IN GENERAL: Social Security Disability Insurance (SSDI) is provided to workers who have paid into the system. Payments are called FICA (Federal Insurance Contribution Act) - and are deducted from your payroll or self-employment earnings. As a general rule, you must have worked and paid FICA for at least 5 years out of the most recent 10 year period. The rule is more lenient for individuals under age 31. So, if you have paid in recently enough, you have coverage under SSDI. Now, you must prove that you are disabled.
WHAT IS DISABILITY UNDER SOCIAL SECURITY RULES?
If you are under age 50, you must prove that you have one or medical and/or mental impairments that will keep you from working at ANY job for a minimum of 12 consecutive (straight) months.
If you are age 50-plus you may be awarded benefits by proving that you cannot perform any of your "past relevant work" (PRW). Past relevant work is the full-time work you have done within the past 5-year period prior to filing for disability.
2 THINGS ARE CRITICAL IN A DISABILITY APPLICATION
1. You must describe all of your past relevant jobs, as defined above. Social Security needs to know your job title for each job and the major duties involved in each job, particularly
- How much you stood/walked and how much you sat on each job.
- The maximum weight you lifted/carried on each job.
Explaining your past jobs helps Social Security to understand the past work you did, and to determine whether you are now able to perform any of that work.
2. You must provide detailed medical evidence from your doctors, clinics, hospitals, counselors or other providers to document the severity of your medical and/or mental impairments. This in effect means obtaining or helping Social Security to obtain all your medical records.
THE USUAL PROGRESS OF A SOCIAL SECURITY DISABILITY CLAIM
While no two claims are alike, and all claims will not take exactly the same path, here is the usual progression of a disability claim:
1. The application stage. After you file your application for disability, it takes Social Security an average of 218 days to process the claim and give you an initial decision. Only about 25 percent of claims are approved in this initial process. Most are denied.
2. Reconsideration - the first appeal. Your denied claim goes back to the state Disability Determination Service (DDS) for a review. This review often takes an additional 10 to 12 months and results in another denial 85 percent of the time.
3. A Hearing Before an Administrative Law Judge - your second appeal. You and your representative (if you have one) appear before an administrative law judge for a hearing. This usually occurs about 6 months after denial at Reconsideration. The judge is not bound by any previous decision and will give you a new hearing. Most claims that are approved will be approved at a hearing.
THE IMPORTANCE OF APPEALS
Most claims will be approved in the appeals process. Thus, every denied claim should be appealed. You should not consider giving up until you have been before an administrative law judge for a hearing.
There is a strict 60 day rule for filing an appeal. If you miss this deadline, you can never file an appeal on the denied claim.
For Assistance Contact
(256) 799-0297
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