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: 43
Latest Activity: Mar 18

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

Private Long term Disability application

Started by Babs. Last reply by Maydayxtoo Feb 19. 1 Reply

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

Recently applied and waiting for a response back???

Started by Liz. Last reply by janice Jan 21. 8 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

Pre-SSDI application process preparation questions

Started by Katie Lady. Last reply by debbie Aug 1, 2013. 1 Reply

Hi Everyone-Some back story:Dx-ed w/PsA about 10 years by excellent rheumatologist tried less aggressive oral meds then moved onto Enbrel and (eventually when Enbrel stopped working well) Humira.Lost…Continue

Tags: questions, doctor, ssdi

Comment Wall

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

Comment by Alma on March 18, 2014 at 6:21pm

Stopped working 2/3/12; filed for SSDI 2/28/12; denied twice; asked for hearing 6/5/12;  just got a hearing for end of May...taking their time of course...


Moderator
Comment by Liz on March 17, 2014 at 10:21am

So I now am waiting for a date to see the law judge but learned my case is in "pre-hearing review" Anyone have any inside info about what this is?

Comment by Maydayxtoo on March 2, 2014 at 12:51pm
I had my video hearing Friday 2/28/14 (I know it was Rare Disease Day)and I felt it went really good, my attorney feels my medical file is in good order and she told the judge that. Since I had 3 failed attempts trying to return to work, my attorney said this hurt me, and I would need to explain why I did it. She said it stinks they hold this against you before your hearing but they do. I explained to the judge why I tried which was,
1. I didn't want to loose everything we have worked so hard for.
2. I picked the easiest job I've done in the past 20 years to see if I could do it so I tried several different jobs in my field, but medically I couldn't do them.
3. I didn't want to accept the fact I couldn't work any longer because that is the way I was raised and that's all I've done since I was 12.

The judge questioned the VE that was on the phone with examples of someone with my age, skills, education, and limits were there any jobs available I could perform, she gave 3 examples and so he continued questioning till she said that I could not perform any of these positions and I would not be employable and that there were no other jobs I could do. My attorney questioned her about one of the jobs and asked according to my limitations from FCT were there any jobs and she said no. My hearing lasted 1 hour and 15 minutes. My attorney said now we wait 6-8 weeks for the answer. I will keep you posted as soon as I find out.
Comment by tmbrwolf329 on February 25, 2014 at 12:00am

Just an update.  Still waiting for word on my appeal, but in the interim, I went to the OK Department of Vocational Rehabilitation Services.  They have since closed my case due to "progressive and worsening symptoms" of my disability.  In other words, as long as I am in this flare (going on 4 years now), I am unemployable.  I also received forgiveness of my student loans for permanent and total disability.  Hopefully these two additional pieces of information will help me win my appeal.

Comment by Broken Angel 13 on February 24, 2014 at 9:06pm

any one from rhode island? i am still working, but i am considering disability. just can't do it anymore. i need real break. no stress. can't do with my job. can't quit. used all sick and vacation time. thought about medical leave.

Comment by tmbrwolf329 on December 21, 2013 at 1:10pm

I first applied for disability in Sept 2012.  Denied.  I made the mistake of not filing an appeal because I was in the process of moving to another state because of my husband's job.  I reapplied (with an attny) in May 2013.  Denied.  I am now in the appeals process.  From the 1st app. they sent a letter w/ an appt the day befor thanksgiving. I got to the appt, waited 45 min. only to be told the SS ofice canceled the appt.  Instead they sent me to the local hosp for xrays.  The 2nd application I was sent to a doctor who asked me a couple of questions, didn't actually examine anything, and then told me to walk a few steps.  That was it.  Both denial letters said that I was perfectly able to do a job I did over 20 years ago and am no longer qualified to do (the banking industry made lots of changes after the banking blowout).  So now we wait.  Again.  If you are going to hire an attny to help, let me warn you NOT to contact one of the ones that have the 1-800 numbers.  Go see someone who is local, who you can actually see and meet.  My attny has been terrible (I screwed up and hired one of those firms that supposedly help anywhere in the country).  Terrible customer service, terrible response time, and the people working in that office STILL keep referring to my PsA as osteoarthritis.  Grrrr

Comment by jennyb on December 18, 2013 at 10:29pm

I received disability insurance 3 years ago. I had to wait until I was 55 to start receiving benefits though. I had no problem with the process; I had enough problems, and good consistent doctoring, that I sailed though the whole thing, I guess I am fortunate.


Moderator
Comment by Liz on December 1, 2013 at 12:17pm

Just an update on my SSI case. I have contacted the www.sslg.com website. I saw them on the bensfriends website & now have a lawyer. I am waiting for a date to have my hearing. I am hoping that will take place the spring of 2014. In the meantime I also have joined with a great social security group that is a wealth of info. In case anyone is interested it is www.SSDFACTS.COM.

Comment by Tracy Z. on August 13, 2013 at 6:32pm

Hi my Name is Tracy Z. and I have a background in Managed Healthcare - National  Insurer Appeals. I also work on a lot of Member Advocacy for Ben's Friends. I work closely with the SSA on Ben's Friends behalf & have worked with international Members re: disability issues.If you have any questions or need any assistance please Message me. If you leave a message on My Page it might be a while before I get back with you. I work on every Forum. A Private Message will send me an email.  Ben's Friends also developed an amazing US National Partnership for Members at  The Social Security Law Group...www.sslg.com. Their  link is also on our partners list. They have offices all over the US & a Spanish office.They come to you if there is not an office close to your location.. They work with other national organizations and foundations, so they understand complex illnesses. Please jet me know if you have any questions.

Thanks,

Tracy

Comment by debbie on June 23, 2013 at 1:51am

Hello,

I applied for SSDI in California. I filled out the necessary paperwork online. I met once with a Social Security Employee at the county office to deliver additional paperwork. 

I contacted my congressman's office to watch my application and act as an advocate. They determined That I was a financial hardship case. California was months behind so they had my application sent to a clearing agency in Arkansas that helps states that are behind. The woman in Arkansas was very helpful and called twice for information. They compleyed the medical portion of my application. I did have to call doctor's offices to remind them to get their medical records sent to SSDI. It took about a month for all my medical records to arrive. 

I have a documented history of PsA and depression due to chronic pain, as well as a few other ailmments.On my application I was thorough. I got a personal copy of all of my medical records. I listed every medication, every doctor, every test. I listed all past medications that didn't work or stopped working.  I listed past doctors as well as urgent care and hospital visiits. All of this was backed up by the medical records they received as I was copying the information directly from the records. The application portion that is sent out later that requests how and what you are able to do was filled out by myself and my son, then mailed in.

I applied Mid January and was just approved mid June 2013. So a total of five months from beginning to end of the process.

My only advice is to contact yur congressman (in the states), be very thorough and give them every detail. Be certain your doctor knows you are applying. Call the SS office and ask what paperwork they are waiting on and get it to them - yours or the doctors paperwork.

I never had to see a SSDI doctor to get a physical, my medical records alone were enough. Of course I am very pleased to get approved on the first try.

If anyone has any questions I would be happy to let you know how I did things in more detail.  Thanks.      

 
 
 
 

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