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Who Determines Disability and How?

If you are unable to work due to a disability, you may be considering applying for Social Security Disability (SSD) benefits to provide a source of income. People who apply for disability usually have many questions, such as:

Who will review my disability claim?

What information do I need to submit with my application?

How much can I expect to receive in disability benefits?

How long will it take for the Social Security Administration (SSA) to decide my claim?

What if my claim is denied?

These are all excellent questions, and knowing the answers can help make the application process a little less stressful.

 

Who will review my disability claim?

Social security disability claims are reviewed by a disability examiner at your local SSA field office. In Illinois, this review is performed by Disability Determination Services’ (DDS), which is part of the Illinois Department of Human Services. DDS has 56 offices in communities statewide; to find your local DDS office, call 800-772-1213.

 

What information do I need to submit with my application?

The disability examiner will review your application and any medical records you provide. The DDS can obtain records on your behalf from the medical provider or providers included in your application. However, this will increase the review time, so it is in your best interest to get copies of your relevant medical records and submit them with your application.

When reviewing your disability claim, the disability examiner looks for information to support a finding that your medical condition makes you unable to work. Social security disability benefits are only paid to people whose disability is long-term; it does not pay for short-term disability. The SSA considers a disability to be total and long-term if it has lasted, or is expected to last, 12 months or longer, or if it will result in your death.

The disability examiner will also examine your financial records to determine whether the disability interferes with your ability to work. Often an individual has a recognized, long-term disability (one listed in the SSA’s Blue Book, which contains more than 100 medical conditions that can qualify applicants for disability benefits) but is still able to work at least part-time. In 2020, the SSA considers a disability to negatively interfere with your ability to work if you earn less than $1,260 per month. If you earn more than this amount, your application will be denied, even if you meet the SSA’s definition of disability.

Because employees pay into social security disability through payroll or self-employment taxes, eligibility for disability benefits also requires that you have sufficient work credits. This means that you worked long enough, and recently enough, in a job that paid into the social security program. The number of credits required varies depending on the applicant’s age, but in general, an applicant needs 40 credits to qualify for disability benefits, 20 of which must have been earned in the 10 years prior to your disability.

If the disability examiner determines that you are unable to continue working in your current job, they will then try to determine whether you could perform any other work. The disability examiner will take into account your age, work experience, and the limitations imposed by your disability in deciding whether there is any other work you can perform.

 

How long will it take for the Social Security Administration (SSA) to decide my claim?

Once the disability examiner reviews all of this information, you will receive a notice of decision in the mail. If the disability examiner approves your claim, you will receive a Notice of Award roughly one to three months after the claim is approved, depending on the caseload of your local SSA field office. This notice will include your monthly benefit amount. Disability benefit amounts vary and are determined by averaging your lifetime earnings that were covered by Social Security. The monthly benefit may be reduced if you receive workers’ compensation, public disability benefits, or certain pensions. You can obtain an estimate of how much you would receive in disability benefits by visiting the SSA website and using their benefits calculator.

 

What if my claim is denied?

If your application is denied, you have the right to appeal. There are four levels in the appeals process. The first, reconsideration, is simply a review of the application by a different disability examiner in the same SSA field office that reviewed your initial application. If this appeal is denied (and most at this level usually are), you can then request a hearing before an administrative law judge. Administrative hearings are less formal than traditional court hearings, but you have the right to testify about your disability and how it interferes with your ability to work. The judge and the SSA attorney can also ask you questions about your disability, as can your attorney if you choose to hire one.

If the administrative law judge denies you claim, you can then appeal to the Appeals Council. The Council is comprised of administrative appeals judges, appeals officers, and support personnel. The Council can approve or deny your claim, or it may remand (send back) the claim to the administrative law judge to reconsider its decision.

If the Appeals Council denies your disability claim, your final option is to file an appeal in Federal District Court. This is a formal court hearing that will be decided by a judge. If you decide to appeal to federal court and haven’t already, we strongly encourage you to hire an experienced social security disability attorney. Disability attorneys have extensive knowledge and experiencing handling disability claims. And because they work on a contingency fee basis, they are only paid if your claim is approved. The SSA sets attorneys’ fees at 25% of any SSD back pay you are awarded or $6,000, whichever is less.

 

Hire a social security disability attorney

You can hire a social security disability attorney at any stage of the application process. Disability attorneys focus solely on helping their clients get SSD benefits and have a thorough understanding of the SSA regulations, the information that is needed to support your disability claim, and the best way to present it. This not only greatly improves the chances that your disability claim is approved, but also makes the process less stressful. Consider the Good Law Group for your representation – call (847) 577-4476.

 

By |2020-09-21T17:13:35-05:00September 21st, 2020|Appeals, Application process, Blog, Eligibility, SSD|Comments Off on Who Determines Disability and How?