A how to guide on applying for Social Security Disability Insurance. Information that is not provided on the social security website. Keys to applying for the best chance of approval.
Adventures in applying
Applying for social security disability (SSDI and SSI), and getting it the first time is like acing your SAT, MCAT, and LSAT at the same time. It isnt impossible, but it is considered pretty rare. Well I was one of those lucky people who was able to get it on the first time. So I am ready to impart my wisdom.
There isn't any special handshake, or magical words that can get you approved, it is all about being, organized, doing your homework and creating an application that is clear and complete.
How much will I be paid each month?
First off there are two disability benefits you are applying for Social Security Disability (SSDI), and Supplemental Security Income (SSI). For adults or kids who never worked they get SSI and for people who worked and have enough work credits you will receive SSDI. Some will be able to receive both. However the maximum SSI as of 2014 is about $721 for a single individual a month and any money from SSDI is subtracted. For example; if you have SSDI which pays $1000.00 a month, then you will not receive SSI because you are getting more than $700.00. But if you had $400 from SSDI a month then you could also earn $321. Getting SSI is tricky because there are rules like you can’t have over $2000 in liquid assets which included bank accounts and retirement funds so you would need to liquidfy them to just qualify. There are no asset limits for getting SSDI.
If you are working and paying out to social security every year, ,you will receive a summary in the mail from social security.This will tell you how much you have paid out, and there will be a section, if you are disable today here is what the estimated payment is, also it will show you the estimated payment at retirement age. This is the best indicator of what you will be paid each month while on SSDI. If you need to request a statement here is the link http://www.ssa.gov/mystatement/
The Application
You, can apply online, or make an appointment to go to your social security office to apply. I decided to go in person, since I wanted to make sure all my documents I had collected, go with my application. I realize not everyone lives near a social security office, so applying online and sending the appropriate documents after applying is the way most people apply.
Filling out the application however, is not the hard part and in my opinion, it isn't even the most important part.
You can find the application here :https://secure.ssa.gov/iCLM/dib
How do they decide if I am disabled?
First off, the people who decide on whether you are disabled in the social security office are not medical professional. They do employ some medical professional to review cases, but the first decision maker is not a medical professional. The social security office determines disability by what I like to refer to as their bible, but they refer to it as the blue book.There are two books one for adults and one for children who are under 18 years old.
Adult Blue Book can be found here
So what is the blue book? Well in short, the blue book is a list by body system of impairments that are considered eligible for disability. These listing are broken down into sections, each section describes the impairment/disease, and what the qualifications one must meet, and the tests at can prove one has such impairment.
The blue book is a medically technical so I advise that you print out the sections of the blue book that you think apply to you and bring it to your doctor. That is the next step. You must make an appointment with your doctor. I recommend the one that is treating the disease you are applying disability for and preferably the one that has known you the longest.
The Letter
So you made an appointment with your doctor to discuss disability. Your doctor play a vital role in the disability process. I think this is where many people go wrong. People who are applying rarely get their doctors involved in the process.
When filling the application out you have list your doctors names and their locations so the social security can contact their office to get the appropraite records. I recommend however that you be proactive and meet with your doctor, and get what you need from them up front so you can send it with your application.
The number one reason applications are denied, is the lack of medical information received. Social Security officer after receiving your application, contact the doctor(s) listed in the application and request medical information. They do not tell the doctor what test results, or doctor notes they need, to verify your impairment. Also it can take many months for social security to receive all reports and if they are not received in a timely manor you will automatically be denied.
This is where I believe a letter from your doctor is so valuable. So when making a doctors appointment you should let them know why you are coming. Composing a letter usually takes an hour. Be prepared and bring the blue book information with you to your appointment. Many doctors do not know what to write, or have even seen the social security blue book so I advise that you work with your doctor to compose the following:
- First Paragraph - should state how long the doctor has known you, and how long you have been treated for that condition at that clinic or hospital. According to the blue book, the last 5 years are the most important in determining your approval. So have the doctor who knows your medical situation, and has treated you the most during that time period compose the letter
- Second paragraph should be your basic vital signs, age, work history (full time or part time), diagnosis and severity of your condition.
- Third paragraph is where the blue book comes in handy. Have doctor review each section then outline the listings that your condition meet. Have you doctor list each listing that you meet, and explain how you meet them and the medical documentation to back them up. For example
Patient meets listing 4.06 of the blue book – Patient has cyanosis current at rest oxygen saturation level is 85% which leads to a hematocrit of 60 measured on the latest blood work that was obtained 10/10/10 , 7/20/09 please see attached office notes in the lab work sections.
It is really important that your doctor not only says the listing that you meet, but the evidence behind it so it is easy for the agent to review medical documents Also the blue book does state in it sections which tests they will take to back up the evidence you have such condition. For this previous example the blue book listed a that it accepts blood test results to prove the hematocrit and a medical document listing the resting oxygen level using an oximeter.
- If you don’t exactly meet the criteria of a listing have your doctor show evidence close to the listing and the severity of it and how it affects you
- Last paragraph the doctor should close with how long your impairment shall last for example:
Patient’s current medical limitations, as outlined does not permit that he/she sits, stands or walks for 8 hours a day. This impairment will last for life, as he/.she does not have therapeutic options available.
Then have your doctor give you copies of the medical records they have, especially the ones that are referred to in said letter. I gave all documents to my agent at the social security office when I applied, but if you apply online I advise mailing the information as soon as you apply
After Applying
The usual time period to hear back from the social security office on their decision is 3 to 5 months. I waited 4 months until I receive my letter saying I was approved. You can only start receiving benifits 5 months after the date you applied.
Also you will probably receive a questionnaire on your abilities to do daily tasks. This form has to be returned in a period of time that is noted or you will automatically be denied. You must be prompt with getting your agent any information they request by the time they request it.
You always have the right to appeal the decision of the Social Security Office. If you are denied many hire lawyers that specialize in disability law.
If you are approved, you will automatically be signed up for Medicare after 24 months on SSDI. So study up because navigating Medicare, is like getting a law degree or graduating medical school.
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