What the SSA Doesn't Tell You About the Application and Appeal Process

Are you applying for or planning to apply for Social Security Disability Insurance (SSDI)? This is no easy task—there are many intricacies involved in a Social Security application, and even the slightest mistake can reduce the chances of being approved for benefits.. This can make you feel isolated, or like there is nowhere to turn to gain insight and understand what went wrong with your claim. Not only that, but frustration can also come out of the appeals process in the event that your application is denied.

That being said, here are some tips and tricks that the Social Security Administration (SSA) doesn’t tell you when it comes to your SSDI application and the appeals process. These can be uncovered for you by our experienced disability experts, whose utmost priority is to ensure you receive the maximum amount of SSDI benefits that you deserve.

Your Condition, Your Claim

Believe it or not, you determine the amount of SS benefits you’re eligible for.

One of the deciding factors in applying is the amount the applicants’ contributions were to the SSA program through payroll taxes, and for how long. Without getting too complicated, this is done using a formula that comprises of the applicant’s contributions, date of birth and date of disability to determine the Primary Insurance Amount (PIA). The PIA directly translates into the amount the applicant is paid.

There is also the requirement for a comprehensive working history to help validate contributions made to the SSA. A recent work test and duration of work test are conducted, during which the SSA reviews your Social Security Earnings Record. You must have enough work credits for both of these tests in order to receive SS benefits (with certain exceptions).

Other things to consider in your application is your current working history:

• If your condition is “severe” enough to limit your daily activities

• If your condition is on the List of Impairments (some conditions automatically register you as disabled, by law)

• If you can do the work now that you could do before

• If you’re able to do any other type of work

Be aware that local state agencies make the final decision concerning disability at the first two levels – not the SSA.  The SSA makes the determination regarding work credits and insured status.

All applications are evaluated on a case-by-case basis, and are not need-based, but contribution based. Make sure you give them as much comprehensive information as possible on your medical condition, medications you’re taking and were prescribed, any laboratory test results, your work history and your most recent W-2.

Appeals Process

Been denied? You have a right to appeal your claim if you disagree with your determination. The four steps to this process are:

• Reconsideration

• Administrative law judge (ALJ) hearing

• SS Appeals Council review

• Review by the Federal Court

You also are able to appoint a representative, which can be an attorney, a friend or a disability expert to assist in handling your claim.

Reconsideration is basically another opinion from someone who did not have input on the initial decision of your claim. You may present any new evidence, as well, and are not usually required to be present. If it is again denied, the next step is the ALJ hearing, which may include testimonies from expert witnesses to shed more light on your specific condition. During this hearing, you may explain your case in more detail to the judge.

If the judge denies you again, you can request a review by the Appeals Council – they will not always grant this, depending on whether they agree with the judge hearing. After this, of course, comes a lawsuit to the federal district court.

Next Steps

All of these pointers only barely scratch the surface into SSDI and ways you can ensure you receive your full benefits. An important thing to keep in mind is that you don’t have to go through the process alone. Our disability experts are here to answer all of your questions and concerns, and make sure you furnish all of the proper information for your claim to be processed. Let us help you today!