your earnings and if you have records proving what they are then those records can help correct any mistaken over- or under-estimation of your benefits by SSA.
Supplemental Security Income: SSI is a financial needs based program. Through the disability part of SSI, benefits are paid to those individuals who are found disabled and have a very low income and little assets. It is not dependent on whether you have worked or not. For some individuals, they may receive benefits through SSD and SSI – if their SSD benefits are low then they may be supplemented with SSI payments as well.
The best place to begin to prepare for the application process, whether for SSD and/or SSI, is at the government website www.ssa.gov/disability which offers answers to questions, forms, definitions, and guidelines.
In preparing to apply for disability benefits, it is helpful first to compile a list your medical diagnoses, a list of the treatment you have received for your injury or illness, and a detailed list of your medications. You can ask the doctor(s) who treats your disability if he or she will support your disability claim and will write a letter to that effect. Having a doctor affirm that you cannot work due to your disability can strengthen your claim. If you are suffering financially or have lost your medical insurance because of your disability then it may seem impossible to pay for ongoing doctor visits. However, treatment is essential to support your benefits claim even if you can only be treated at the county health department or free clinics.
The medical record is the next item to prepare. It should include a list of the names, specialties, addresses, and phone numbers of all treating physicians, offices, and hospitals now and in the past. You can go the extra step to get copies of your complete medical file from each of your treating sources and submit them in an organized manner with your application. If you do this rather than leave the collecting of your medical records to SSA, you can ensure that they have all your records promptly and do not miss any. You will need to provide SSA with a signed copy of their record release authorization form so they can obtain any other information they need for your claim.
Once all the records are gathered to support your application, you may apply online at www.ssa.gov/applyfordisability by telephone, or schedule an appointment to apply in person at your local Social Security office at 1-800-772-1213.
If despite all best effort the initial disability application is denied then try not to be too discouraged as some 60 to 70 percent of first-time applications are denied. From the date of the denial, you will have 60 days to file a request for a hearing before an administrative law judge (your appeal) and it is necessary to act on this quickly. The sooner an appeal is filed, the sooner you get into line for a hearing date, and the sooner benefits may be granted. It is important to get help from a disability lawyer for this appeal to make certain your case is fully prepared before the hearing and to represent you during the hearing itself.
Sterling Law Office handles Social Security Disability cases on a contingency fee basis for all professional legal fees. This means that we get paid if and when you get paid your past due benefits. If you are disabled and due government benefits, Sterling Law Office staff will do our utmost to help you secure them.
Posted by Mary Wreford and Wendy K. Bailey, Esq., August 10, 2007
The information presented in this article is for general information only and should not be construed to be legal advice.