DISABILITY APPLICATION PROCESS

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DISABILITY APPLICATION PROCESS

A forum to discuss the Disability Application Process and learn from member's experiences in the US and internationally.

Members: 46
Latest Activity: on Tuesday

OVERVIEW OF APPLICATION PROCESS

Filing for disability insurance isn't necessarily a "crisis" in itself.  But job loss for many people is.  Thus you may need to apply for help at a time when you are otherwise in the middle of a mess.  You might find yourself dealing with a lot of distractions while you're trying to get financial help for your day-to-day expenses.  

The disability process is different from country to country.  In the US, it is also different for private disability insurance (which you have paid for, or which was provided through an employer) versus for Social Security Disability Insurance (SSDI).  The central "contract" is the same.  In return for having paid in a monthly insurance premium, an insurance company or government agency will partially replace your income for some identified period of time, after a medical condition makes it impossible for you to work.

For both public and private insurance, there is a waiting period after you have been forced to stop working, before you can apply for disability compensation (for SSDI it is five months).  To qualify for disability under SSDI, you'll need to go through an evaluation called "Residual Functional Capacity" or RFC, and demonstrate a level of disability which will keep you from working for at least a year. There is also a maximum amount of money that you are allowed to earn from occasional or part time employment, without a decrease in your SSDI benefit.  Disability payments and allowances for other outside income are generally not high.  But everything helps.

In the US, it is important to know that the SSDI application process may involve as many as three stages which might require a year or more to get through.  To start, you need to go to your nearest Social Security Administration office for pamphlets which describe what you do and what documents you need at each of these stages.

For the first two rounds of the process, you won't need a lawyer and in my opinion you would be well advised not to hire one.  What the attorneys don't want you to know is that a Social Security representative can assist you with the paperwork by asking you the questions and then they fill in your answers, either in person or in a phone interview.  You don't have to do anything.  Then the Social Security personnel send requests to your doctors for your records.  You are not involved in that process at all.  Additionally, your attorney actually doesn't do anything until a denial is made and you request a hearing and they don't even spend a moment filling out your paperwork - their paralegals do.  I was able to be approved on my first application without an attorney and it saved me thousands of dollars.  

A lawyer' fee for representing you in the SSDI process can be determined in one of two ways, both of them set by the Social Security Administration, not State law. The nominal fee is 25% of any award that you get of SSDI payments previously denied, up to a maximum of $6,000 dollars.  However, the lawyer may also petition the Social Security Administration for some other level of compensation after an award is made. 

If you must change disability lawyers in the middle of a case, things can become both complicated and expensive.  For background reading see The Social Security Insider.    Be aware also, that some lawyers don't support first-time applications because they feel the awards may not be large enough to cover their expenses.  In any event, if you and/or a family member can do this process for yourself without a lawyer's help, you might come out better financially.

Your disability application will need to be backed by letters from your doctor (or doctors).  These letters must identify your medical diagnosis and describe any past or present treatments that have a bearing on your ability to work.  The doctor will also describe your symptoms and reactions to treatment, showing how these symptoms make it impossible for you to take regular employment -- even working from home.  Many patients report being required to be interviewed by another doctor who is appointed to evaluate you and confirm that the symptoms and issues in your application actually exist.  To be awarded disability, you must demonstrate that you are expected to be unable to work for at least a year.  And the doctors who support your application need to be considered mainstream practitioners.   The findings of a Chiropractor or Herbalist will have much less credibility than those of an MD, Doctor of Osteopathy or Ph.D. Psychologist.

About a third of all first-time SSDI applications are granted on the first try.    Another 10-20% are granted on a reconsideration application. The rates of successful application vary sharply from US State to State.  Numbers quoted on the website of  "The Ultimate Disability Guide" vary from a high of 52% approval on a first application in Hawaii, to a low of 23% in South Carolina.  

If you apply for SSDI and are denied, and then you apply for reconsideration and are again denied, there is a second level of review before an Administrative Law Judge.  At this level you should be represented by an attorney.  There is yet a third level of review in an Appeals Council.  Theoretically, you could go even higher than the Appeals Council in Federal Court, but such legal actions are quite rare.

Be aware that once you have "won" an SSDI case, you also need to be mentally prepared for a periodic review by the Social Security Administration to determine whether you continue to be disabled.  If all of this looks like an obstacle course to you, then you have a lot of company among disability applicants.

For additional information and insights, I suggest that you visit the Ultimate Disability Guide, above.

More links:

"The Social Security and Disability Resource Center.

How Do I Submit and Support a Disability Claim?

Discussion Forum

Self employed....

Started by sunshine. Last reply by sunshine on Tuesday. 3 Replies

Hey guys...new to this group and need some help.  I had to quit my job...after being on FMLA for a month because I just wasn't able to be reliable even part time.  My husband is self-employed and I…Continue

Private Long term Disability application

Started by Babs. Last reply by Butler Jul 4. 2 Replies

Hi everyone,Has anyone applied for LTD through a private insurance company ?  I have numerous health conditions that are not improving, in fact getting worse as I age ( 59..ugh !). Was allowed short…Continue

Is there an option for people who haven't been working?

Started by nym. Last reply by Babs Jun 2. 3 Replies

I had a friend recently ask me why I'm not on disability, as it was the plan for me to go back to work part time when my youngest turned 6, and that just can't happen because of my health issues.…Continue

Recently applied and waiting for a response back???

Started by Liz. Last reply by basset momma May 31. 9 Replies

Just wondering if anyone in this group has applied for disability & wanted to share with the group where they are in the disability process??Continue

Comment Wall

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You need to be a member of DISABILITY APPLICATION PROCESS to add comments!

Comment by sunshine on October 10, 2014 at 3:47pm

Thanks Garmstro for the input and Congrats!  Hope you get a good report soon!  :)

Comment by garmstro67 on October 10, 2014 at 2:38pm

Sunshine,

    I owned a business with my brother, and actually still do, however I have not collected a pay check for over 2 years. I think it does make your case a little different, but if you can't do your job then it is still being disabled. I feel that the fact that I owned my own small business may have even helped me when I went in front of the judge, I do not have anything concrete on that, it is just the feeling I had during the hearing. Good luck.

Comment by garmstro67 on October 10, 2014 at 2:34pm

I thought I would fill every one in on the appeals hearing I had today for SSDI. I and my lawyer think it went very well. The judge wants to see some x-rays of my fused ankle to verify the damage. At the beginning I was not feeling too good as they had a doctor on the phone who was just being unrealistic and speaking to things the judge did not even ask about. Eventually the judge pretty much cut him off and said that would be all. The doctor basically said that I could go back to work because my symptoms come and go. I feel the judge was very fair and understanding. I have not got the official results yet, but my attorney is VERY confident that I will be approved as soon as the judge can see my x-rays. To say I am relieved would be a huge understatement. I will be keeping everyone up to date once I am approved, then I will continue in this thread so that I can try to help other people like so many have helped me on this site and this thread in particular. Peace.

Comment by sunshine on October 8, 2014 at 9:06am

Hi there....I am new to this group and was wondering if anyone in this group is or has been self employed?  Need some advice.....  Thanks!

Comment by tmbrwolf329 on October 3, 2014 at 12:35pm

OH! Here is an FYI: If you have worked in manual labor or what they call "unskilled" labor, you are more likely to be approved for Disability quickly.  If, however, you work in a career that required specialized education/certification or are highly educated, it is almost guaranteed to delay your application, as there are supposedly "more opportunities" to work in a less labor intensive job if you have some educational background.  I believe this is utter and complete rubbish, but I heard this from a disability attorney and from a person at the SSA both.

Comment by tmbrwolf329 on October 3, 2014 at 9:46am

My favorite part of the SSA application process (sarcasm intended) is when they denied me because I am supposedly perfectly capable (according to them) to do a job I did 15 years ago in banking that I am no longer qualified to do thanks to the banking fiasco that started this latest recession.  Banks no longer hire people to do general ledger accounting unless they have a degree in accounting.  Not to mention that I actually cannot physically do the job anyway.  

I already have a master's degree that I cannot use (organizational psychology) and I spent the 10 years prior to my "retiring" from my old job preparing for a future that no longer exists for me.  I was the CEO of a midsize nonprofit organization in deep south Texas for 10 years and worked on getting enough credentials under my belt to become a nonprofit board consultant.  Had planned to start my own business doing that, but I can no longer travel because of my physical limitations, can no longer do presentations due to my anxiety issues, and cannot spend hours and hours preparing presentations and leading retreats because of both of the above.  What made me really sad was up until about 6 months ago I had $75k in student loans for my master's degree with absolutely no way to pay them back.  Talk about stress!  Then I found out about the Total and Permanent Disability Student Loan Forgiveness program and applied.  They have decided that I qualify, and my loans have been forgiven, so at least that is something wiped off my plate.  Things have gotten so tight for us financially that my  husband and I are seriously considering Chpt 7 bankruptcy.  Except that we don't have enough money to pay the lawyer to file for us.  According to the available online calculators, he and I make a negative $475/mnth in disposable income (they have specific allowances for things like housing, utilities, food expenses, etc.)  Once I figured that out, I realized its pretty miraculous that I've held us together for this long.

Comment by Babs on October 3, 2014 at 9:02am
tmbrwolf329 I am sorry to hear about your dealings with SSA, denials and worsening symptoms. Being helpless against the system is very high on the frustration scale for sure. I was extremely fortunate that my SSA process took me less then a year and cannot imagine how it feels to be denied. I was actually told by the SSA person in charge of my case( they have official names, just don't remember!) that I received it so quickly because I had multiple physicians and tons of records sent to them. I was working as am RN which is demanding physically , I just could not do it anymore. I think having a job of such a limited scope of jobs that I could do as as alternative helped also. I read these posts and feel guilty at times, I thought I had it rough,staying awake til 4AM some nights gathering and organizing my paperwork, etc. The more I read the more thankful I am I was not put before judges and going through the stress of rejection. Your post yesterday was very emotional, that is what you have to show "the system", tell them like you wrote it. A few years ago I requested an appeal hearing at the Independence Blue Cross headquarters in Philadelphia over a drug they refused to approve. There were 5 people in the room...a person recording the hearing, a Blue Cross physician, two other BC employees and me. They actually set a timer giving you 15 minutes to present your case, so I wrote my appeal and started to read it. After about 5 minutes they all looked bored to death and not paying attention to me. I ended up putting the paper down and started talking to them, showing the real me...the pain I had,the frustration and even anger. I won the approval I think because I showed them I was not a number or just another person, I was me and I deserve and demand your attention. They tried to intimidate me,and they did but I gave it my all and showed them we are all individuals, not just a file or another case. I don't know if it's possible, but try to push past your anxiety, show everyone who is putting you aside that you need and demand help! Not years from now but right now! Hopefully you will be heard, but if not don't see it as a failed attempt, use that experience to build on the next time. If you can write with such passion and freely express your frustrations out there for all to read, use that passion face to face if possible. It's worth a try and you may surprise yourself with the strength you have! I hope you get the help, I'll be thinking and sending positive you way, hang in there OK?
Comment by basset momma on October 3, 2014 at 1:45am

I totally agree with tmbrwolf329 - we should do a class action lawsuit.  It's horrible what we have to go through to have our sickness recognized as debilitating too.  Sorry you've had such a hard time.  Hope you have a lawyer involved.  Good luck and hang in there.  :-)

Comment by tmbrwolf329 on October 1, 2014 at 10:52am

Sorry I haven't been here for awhile.  Things have been crazy and I've been spiraling down instead of coping (what can I say, I have lousy defense mechanisms).

 I am now officially on year 3 (or maybe 4??) of my fight with SSA - and I am so not happy.  I have been denied repeatedly, and am now awaiting an appointment with the judge.  My attorney told me it could take up to a year to get the appointment.  Meanwhile, I am still unable to work, am unable to afford the very costly infusion for Remicade - even though I can get the meds for free from the Patient Assistance program, and am now basically treating the symptoms and not the disease.  I have exhausted the efficacy of most of the biologics - and now can't get into any clinical trials for new ones because I've been on too many biologics.  I am taking 25 mg methotrexate by injection weekly, and 1000 mg of sulfasalazine daily, but it seems like things are heading downhill fast, and the meds I am taking just can't keep up.  My case with the OK Dept of Vocational Rehabilitation got closed because my symptoms are "ongoing and deteriorating," and I've had 3 different doctors insist I cannot work.  Of course, its kind of obvious I can't work when I can't walk much, can't bend, take stairs, lift my arms over my head for longer than it takes to put my hair in a ponytail (and not even that long some days), can't stand for longer than a few minutes without losing my balance, can't sit for long because my sciatic nerve gets all hinky, and can't comfortably lay down either.  I only sleep sporadically - and never more than 2 or 3 hours total each night.  I'm about to ask the doc to put me back on anti-anxiety meds, as my anxiety levels have skyrocketed - along with my blood pressure.  Since beginning this disability process for PsA, I've added the diagnoses of high blood pressure, IBS, plantar faciitis,  and diabetes in addition to the PsA, insomnia, and 4 herniated lumbar discs I started with. Yeehaw.

 I feel like we should all band together and file a class action lawsuit against the SSA.  Maybe that would get their attention and speed the process up a bit.  It is absolutely ridiculous the hoops we have to jump through to qualify for the money we've been paying into the system our whole working lives.   I, for one, am sick to death of their worksheets and questionnaires, and being treated like I am a hypochondriac. 

Normally I am not this disgruntled, but my grandkids just left after being here for 4 days, and I am exhausted.  Its one thing to say I don't have energy or the stamina to chase kids around and another thing entirely for my daughter to figure out I mean it.  (and now she is considering moving to OKC to be "closer" to us - meaning she plans to move here and get a job and leave the kids with me every day.  NOT GONNA HAPPEN.  Not safe for them or me!)  Life is grand.

Comment by garmstro67 on October 1, 2014 at 10:21am

Thank you so much Alma, I really do appreciate the help that you have provided, plus just talking to someone who has been through this recently. I hope all remains as good as possible for you.

 
 
 
 

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