10 Things to Know Before Applying for Social Security Disability

Before you begin an application for Social Security Disability Insurance Benefits (SSDI) or Supplemental Security Income Payments (SSI), it is important that you understand the requirements of the program, and the process that is used to determine your disability. The information below provides you with an overview of the general requirements of the Social Security disability programs. These are generalizations that help clear up misconceptions and help you better understand the disability programs. It is always important that you contact the Social Security Administration or a knowledgeable attorney before you decide whether to pursue an application.

  1. You must qualify non-medically – Social Security has two main disability benefit programs. When you apply, SSA determines your eligibility for both programs. If you qualify for both, you usually only receive payments from the program that would compensate you at the highest rate.
    1. Social Security Disability Insurance – This is an entitlement-based disability program. To qualify non-medically:
      1. You must have worked, paid Social Security taxes, and earned at least 20 quarters of coverage in the last 10 years before you became unable to work. (You can earn a maximum of 4 quarters of coverage per year. In 2009 you must have earned $4,360 to earn 4 quarters of coverage); and
      2. If you are working, your work must be at a level below Substantial Gainful Activity. (In 2009, your earnings must be less than $980 per month to be working at a level below Substantial Gainful Activity).
    2. Supplemental Security Income – This is a poverty-based disability program. To qualify non-medically:
      1. If you are single -
        1. You must have little or no income from any source. In 2009, you must have less than $694 per month in unearned income ( i.e. workers compensation, VA benefits, disability benefits, unemployment, etc.), or less than $980 per month in income from active employment; and
        2. The value of your assets (excluding primary home and primary vehicle) must be less than $2,000 (this includes money in the bank, investments, retirement accounts, or anything else that can easily be converted to cash)
      2. If you are married (or if you live with a significant other of the opposite sex)
        1. You and your spouse must have little or no income from any source. In 2009, you must have less than $1,031 in unearned income (i.e. workers compensation, VA benefits, disability benefits, unemployment, Social Security benefits), or less than $2,107 per month in combined income from active employment, and
        2. The value of your combined assets (excluding primary home and primary vehicle) must be less than $3,000 (this includes money in the bank, investments, retirement accounts, or anything else that can easily be converted to cash).
  2. You must qualify medically – The medical qualifications are identical for each program. If you are under 50 years old, you must prove that you have a medical condition (or a combination of medical conditions) that will prevent you from performing any full-time work on a continuous basis or that meets a medical listing.
    1. There is no partial disability available from SSA. In order to qualify you must be unable to do all full-time work.
    2. You must have medical documentation. You must be seeing a doctor on a regular basis, and your doctor must believe that you are disabled.
    3. You must have either already been out of work (or making less than $980 per month in 2009), or plan on being out of work for 12 months.
    4. You will not qualify because you can only obtain unskilled work at minimum wage. SSA only cares about your ability to work, and not how much you can make at full-time work, or whether an employer would actually hire you.
  3. Most people get approved on their initial application. It is a general misconception that SSA denies the majority of people that apply at least two times before they are approved. In reality, SSA approves about 50% of people in Delaware on the initial application. (It becomes much harder to be approved after the initial decision has been made).
    1. If you are denied at the initial application, you most likely you will have to attend an Administrative Law Judge hearing. It usually takes between 2-3 years after the initial application before an individual will reach the Administrative Law Judge level and receive a decision.
    2. Most people that are approved based on an appeal of an SSA decision could have been approved at an earlier level. Most people that are denied at the initial application level either do not qualify for benefits (do not have a severe enough condition), or else previously had not provided enough information to SSA that would result in a favorable decision.
  4. Attorneys cannot speed up a decision.
    1. SSA processes cases based on the order that individuals file for benefits.
    2. There is no requirement that a decision be made in a certain amount of time. (SSA can take 2 months or they can take 18 months or more).
    3. Most delays in processing cases occur because SSA is waiting for responses from your doctors, or because they are waiting on information from the person applying.
  5. Attorneys can increase your chance of success.
    1. An attorney that handles mostly SSA claims is familiar with the type of evidence that SSA needs to approve a claim. Although they cannot make SSA make a decision faster, they can obtain information from your doctors to increase your chance of being approved at an earlier level.
    2. Attorneys can advise clients of SSA rules and explain if a case will be difficult to win. Attorneys can also help with the application process and make sure that an individual understands questionnaires that they are asked to complete.
  6. Doctors usually do not provide SSA with opinions. In every denial notice, SSA lists doctors that have provided reports. Individuals usually assume that this means that their doctor provided SSA with a detailed description of their condition, or stated that they could work. Normally, this only means that your doctor’s office provided a copy of your medical records. The majority of the time your doctor will not even know that SSA received information from them.
  7. Social Security only obtains information from doctors you tell them about. If you do not provide SSA with information about all of your doctors, they will not obtain records from all of your doctors. It is important that when you apply for benefits you provide SSA with all details about every doctor that you have seen. This includes phone numbers, addresses and dates of visits. If you do not tell SSA about a doctor, they will not obtain information from him/her.
  8. Medical Examinations from SSA doctors are not usually necessary – SSA only schedules a consultative medical examination with one of their doctors if your own doctors have not provided sufficient information or if you do not have your own treating doctors or specialists. If an examination is not scheduled, that means that your doctor has provided enough information about you and your condition for SSA to make a decision.
  9. Social Security considers all of your impairments.
    1. Unlike Workers’ Compensation or Personal Injury claims, SSA needs information about every medical condition that you have been diagnosed with and that you have received treatment for. Both physical and mental disorders are considered by SSA. When applying for benefits it is important that SSA be advised of any medical impairment that may limit your ability to work. (This even includes conditions that you were diagnosed with while you were still able to work).
    2. Most often individuals fail to provide SSA with information about depression or anxiety. These conditions can be severe enough that you could be found disabled even without a physical impairment. That is why SSA must know about every problem you have.
  10. You do not have to wait to be denied to obtain an attorney.
    1. Our office can help you with a SSA claim even if you have not yet applied. Attorneys that handle a large number of SSA cases are usually willing to represent individuals at any level in the process. Since attorneys know what information SSA is looking for, having an attorney at the beginning of the process can increase the chance of an approval.
    2. Most Social Security attorneys have a free initial consultation by telephone or in person.
    3. Usually attorneys only charge a fee in Social Security cases if an individual is approved for benefits.

There are exceptions for all the areas that are covered. To determine if you qualify for Social Security Disability Insurance or Supplemental Security Income, please contact Steven Butler for a free consultation. Steven is a partner Linarducci & Butler, PA and limits his practice to Social Security Disability/SSI claims. Steven is happy to provide you with a free consultation to determine if he can assist you with your claim. Please use our contact form or call 302-613-0707 to schedule a free consultation appointment.

Steven Butler

Attorney at Law; Director at Linarducci & Butler, PA



Leave a reply