What is Social Security Disability Insurance?

Social Security Disability Insurance is a payroll tax-funded, federal insurance program. Its purpose is to provide income to people unable to work because of a disability.

Who is eligible to receive Social Security disability?

Generally, if you’ve worked most of your life and paid your FICA tax, you will be eligible for Social Security Disability. Specifically, you must have worked ten years in your lifetime and five years out of the last ten at the time you became disabled for SSD eligibility. Widows over 50 and children under 22 may be eligible based upon the earnings that a spouse or parent have contributed.

What is the definition of “disability” under SSDI?

Under the law, disability is defined as the inability to perform a full-time job in a regular competitive work environment due to a physical or emotional problem or a combination of physical and emotional problems that your doctor feels makes you unable to work. In addition, the disability must be expected to last at least 12 months.

It is important to note that the determination of whether or not you are disabled does not hinge on whether you can do the job you did previously, but whether, considering your age, education and work history, you would be unable to perform any job that exists in the national economy on a full-time basis. The rules are more lenient for those who are over 50 years of age, because the law assumes that as you get closer to retirement age you are less adaptable. By the same token, those under 50 must clear much higher hurdles in order to receive benefits.

With that definition in mind, to obtain benefits you must have a doctor state that you are unable to work a normal, competitive, 5-day a week, 8-hour a day job. The doctor’s opinion must be supported by ‘medically acceptable clinical and laboratory findings’. Unfortunately, many genuinely disabling conditions are difficult to diagnose by objective testing

When should I apply for SSDI?

A good rule of thumb is to apply as soon as you and your doctors agree that your disability is going to last a full year. This is important because it can take many months for Social Security to approve or deny your claim. When you are ready to file you can obtain the necessary forms from your local Social Security Office or by applying online.

What steps are involved in the SSDI process?

There may be as many as five steps involved.

1. Complete the forms, make sure that you have gathered and submitted all the information necessary, and submit your claim.

2. While you may be awarded benefits when you first apply, most claims are denied. If your claim is denied, you will then have to file for reconsideration. Reconsideration is the stage in the process in which you are least likely to be granted benefits.

3. If you are again denied, you must request a hearing in front of an Administrative Law Judge. You must be prepared to present medical evidence and you will have the opportunity to tell the judge in your own words why you can’t work.

4. If you are again denied, you have the right to bring your claim before The Appeals Council. The Appeals Council can also deny your claim or send the case back to an Administrative Law Judge for another hearing. In some instances, they will reverse the case quickly and order the system to pay your claim.

5. If you lose at every stage of the administrative process, you are entitled to file in the United States District Court.

Do I have the right to be represented by an attorney?

If you think the system is designed to discourage disabled workers from seeking the benefits they’ve earned and that their families may desperately need, you’re right. The process is extremely difficult to navigate and a it can be years before a final decision is handed down. Not to mention the fact that you’ll be attempting to battle the bureaucracy while you’re struggling to deal with your disability and the financial problems that accompany being unable to work.

That’s why the law allows you to be represented by professionals who understand the system—like the legal team at Anzellotti, Sperling, Pazol, and Small.

Does having legal representation really make a difference?

Yes. According to report issued by the U.S. Inspector General in August of 2010, being represented by counsel does make a notable difference in the outcome of SSDI claims.

The report found the following:

• 91 to 94 percent of claimants who successfully appealed denials had representatives at the hearing level;

• Representation may be directly related to success because professionals assist claimants in developing medical evidence, are skilled at noticing additional impairments, especially mental impairments, and ensure claimants stay

focused at hearings;

• Many claimants find it necessary to secure representation at the hearing level in order to continue through the complicated process;

• A survey of claimants found that 78 percent experienced barriers to handling the disability process on their own including reading, understanding, and completing forms. Five percent of claimants surveyed stated SSA did not inform them that claimant representation was available. Clearly, having representation—and having the right representation—substantially improves the chances that your disability claim will be approved more quickly than if you take on the system alone.