A Social Security Disability or SSI Case from Start to Finish
Applying for SSDI and/or SSI
ApplicationA disabled person may apply for Social Security Disability Insurance benefits and/or SSI benefits. SSDI benefits are available to disabled individuals who have earned enough credits in order to achieve disability "insured " status. Insured status is usually attained by gaining 40 quarters of full-time work credits. SSI, or Supplemental Security Income" is a welfare program for the disabled. A disabled person may qualify for SSI, even if they have not achieved insured status for purposes of SSDI, as long as they meet certain means tested criteria, such as having less than $2,000 of countable assets. An initial application may be completed online on Social Security's website. The SSI application must typically be completed by means of a telephone interview with a Social Security representative or by an in person interview at the local Social Security office. You must provide a complete list of all your medical providers and a brief description of your work history for the 15- year period prior to becoming disabled. You will submit a medical authorization form, allowing Social Security to obtain all your relevant medical records. If you have opinion letters from your doctors or other medical providers with respect to your physical and/or mental limitations, those should be submitted as well. Your case will be sent to a state agency known as "Disability Determination Services", where a disability examiner and a medical consultant will be assigned to your case. At the initial decision level, you will need to complete at least two important forms known as an "Adult Function Report" and a "Work History Report". The Work History Report is an especially critical document in describing your prior work history in detail, which is a critical part of your case. Filling out that form incorrectly, or leaving out important details, could cause harm to your case. Social Security may schedule you for one or more ConsulItative Medical Exams. it is very helpful to have an attorney representative assist you with your case, even at this application stage.
ReconsiderationIf your case does not get approved at the initial stage, do not become discouraged. This is not unusual. Appeal that decision. The first level of appeal is known as a reconsideration. The appeal is typically completed online. It is important to let Social Security know about any new medical treatment you have received. It is also important to let Social Security know if your condition has gotten worse and if you have any new medical impairment(s). Your case will again be sent to Disability Determination Services, but this time to a different examiner and medical consultant, to be reviewed by a fresh set of eyes. If your condition has changed since the time of the initial application, you will be asked to complete a new Function Report, describing your daily activities and the limitations imposed by your medical impairment(s).
ALJ HearingDo not be distressed if your claim is denied at the reconsideration level. Appeal that decision. A denial at the reconsideration level is quite common. The next level of appeal is to request a hearing by an Administrative Law Judge. Though the wait time for a hearing can be significant (often a year or longer), you will for the first time, have the opportunity to testify before a Judge and tell him or her all the important details about your case. This is your "day in court." It will be necessary to have an attorney represent you at the hearing if you are to have any hope of understanding the nuances of the hearing. My advice: if you haven't gotten a lawyer by now, lawyer up! There will almost always be a Vocational Expert at the hearing, whose testimony you will not understand without the help of an attorney. There may also be a Medical Expert at the hearing, whose testimony may be difficult to understand. Your attorney will help you prepare for the hearing and will cross- examine and ask hypothetical questions of the Vocational Expert. Your attorney may also ask pointed questions of the Medical Expert if there is one. You are typically allotted about an hour for the hearing, so it is extremely important to be well prepared. Your attorney will know how to present your case in the most effective and convincing manner possible, especially given the time constraints. With a well-presented case and the assistance of an experienced attorney, your chances of prevailing at the hearing are much higher than at the prior levels of adjudication.