If you suffer from a physical or mental condition that prevents you from working, you may be eligible to receive monthly Social Security Disability (SSD) benefits. However, what it takes to obtain these benefits may be a mystery to you. You are not alone. Many people find the process to be confusing. We want to clear up that mystery. Below, we outline the basic steps of applying for SSD benefits and explain issues you may face while seeking approval of your claim.
The SSD benefits application process can be lengthy, and strict time limits apply. A person who believes he or she suffers from a qualifying disability should begin the process of applying for benefits as soon as possible.
If you can no longer work because of a physical or mental condition, you should see your family doctor or a specialist without delay. A doctor can examine you, order tests and ultimately diagnose your condition. This diagnosis will be important for your future care and treatment. It also will be important for your SSD benefits claim.
Your next step is to make an initial determination of your eligibility. Generally speaking, you may qualify for SSD benefits if you:
Work credits are based on your earnings. If you do not meet the SSA’s work credits requirements, you may still be eligible for a different form of benefits called Supplemental Security Income (SSI).
A “disability,” according to the SSA, is a physical or mental impairment that:
If you believe you meet the SSA’s non-medical and medical requirements, you should go forward with preparing your application. Be careful and be thorough. Many SSD applications are denied due to technical errors. Go to the SSA website to see a checklist of information and documents you will need to provide.
When you are ready to submit your application, you can submit it by:
Hold on to your confirmation number. You can use that number to check on the status of your application after you submit it.
After you submit your application, the SSA will determine your eligibility. The process basically involves two steps:
A two-person team from DDS typically will review your application: A staff doctor or clinical psychologist and a claims analyst, or examiner. Sometimes, it will be only a single decision-maker. DDS will go through a five-step sequential evaluation process. The five steps are:
To determine your medical eligibility, DDS must have the most current information about your condition. If any changes occur in your condition, you should follow up by sending your new medical records to the DDS team that is reviewing your case.
When your case is sent to DDS for review, you should receive a notice that contains the name of your claims examiner and the address to use when sending in your new medical records.
Additionally, if DDS believes it needs more information, it may request for you to submit more medical evidence or ask you to undergo a consultative medical examination. This examination will be conducted by an independent physician and not the physician who is reviewing your application.
You must submit any record DDS requests and go to any consultative examination DDS requires. If you fail to cooperate with DDS, your application could be denied.
If you meet both non-medical and medical eligibility requirements, your SSD benefits application should be approved. You will receive a Notice of Approval letter. The letter will provide the following information:
As of January 2016, the average monthly amount paid to disabled workers receiving SSD benefits was $1,165.76. Please see our Benefits Calculator for an estimate of the amount you could receive in monthly payments. The amount you receive is subject to cost of living adjustments (COLA). This adjustment is based on economic data from the previous year.
If medical improvement is expected in your case, a CDR may be conducted as soon as the first year after you begin receiving benefits.
If a CDR results in a determination that you are no longer disabled, your benefits will be terminated. Otherwise, you should continue to receive benefits as before.
To learn more about returning to work while still receiving SSD benefits, please check out information about the SSA’s Ticket to Work program.
If your application is denied, you will receive a Notice of Denial letter. The letter will state the date when your claim was denied and provide a detailed explanation of the reasons for the denial.
If you wish to appeal the decision, you can submit a Request for Reconsideration in writing. You must submit the request within 60 days of the denial date. At this stage, a new DDS team will review your claim.
If your application is denied again, you will have 60 days from that denial date to request a hearing before an administrative law judge. Your hearing would be held at the nearest Office of Disability Adjudication and Review (ODAR). In Virginia, those offices are located in Richmond, Roanoke, Charlottesville, Falls Church and Norfolk. Satellite offices are located in other areas.
While roughly 40 percent of initially denied claims are approved at the hearing stage, you may have to wait more than 16 months before your hearing is even held.
As a result, you should explore options to speed up a decision on your application. These options include:
If a hearing does not result in approval of your application, you may pursue an appeal with the Appeals Council based in Falls Church, Virginia. If your claim is not approved during the administrative appeals process, the next step would be to file a lawsuit in the nearest federal court: The U.S. District Court for the Eastern District of Virginia or the U.S. District Court for the Western District of Virginia.
If your SSD benefits application is denied after you submit a Request for Reconsideration, you can request a hearing before an administrative law judge. However, the wait time from hearing request to hearing can be lengthy, as seen in the average wait time chart below (based on monthly data from the five hearing offices in Virginia).
How much can you receive in monthly SSD benefit payments? You can use our calculator to get a rough estimate.
The above estimate is based off of your date of birth and your historical earnings. Please be aware that this calculator is only an estimate. Your actual benefit amount may vary significantly due to other factors. We highly recommend that you speak with a Social Security Disability Attorney and use the free calculator provided by the Social Security Administration’s office.
Our disability calculator uses the information provided to give our closest estimate based off of your annual earnings. We highly encourage you to provide the most accurate data possible.
For a more accurate benefit estimate we recommend you modify your income history by using the fields below.
If you modify any values in your Income History, please click the Calculate button to update your Estimated Monthly Benefit Amount
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