What Happens At The Request For Hearing Stage Of The Appeals Process
If you do not agree with the reconsideration decision made on your application for benefits, you may request a hearing before an administrative law judge . This appeal of the request for reconsideration decision must be filed within 60 days of the date you received the written denial letter.
Within a few weeks of filing a Request for Hearing, the local Social Security Administration office handling your claim will send your file to the Office of Hearings Operations . Then you will receive a letter from OHO acknowledging receipt of your Request for Hearing. At this time, your attorney will have online access to your entire electronic folder. Reviewing your file at this stage is advisable. That way you and your attorney can see what medical records and other evidence the state agency based its decision on, and how it evaluated that evidence. This is an ideal time to begin formulating how you and your attorney will present your case to the administrative law judge.
From the date you request a hearing with a judge, you will have to wait about 12 to 15 months for the hearing. The Office of Hearings Operations must provide you with the hearing date, location and name of the administrative law judge at least 75 days before the date of the hearing .
Information About Family Members
- Social Security numbers and proof of age for each family member who may qualify for benefits and
- Proof of marriage, if your spouse is applying for benefits, as well as dates of prior marriages, if applicable.
If you don’t have all the documents you need, don’t delay filing for benefits. We will help you get the information you need.
Special Rules For People Who Are Blind Or Have Low Vision
We consider you to be legally blind under Social Security rules if your vision cannot be corrected to better than 20/200 in your better eye or if your visual field is 20 degrees or less, even with a corrective lens. Many people who meet the legal definition of blindness still have some sight and may be able to read large print and get around without a cane or a guide dog.
If you do not meet the legal definition of blindness, you may still qualify for disability benefits if your vision problems alone or combined with other health problems prevent you from working.
There are a number of special rules for people who are blind that recognize the severe impact of blindness on a person’s ability to work. For example, the monthly earnings limit for people who are blind is generally higher than the limit that applies to non-blind disabled workers.
In 2021, the monthly earnings limit is $2,190.
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Benefits For People With Disabilities
The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.
Social Security Disability Insurance pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes.
pays benefits based on financial need.
When you apply for either program, we will collect medical and other information from you and make a decision about whether or not you meet Social Security’s definition of disability. Periodically, we will need updated information about your condition. You may receive a Disability Update Report . This form can now be completed online.
Use the Benefits Eligibility Screening Tool to find out which programs may be able to pay you benefits.
If your application has recently been denied, the Internet Appeal is a starting point to request a review of our decision about your eligibility for disability benefits.
If your application is denied for:
Which One Should I Choose
Whether you should get short term disability insurance, long term disability insurance, both, or neither really depends on your situation, so there is no one-size-fits-all answer. If you have several months income in your savings account, you may be able to forgo short term coverage. But if missing one or two paychecks would cause serious financial hardship, short term coverage might be the priority.
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Fact: Ssdi Is Designed To Be A Long
You can apply only if the disability is expected to be long-term 12 months or longer or if the condition is so severe that it’s viewed as terminal. The program is meant for those with ”the most severe impairments in the country,” Jarrett says.
Other private programs pay out for short-term or partial disability, but Social Security disability insurance does not. Yet some states may award temporary funds to people who can’t work because of illness not caused by work. You can contact your state’s Department of Labor to see if you quality for temporary disability benefits.
Your Right To Question The Agencys Decision
You have the right to appeal the Social Security Administrations denial of your claim at every step in the process. Most of the time, you must appeal the agencys decision within 60 days of receiving the denial notice. Your appeal must be in writing. You have the right to be represented by an attorney. If you hire an attorney, everything the agency mails to your attorney will also continue to be mailed to you. Click HERE for more information about your right to question the decision made on your claim.
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How The Continuing Disability Review Process Works
Once disability benefits have been awarded, the Social Security Administration typically will review your case in a few years to determine whether you still meet their definition of disability.
Disability is defined as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment, which can be expected to result in death or that has lasted or can be expected to last for a continuous period of not less than 12 months.
A person who has been awarded disability benefits may regain the ability to return to work after having surgery or receiving other restorative medical treatment. If your benefits were awarded by an administrative law judge, the judge can recommend to the agency that your case be reviewed after a certain period of time .
If you receive a cessation notice saying the agency has decided to stop your benefits, you MUST APPEAL WITHIN 10 DAYS if: You want your benefits to continue during the appeal process You are willing to risk having to pay back those benefits if you lose your appeal.
If you choose not to have your benefits continue during the appeal period, then you have 60 days from the date you received the cessation notice to file your appeal. Click HERE for the necessary forms and for more information about the CDR appeal process.
Myth: Why Bother I’ll Just Be Denied
Not true for everyone, says William Jarrett, a spokesperson for the Social Security Administration. While Jarrett says standards are strict, and the process is rigorous, the SSA wants to be certain the person is truly disabled and unable to work. And the rejection rate is high, he says.
”The allowance rates for disability claims in fiscal year 2013, the most recent data available, was around 33 percent,” he says. That means 33 percent of the applications received in fiscal year 2013 were approved.
“In my experience, people rarely get it the first time they apply,” says Melissa Proudian, an attorney in Fresno, California, whose primary focus is on Social Security disability cases. But if you’re denied the first time around, you can appeal.
And if the administration determines that you have a true, severe disability, they pay out.
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Apply For Benefits Online
You should apply for disability benefits as soon as you become disabled. Follow these easy steps to apply online for disability:
- To start your application, go to our Apply for Benefits page, and read and agree to the Terms of Service. Click Next.
- On that page, review the Getting Ready section to make sure you have the information you need to apply.
- Select Start A New Application.
- We will ask a few questions about who is filling out the application.
- You will then sign into your mySocial Security account, or you will be prompted to create one.
- Complete the application.
You can use the online application to apply for disability benefits if you:
- Are age 18 or older.
- Are not currently receiving benefits on your own Social Security record.
- Are unable to work because of a medical condition that is expected to last at least 12 months or result in death and
- Have not been denied for disability in the last 60 days.
Note: If your application was recently denied, our application is a starting point to request a review of the determination we made.
You may be able to file online for SSI at the same time that you file for SSDI benefits. Once you complete the online process above, a Social Security representative will contact you if we need additional information.
Do I Have To Choose Between Ssi And Ssdi Benefits Or Can I Receive Both At The Same Time
Many people receive payments under both programs at the same time. However, to qualify for Supplemental Security Income , you must meet the Social Security Administrations low income and asset criteria.Just like state government welfare programs throughout the United States, the eligibility rules are fairly complex. Income both earned and unearned as well as other financial resources and assets will affect your eligibility for SSI benefits. This includes any SSDI benefits, which means only those who qualify for a relatively low monthly SSDI benefit will be able to receive SSI and SSDI at the same time. In most instances, if your monthly SSDI benefit is $794 or higher, you will not qualify for any SSI.
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How Much Will I Receive In Monthly Benefits
The amount of benefits an applicant may receive for SSDI depends the applicants work history and income. The Social Security Administration uses the work history and income to determine the Average Indexed Earnings and Primary Insurance Amount . The AIME and PIA are used to calculate the monthly disability benefits and are described below:
Applying For Ssdi Post
When youre submitting a claim for SSDI, be sure to provide as much information to your doctor as you can. This can help with the documentation of your disability in your medical records. If you feel comfortable scheduling an in-person appointment, that is the best option, but even if telehealth is the route youre most comfortable with, make the most out of the appointment by going over your symptoms and any other relevant information with your doctor in detail.
When more information becomes available about the long-term effects of COVID-19, the types and severity of illnesses will determine each individuals eligibility for disability insurance benefits. But the quality of medical evidence about your condition is a significant determinant of whether you will be approved or denied for Social Security disability benefits, and telehealth visits cant provide the same quality of evidence as in-person assessments.
Along with the uncertainty surrounding COVID-19 long-haulers and the factors important for processing their disability claims, the pandemic has made it more difficult for the Social Security Administration to operate at peak efficiency and productivity. Many SSA offices remain closed or only offer limited appointments, and there have been processing delays for SSDI as a result.
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What Happens If The Adult Child Gets Married
If he or she receives benefits as a disabled “adult child,” the benefits generally end if he or she gets married. However, some marriages are considered protected.
The rules vary depending on the situation. Contact a Social Security representative at 1-800-772-1213 to find out if the benefits can continue.
To speed up the application process, complete an Adult Disability Report and have it available at the time of your appointment.
Those Who Can No Longer Work Because Of Covid
COVID survivors who are unable to work because of lasting effects from the virus should consider applying for disability benefits, though this can be a difficult road, says Barbara Comerford, founder of the Law Offices of Barbara B. Comerford in Paramus, N.J.
Social Security disability insurance is one option. To qualify for it, generally you must have earned 40 credits during your working years, 20 in the last decade before you became disabled, though younger workers may qualify with fewer credits. In 2021, workers earn one credit for every $1,470 in wages, or a maximum of four credits after $5,880.
You must also meet the definition of disabled. That means you are unable to continue working at your job, you can’t switch to a different position because of your condition, and the disability is expected to last for at least a year. Comerford, who has represented clients that have applied for disability because of long COVID, says the Social Security Administration has been more willing to pay out benefits, especially for older workers who are close to full retirement age.
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Is Your Condition Severe
Your condition must significantly limit your ability to do basic work-related activities, such as lifting, standing, walking, sitting, or remembering for at least 12 months. If it does not, we will find that you are not disabled.
If your condition does interfere with basic work-related activities, we go to Step 3.
What We Mean By Disability
The definition of disability under Social Security is different than other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability.
We consider you disabled under Social Security rules if all of the following are true:
- You cannot do work that you did before because of your medical condition.
- You cannot adjust to other work because of your medical condition.
- Your disability has lasted or is expected to last for at least one year or to result in death.
This is a strict definition of disability. Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities, including workers’ compensation, insurance, savings, and investments.
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Qualifications For Social Security Disability Insurance
You pay into the systemOur Social Security System is based on a pay-in / pay-out model. In other words, when you work at your job, you pay taxes to the Social Security System. If you become disabled, you, your spouse, or your dependent children are eligible for a monthly benefit. However, just because you pay into the system, it does not guarantee that you will be automatically approved if you file for social security disability.
Your disability aligns with their criteriaThe definition of a disability under the Social Security Administration is different from other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability. You may be considered disabled under Social Security if:
- You cannot do work that you did before
- They decide that you cannot adjust to other work because of your medical condition
- Your disability has lasted or is expected to last for at least one year or to result in death.
How Does The Request For Reconsideration Stage Of The Appeals Process Work
If your initial claim for SSI, SSDI or both are denied, you have the right to appeal the denial by filing a Request for Reconsideration. You must file your request within 60 days from the date you receive the initial denial.
At the reconsideration level, your case will be sent back to Disability Determination Services a state agency responsible for: gathering medical records and other relevant evidence having that evidence reviewed by a medical professional and making a decision on your claim. The person who handles your claim at the state agency on reconsideration will not be the same person who handled it when you filed your initial claim for benefits. It typically takes three to five months to receive a decision. Click HERE for the necessary forms and more information about filing a Request for Reconsideration.
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Other Payments May Affect Your Disability Benefits
If you receive certain other government benefits, such as workers’ compensation, public disability benefits, or pensions based on work not covered by Social Security , the Social Security benefits payable to you and your family may be reduced.
For more information about how these benefits can affect your Social Security payments, please refer to the following publications:
Myths And Facts About Social Security Disability Insurance
Here’s what you should know if you’re applying to Social Security for long-term disability due to a medical condition.
If your health is so severely impaired that you cannot work, you may have considered applying for Social Security disability insurance , a federal program designed to provide long-term financial protection for those who’ve paid into the program as working adults.
If you’ve been reluctant to apply for SSDI because of horror stories about mountains of paperwork, denials, and long waiting periods for your first check, take heart: Many of these tales are simply myths. And help for the application process is available much of it for free.
To help you sort the myths from the facts, we consulted a Social Security spokesperson, a lawyer who handles Social Security disability cases, and a patient advocate.