Social Security Disability Requirements You Must Consider
If you are an individual living with a disability, both the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs can provide you with critical financial assistance while you are unable to work. Unfortunately, Social Security disability requirements are complex and often confusing to understand. As a result, many applicants who legitimately qualify for benefits get their claims denied. You have the right to appeal a denial of benefits in most cases. However, you could fight for months or years only to receive additional denials. The Social Security disability attorneys at Gerling Law understand these challenges, and we are prepared to fight to get you the benefits you deserve. We can help you understand the Social Security disability criteria, the application process, and how to proceed if your claim was already denied. Understanding the Social Security Disability Claims Process To apply for SSDI or SSI, you must follow the process required by the Social Security Administration (SSA), using the forms and format that the agency requires. If you deviate from the process in any way, the SSA may automatically deny your claim. Your application must include all required documentation and medical records. Most important, your application must clearly represent how your condition affects your ability to work. Once you complete your application and submit it to the SSA, the agency will put it into the queue for evaluation by a reviewer. Reviewer comments are typically returned within approximately three to six months. If the SSA approves your application, your benefits could begin in as little as four weeks. If the SSA denies your application, however, you have a limited amount of time—typically 60 days—to submit a request for reconsideration, or RFR. Do You Qualify for Social Security Disability Benefits? The criteria for determining whether you qualify for Social Security Disability benefits depends on which type of benefits you plan to apply for. Each type of disability benefits requires a unique criteria for qualification. Social Security Disability Insurance (SSDI) SSDI benefits are specifically for disabled workers, adult children with disabilities, disabled widows or widowers of qualified benefits recipients, and divorced spouses with disabilities. To qualify for SSDI, you (or the qualified party) must have had a job for a long enough period and paid the required amount of Federal Insurance Contributions Act (FICA) taxes to become fully insured by the SSA. Supplemental Security Income (SSI) Impoverished senior adults and disabled persons who have not worked long enough or paid enough FICA taxes to qualify for SSDI may qualify for SSI, provided they meet the stated guidelines for income and assets. Finally, you must have an accepted condition that prevents you from functioning sufficiently to fulfill work duties. What Conditions Does Social Security Consider as Disability? If you suffer from a mental or physical impairment that prevents you from performing your job duties, the SSA may deem you as having a qualifying disability. Any disability condition must qualify as either life-threatening or of sufficient severity to prevent the applicant from working for one year or longer. If your condition is already included in the official SSA list of acceptable conditions (a document known as the Listing of Impairments, more commonly referred to as the SSA Blue Book), the application process may be easier. However, if you have a condition that is not included in the Blue Book, you can still qualify for benefits. The only difference is that your application must document the condition sufficiently, specifically in the way it prevents you from working. Documenting your condition is one of the most critical aspects of a successful benefits claim. Providing too little documentation can lead to a denial of your application. Providing too much documentation can also interfere with getting claim approval. For this reason, it is critical to have both an attorney and a medical provider who understand the process and what the SSA needs to approve your claim. In most cases, a formal medical assessment known as a residual functional capacity (RFC) assessment will form the basis of your claim. The medical professional who administers this assessment must be appropriately qualified under the SSA’s criteria. If you have your RFC performed by a doctor or another medical treatment professional who doesn’t know how to conduct or document your RFC assessment, or if the doctor is not qualified to perform the assessment, it could lead to a denial of your claim. Does Mental Illness Qualify for Social Security Disability? You may be entitled to receive SSDI benefits if mental illness affects your ability to work. Just as with a physical condition, any qualifying mental illness must prevent you from working for at least a year. The condition must also prevent you from being successfully trained to work in another position or in another capacity. Your functional assessment must be performed and documented by a qualified psychiatrist, psychologist, or other accepted treatment professional. Some of the most common types of mental illness that could qualify for SSDI include dementia, anxiety, depression, schizophrenia, bipolar disorder, and a variety of other personality and affective disorders. What If Your Social Security Disability Claim Was Denied? The SSA commonly denies initial disability claim applications. The good news is that if you receive a denial, it doesn’t automatically mean you don’t qualify for or won’t get your benefits. If you do receive a denial, you have only 60 days to request a formal review. If you don’t request a reconsideration within this period, you will have to submit a new application and restart the process. Once the SSA receives your formal request for review, it will assign a new reviewer to your case. Once this occurs, the process for review typically takes three to four months before the reviewer issues a decision. If you receive a second denial, you can request a formal hearing for your claim. However, you must submit your request within 60 days. A formal hearing could take up to two years to take place. An administrative law judge (ALJ) oversees the...
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