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 process. The ALJ has up to 90 days after the hearing to deliver a decision.
If your claim is denied at this stage, you still have other options for appealing. To understand more about these options, discuss your claim with one of our experienced Social Security disability lawyers.
Can an Experienced Disability Attorney Help You?
The disability claims process can be long and time-consuming, especially if you have to deal with one or more denials. During this time, you won’t have access to your critical financial benefits. This is one of the most important reasons for having an attorney to help you as early as possible in the process.
An experienced SSDI lawyer understands all the details of the process and knows how to navigate the SSA’s requirements. Your attorney will also understand the importance of getting your claim approved as early in the process as possible.
The Gerling Law disability attorneys handle every aspect of your claim from start to finish. We understand what documentation you need to submit with your application and what information you should omit.
If you have a pending SSA disability claim, you might be contacted for further information. Before you provide any additional information or submit to any requested medical exams, talk to an attorney. We can answer your questions and provide the information needed for your claim. We fight to get your application approved as quickly as possible, so you can get the benefits you deserve.
How Much Does a Social Security Disability Lawyer Cost?
Social security disability lawyers accept clients on a contingency basis. In other words, they don’t collect any legal fees if they don’t get your benefits approved. In most cases, your lawyer must submit a fee agreement to the Social Security Administration for approval. Once the SSA approves the fee agreement, the SSA will pay your attorney’s fees directly out of your backpay. The SSA also sets limits on the percentage of fees an attorney can charge.
The bottom line is that when you work with one of our experienced disability lawyers, you won’t owe any legal fees until and unless we get your benefits approved. We also offer a free consultation and case evaluation, so we can answer your questions and help you decide on your next steps.
Get Help from Our Social Security Disability Attorneys Today
The experienced disability lawyers at Gerling Law understand how difficult it can be when you can’t get access to benefits that you desperately need. We are here to help and fight to get you the compensation you deserve.To ensure your safety and make it as easy as possible to get the help you need, we offer a variety of options for virtual disability lawyer consultations. In fact, we can handle every aspect of your case virtually. You won’t have to worry about commuting to an appointment with us or having to be exposed to unnecessary risk. Contact us now at 1-888-GERLING (866-681-3919) to discuss your claim with one of our experienced, compassionate Social Security disability lawyers, or complete our online Social Security disability case evaluation form now and we will contact you shortly.
Gayle Gerling Pettinga
Born and raised in Evansville, Gayle is a respected, experienced lawyer and a valued community leader. She graduated near the top of her class at Indiana University’s prestigious Maurer School of Law. She’s practiced law with one of the largest firms in Indianapolis as well as one of the largest pharmaceutical companies in the world. And that means she knows how big law firms and big companies think and how they operate – and she will put that knowledge to work for you.
Gayle has received numerous awards and honors including Martindale-Hubbell — Peer Review Rated: AV®, American Institute of Personal Injury Attorneys 10 Best Attorneys in Indiana for Exceptional and Outstanding Client Service, and YWCA Evansville 100 Years, 100 Women Honoree, 2011.
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