The Big Picture When You File For Social Security
The mechanics of your disability claim start long before you even think about filing. There is a lot of document gathering, doctor visits, and finally, the decision to file.
In my article Why You Should Immediately Appeal Your Denial, I posted this image:
While this is a good overview of a disability claim, the backstage of a claim is much more involved.
Listing Your Medical Conditions
As part of the application, you will have to list your illnesses or injuries for which you are requesting disability compensation. Be very specific. Provide the approximate date you began having symptoms. Know that for every disability you list, the length of time it takes to process your claim increases. List only those disabilities for which you suffer symptoms and/or have received a medical diagnosis. This will help speed up your claim.
Whats Needed To Increase Your Current Rating
You do NOT need in-service records when filing for an increase on an existing rated condition. When preparing for this process, it is essential to remember you are already service-connected for the condition. Meaning you already have established the service link and there is no need to prove this again. What you need are current records. Current records will let our doctors and the VA know how your condition has worsened. It also shows the state that requires attention and if the treatment is not working.
These are all things the VA bases your rating on. To get an increase, you must show how it is affecting your quality of life and if there is evidence of the condition improving with treatment. Our doctors compose a stellar DBQ with these records. Adding your DBQs and nexus letters is the best way to set yourself up for success with the VA the FIRST time.
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What Qualifies For Long
The qualifications for long-term disability are usually more stringent than those for short-term disability. With short-term disability, benefits can be awarded if the employee is unable to do their job. With long-term disability, benefits will typically only be awarded if the employee is unable to do any job. What constitutes a qualifying event will be specified in the policy, so it is important to understand when benefits may apply before accepting a long-term disability policy.
Qualifying events may include chronic pain, cancer treatments, or debilitating illness or injury lasting more than 26 weeks. If an employee could qualify for another form of income replacement, such as Social Security Disability Insurance, the long-term disability policy will no longer provide benefits.
Can I Still File A Paper Form
Yes. The option to file a paper form is available. The paper Claim for Disability Insurance Benefits or Claim for Paid Family Leave Benefits form can be ordered through Online Forms and Publications. Forms can also be requested by calling the DI Automated Phone Information System or the PFL Automated Phone Information System.
All forms are available at no cost.
Orders of 25 forms or fewer can take one week for delivery and orders of 25 forms or more can take two to four weeks for delivery. You can also obtain a claim form from a physician/practitioner or employer, or by visiting an SDI office.
Note: These claim forms use special ink which allows data to be scanned, captured, and uploaded into SDI Online for processing. They cannot be copied or reproduced only the original versions of the current claim forms are accepted. If you submit a copy of the claim form, the EDD will return the form and include a current original version with a letter telling you to complete and return the correct version of the form or to file a claim using SDI Online.
You may also request assistance by calling the EDD:
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The Disability Insurance Claim Packet
Youâll be required to submit a claim packet when you file your claim. The claim packet is a collection of forms that you need to fill out as well as legal documentation that describes your rights and responsibilities as an applicant for disability insurance benefits.
The claim packet also details your disability and its severity to prove to the insurer that youâre disabled and eligible for benefits. A typical claim packet will ask for the following information:
Wait For A Decision On Your Claim
Once you have submitted your application and fulfilled any further requests for information, you just have to wait for the claims representative to make a decision. They will either approve or deny your claim. Normally it takes up to 30 days for the claim representative to make this decision, but it can take longer in some cases. If you have been waiting months for a decision, something strange is going on and you should take the appropriate steps to get to the bottom of it.
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We Help Disabled People Apply For Social Security In Michigan
When people ask us how to start the disability claims process, our answer is to talk with us and find out whether filing for Social Security Disability benefits makes sense for them.
At Mancini Schreuder Kline PC, we evaluate your total situation and tell you whether filing for SSD benefits is in your best interest.
What Medical Evidence Is Required When Applying For Ltd Benefits
The medical evidence required to substantiate your claim is often complex. For example, you will need to receive frequent and long-term care. If youre not, the insurance company may not believe that your disability is severe enough to qualify for LTD benefits.
Youll need to make sure that your insurance company receives all of your medical records. If any medical records are missing even those from before your disability was incurred your claim may be denied.
Finally, you will need a doctors statement that speaks the validity of your disability. The statement should indicate your limitations, specifically in regard to your work-related tasks.
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How Do Back Payments Work With Social Security Disability Benefits
Getting access to Social Security disability benefits can take a long time. About 70 percent of the people who apply for these benefits are denied on their first try. Most people who are currently receiving disability benefits have gone through an appeal after their initial denial. With that said, when your claim is finally approved, and you start receiving your Social Security Disability Benefits Waukegan, you will also receive back payments from the time it took to approve your claim.
Date of Application
Back payments from the Social Security Administration are made because it takes a long time to process a request. There are a few determining factors that can help you figure out how far back your payments would have started. The first determining factor is your application date. You may receive back payments from the time of your application, and you may even be eligible to receive retroactive benefits which apply to the year before your application.
Start of Disability
You can receive Social Security disability benefits based on the date of the start of your disability as you record in your disability benefits application. This date is the date you record as most likely the time your disability began. This date is called the alleged onset date, or the AOD.
How Long Does Long
Once long-term disability benefits have been approved, an employee can continue to receive benefits for the length of the policy term or until they return to work. Most long-term disability plans provide coverage for 36 months, although some plans can provide coverage for up to 10 years or even for the life of the policyholder.
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No Attorney Can Promise That You Will Win Your Case
But I believe that the knowledge acquired in this course will give you a better understanding of the process and greatly reduce the stress associated with starting a disability claim.
So if you have been thinking about filing your claim and you didnt know where to start, get your 5 Day File Your Disability Claim Course now!
Until next time,
If you prefer to read a book instead of a course, my book Real Tactics for Filing Your Disability Claim is on Amazon Kindle and paperback!
The book follows the same strategies and lessons from the 5 Day Course but you can read it all on your Kindle, tablet or phone.
Simply click on the image and you will be directed to my book:
Submit Your Application And Provide Any Further Information
Once you have the application prepared, you simply send it in to the disability plan or program. The disability plan or program will assign a person to review your application this person is called a claim representative, advisor, or adjudicator. The representative will often call or write to ask you for clarifications or more information. You should always cooperate and give the requested information to the best of your ability. Being open and honest with whoever is adjudicating your claim will always help your case.
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After You File Your Claim
OK, you’ve filed your claim, now you sit and wait. It can take months, but usually the VA will send you a letter when:
If you submitted a claim online you can check the VETS.GOV website for the status. If you filed through a Veteran’s Service Organization you can check your claim’s status through them..
The VA may have to contact the DoD for records or if they need more medical information, they may ask you to provide it. The VA may also schedule an examination for you to assess the disabilities you claimed. If the VA requires you to undergo a medical exam to support your claim be sure to show up for the appointment, or risk having your claim delayed by several months. The VA may schedule you for multiple medical appointments depending on how many or what type of disabilities you claim.
Other than attend scheduled examinations, you dont need to do anything else unless VA sends you a letter saying it needs more information.
If I Start My Va Disability Application Does Va Consider This Intent To File
No. Simply starting your VA disability application doesnt show your intent to file. Youll need to submit an intent to file form, which sets the effective date . Then you can focus on gathering supporting documents to turn in with your disability application. If you submit an intent to file before you file your claim, you may be able to get retroactive payments .
Note: If you file your claim online, you don’t need to separately send an intent to file form. The online application already includes your intent to file.
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Get A Medical Certification
Your physician/practitioner must certify to your disability by completing and submitting the medical certification using either SDI Online or the DE 2501 Part B â Physician/Practitioners Certificate of the paper claim form. It is your responsibility to have your physician/practitioner complete and sign the form and submit it to us within 49 days from the date your disability begins or you may lose benefits.
Have your physician/practitioner complete the medical certification portion of your disability claim.
- A nurse practitioner may certify to a disability within his/her scope of practice however, he/she must perform a physical examination and collaborate with a physician or surgeon.
- A licensed midwife, nurse-midwife, or nurse practitioner may complete the medical certification for disabilities related to normal pregnancy or childbirth.
- If you are under the care of an accredited religious practitioner, you may download and print the Claim for Disability Insurance Benefits-Religious Practitioners Certificate .
Note: Your claim is not complete until your physician/practitioner completes a medical certification.
Explain Whether You Meet Or Equal A Listing
You should ask your doctor or psychologist to comment on whether your medical conditions meet or “equal” the requirements of a disability “listing” that’s relevant to your impairment. For instance, if you have poor hearing, you might meet Social Security’s listing for “hearing loss.” Social Security’s disability listings are found in its Blue Book. Most doctors will need to be given a copy of the particular disability listing for reference.
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Sending A Witness Letter
Witnesses can send their third-party letters directly to the Social Security Administration. The letter should reference the claimant’s name and Social Security number.
In lieu of a letter, a witness could attend the claimant’s Social Security disability hearing and give live testimony to an ALJ, but this isn’t always practical, especially in the case of former employers.
When You Start Your Disability Application Online It Notifies Us Automatically Of Your Intent To File
If you start filling out a claim form online for disability benefits, this will reserve a potential start date for your benefits. You dont need to call us or submit a separate intent to file form.
Note: This automatic intent to file only applies to online disability applications. It doesnt apply to online pension or DIC applications.
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Learn The Proper Way To Draft An Effective Disability Appeal Letter
By Bethany K. Laurence, Attorney
If the Social Security Administration decides that you are not eligible for disability benefits, or decides that the amount of your disability benefits needs to change, the agency will send you a notice outlining its decision. You have the right to appeal this decision, and if you disagree with the result of the appeal, you can appeal further to an administrative law judge . If you disagree with the ALJ’s decision, you can appeal to the Appeals Council, and finally, if you disagree with the Appeals Council decision, you can appeal to a federal court.
Although the SSA requires you to fill out certain specific forms when you appeal a decision, those forms include a space for you to explain why you think the decision was wrong. The forms only give you a few lines to write your explanation, but you should feel free to write the phrase “see attached page” on the form and submit a letter along with the form that carefully outlines the problems you see with the determination. You must appeal in writing within 60 days of the date you receive the notice.
What Qualifies For Short
To qualify for short-term disability benefits, an employee must be unable to do their job, as deemed by a medical professional. Medical conditions that prevent an employee from working for several weeks to months, such as pregnancy, surgery rehabilitation, or severe illness, can qualify to receive benefits. Since employers in most states must legally provide workers’ compensation insurance to all employees, any injuries incurred on the job are typically covered under a workers’ comp policy and are therefore not eligible for short-term disability.
While most non-work-related temporary medical conditions are covered by a short-term disability policy, there can be exclusions for preexisting conditions or intentional and foreseeable injuries . While employees can qualify for time off under the Family and Medical Leave Act to care for a sick relative, most short-term disability policies would not provide benefits if the covered employee is not the one with the illness.
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Social Security Disability Benefits: An Overview
The Social Security Administration pays disability benefits under two programs:
Social Security Disability Insurance SSDI provides disability benefits to blind or disabled individuals who are insured based on federal insurance contributions paid into the Social Security Trust Fund. Certain family members can also receive benefits based on a worker’s contributions.Supplemental Security Income SSI provides benefits to individuals who are disabled, blind or elderly, with limited income and resources, including children under age 18, who are disabled, blind or elderly.
The medical requirements that determine who is eligible for disability payments are the same under both programs. Under the Social Security system, disability payments are based on inability to work. Individuals are considered “disabled” if they are unable to do any kind of work and their disabilities are expected to last for at least twelve months or result in death.
How To Start When You Need To File For Social Security Disability
When claimants want to file for Social Security most are hesitant to start the process because they simply dont know where to start.
A lot of people begin with the internet to find some basic information and thats where the confusion begins. While Social Securitys official website is very informative, it still doesnt offer the big picture of how the process works.
It also doesnt tell you the secrets to winning your claim.
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