Demystifying The Process of Social Security Disability Insurance Benefits
You’ve worked at a job for years, established a career, become part of the fabric of your workplace. All of a sudden, without apparent warning, you are no longer able to work. Whether it is due to a workplace injury, automobile accident, or illness that debilitates you, your ability to perform gainful employment is compromised. What do you do?
There are several kinds of ailments that will qualify a worker for benefits under Social Security Disability Insurance. But the process to receive these benefits might seem daunting, particularly if your initial claim is rejected.
A person is eligible for SSDI benefits as long as they have paid Social Security taxes and worked for a certain period of time. You can file a claim for SSDI benefits if you have an injury or illness that prevents you from doing “substantial gainful activity” which has lasted or is expected to last for 12 continuous months.
The initial claim can be made online at ssa.gov, the web site of the Social Security Administration. You can also call 800-772-1213 to make the claim via phone or set up an appointment with a local SSA office, including those located in New London and Norwich.
It is important to have your medical information on hand when making your claim. These records should include the names and contact information for your treating physicians, a list of medications you are taking, and laboratory and test results. You should also have a summary of the work you performed prior to your injury or illness, your birth certificate, and your Social Security number.
The claim should be made as soon as possible, since it will usually take three to five months for the initial claim to be processed. The SSA will determine if you have a medically severe impairment by first looking at 14 “listings.” If you meet a condition included in the listings, you will qualify for SSDI benefits.
The SSA will also look at medical and vocational guidelines known as “grids.” These will compare information such as age, education, and prior work experience to determine the factors that may have contributed to an injury and illness as well as your ability to perform other work.
SSDI benefits will be based on your average lifetime earnings. If you are approved for the benefits, you will begin receiving monthly payments six months after the date on which the Administration determines your disability began. After two years of receiving SSDI benefits, you will be eligible for Medicare.
If your initial claim is denied, you still have several options to appeal the SSA’s decision and receive benefits. Within 60 days of the decision, you can file a request for reconsideration. If this is denied, you have another 60 days to request a hearing before an administrative law judge. If this official upholds the decision, you can file a claim with the Appeals Council in Virginia. Even if this body upholds the original decision, you can file a claim in a Federal District Court.
Jay Berryman, an attorney with Suisman Shapiro who handles a wide range of SSD claims, says this process is often marked by lengthy delays. Three or four months might pass before there is any action on your appeal, and nine to 12 months might pass before a hearing takes place.
“There’s a significant delay,” says Berryman. “Connecticut is actually better than most states in moving claims to administrative hearings.”
If your appeal is successful, your benefits will be retroactively awarded from the date of your first filing.
Berryman says workers of all ages are eligible for SSDI benefits as long as they have worked for the required period of time before filing a claim. Certain circumstances do make it more likely that a person’s claim will be accepted, however. For example, a worker over the age of 55 who has done arduous labor for several decades will be able to qualify for SSDI more easily than a younger worker who has done sedentary work for a shorter period of time.
An attorney can assist with SSDI claims by working with a client to determine the issues that are unique to them. If a person’s claim is rejected because the SSA determines that they have residual functional capacity allowing them to perform other tasks, an attorney might be able to explain how they cannot do the full range of tasks required in certain jobs.