Frequently Asked Questions

It is a very common question, and it's one that is difficult to address. Every case has its own specific characteristics that can either speed up or slow down a decision. But first, let me see if I can narrow down the options. If your case is dismissed twice and you have to go to a hearing, you should expect your case to take two years to complete. In most states, the claimant must wait several months after filing an appeal for a hearing before getting his or her case heard by an administrative law judge, or ALJ.

Let's begin with what each represents:

SSDI is an acronym for Social Security Disability Insurance. SSI stands for Supplementary Security Income.

When an applicant is considered medically disabled, SSDI is granted if he or she has received the appropriate amount of job credits for his or her age and has not caused those credits to expire. Consider it this way to make it easy to understand: it's like paying into an insurance policy. A demand for benefits may be made as long as the policy is still current. If you are unable to function due to physical or mental limitations. Do not wait too long to apply.

A claimant's eligibility to apply for this type of disability usually expires after 5 years. After receiving SSDI for 2 years, the claimant will be eligible for Medicare benefits.

SSI is similar to SSDI, but it is not the same. An individual must meet the medical criteria to be eligible for these benefits, but no job credits are required. However, to be eligible for SSI benefits, an individual must earn no more than a certain amount per month and have few non-exempt assets. Instead of having to wait a long time to apply for Medicare coverage, the claimant will qualify for Medicaid right away.

If you applied for disability online, the local Social Security office will give you documents confirming your eligibility. This is the stage at which the procedure starts. Your case is then referred to a disability determination program (DDS) in your home state after all of your administrative problems have been resolved.

These are state employees at Disability Determination Services (DDS) who are compensated by the Administration and are qualified in Social Security Disability law. Once your case is received, a claims examiner can review your medical history and make a decision on your claim. You will also be asked to complete a Function and Work History Report as part of the process.

These reports often assist the claims examiner in assessing what job you may be able to perform, considering your physical or mental disabilities, as well as how your everyday restrictions show that you are unable to work.

If your original application is rejected, you will have an option to file a reconsideration appeal, in which a new claims examiner will review the medical evidence. If you are denied a second time, you must file an appeal to get your case reviewed by an Administrative Law Judge (ALJ). Most cases end here, but if the judge denies your claim, you will have the opportunity to have your argument heard by the Appeals Council.

Following that, the case will either be remanded back to the judge who heard your case or denied once more. If that fails, you will take your case to a Federal District Court and then to the appropriate Court of Appeals. And, believe it or not, if the case is deemed relevant enough to be entertained by the Supreme Court of the United States, it may wind up there in the end. However, bear in mind that most cases conclude after the first hearing, and yours is likely to be one of them.

I admire your courage if you are not worried about your hearing. Most people are understandably concerned about their hearing, and I am always impressed by their perseverance in experiencing such a challenging process.

Each judge holds his or her own hearing and performs it in his or her own manner. Some judges take full care of the hearing, leaving the claimant's lawyer with nothing to do. Some judges request an opening and closing statement from the attorney, while others do not.

However, regardless of the judge who hears the case, there are certain fundamental events that can occur during the hearing. First, a vocational or medical specialist is present to support the judge in making his or her decision. Since there is no competing or opposing counsel trying to deny the person's claim, the judge may almost always challenge the claim directly.

The typical sequence of events is as follows:

The judge records the case and asks the claimant's counsel to state a hypothesis of the case or make an opening statement. The judge then asks the claimant about the medical conditions that prevent him or her from working. Then, the judge will question the claimant's counsel.

Following that, a series of hypothetical questions is posed to the medical or vocational expert. These questions are hypothetical in reference to the claimant. 

The judge then delegates the expert testimony to the claimant's lawyer. The ultimate goal is for the expert to state that there are no jobs available in the national economy that the claimant can do. If this is the finding during the hearing, it raises the likelihood of a favorable outcome.

Finally, the claimant and his or her lawyer are dismissed once the hearing is adjourned. This process lasts less than an hour and likely 30-45 minutes. In one to four months, the claimant will obtain a letter SSA with the final ruling.

That's not a simple question, and it cannot be answered simply by reading this brief response.

The Social Security Administration follows a 5-step process to decide whether or not an individual is disabled. Remember that the Administration has the authority to ascertain your inability to function for the purposes of obtaining disability benefits. People sometimes feel that only because their doctor decided that they are unable to function proves that they are disabled.

The Social Security Administration has its own definition, it's a legal definition and not a medical one, of disability:

An individual is deemed disabled if he or she is unable to participate in significant gainful activity due to any medically determinable physical or mental impairment(s) that can be expected to result in death or that has lasted or can be expected to last for a continuous period of no less than 12 months.

Consequently, if you can apply these 5 measures to your own mental or physical conditions, you could be effective in deciding whether or not you are disabled:

You should proceed to Phase 2 if you are not engaging in substantial gainful work.

Is your disease (or a combination of conditions) severe?

Step 2 requires that the illness last for at least 12 months or be intended to last for at least 12 months and that it interfere with a person's ability to participate in simple physical and/or mental work activities. To summarize, if the illness impacts you emotionally or physically to the point that it interferes with your ability to function, you will be able to skip Step 2 and continue to Step 3.

Does your condition fall into one of the categories?

If the illness is severe enough to satisfy the Social Security Administration's definition of disability, you will be determined if your impairment meets the severity criteria (Step 2) and you are not engaged in significant gainful work (Step 1). If this is not the case, proceed to Phase 4.

Will you do any of the jobs you've done in the last 5 years?

And if you meet the severity criteria, you are still not disabled if you can do any job you have done in the last 5 years and have worked long enough to have mastered the job. If you are unable to perform any of your previous related jobs due to a physical or mental disability, the assessment will progress to Phase 5.

Is there anything else you can do?

If you can perform some form of a job by taking into account your age, experience, and previous related work skills, you are not disabled. If, however, you are unable to perform any other type of job in the national economy, due to your mental or physical condition(s), and you meet the other criteria, you may have a good argument for being disabled.

To be considered disabled under Social Security's rules, you must meet certain conditions. An individual may believe he or she is impaired, but will be rejected because he or she does not fit within the standard. Let's begin with the most fundamental concept of being discovered disabled. An individual must have such a serious impairment or combination of impairments that he or she has been out of work for 12 months or more, may be required to be out of work for 12 months or more, or has a disorder that causes the applicant to be terminal in order to be found disabled under Social Security disability laws.

Of course, it's not that easy now.

To begin, the claimant's disability (or combination of impairments) must “substantially” impair his or her ability to perform basic work activities. Sitting, standing, walking, kneeling, leaning, reaching, focusing for long periods of time, getting along with others in the workplace, and so on are examples of such behaviors.

If your impairment(s) prevent you from performing one or more of these tasks, you may be eligible for Social Security disability benefits. However, and there's always a “but,” a claimant's capacity to perform one or all of these daily tasks is dependent on his or her age, education, and whether or not he or she has acquired skills from previous work.

Let's look at some examples to help you understand.

The first example is:

A claimant who is over 55 years old, with a high school diploma, and has worked in unskilled labor for the last fifteen years before applying for disability benefits. Despite his or her impairments, whether he or she may function at a light or sedentary stage, he or she is likely to be approved for disability benefits.

The second example:

A Claimant is over 50 years old and can still work at a light or sedentary position, and has no transferable abilities from previous jobs; he or she might be eligible for disability benefits.

The third example:

The same claimant as in Example 2, but now the claimant is under 50 years old with the same impairments as in Examples 1 and 2. Since the claimant is under the age of 50 and can still work at a light or sedentary position despite his or her impairments, he or she would likely be denied.

As you can see from these examples, disability benefits can be granted or refused based on a person's age or past work history. There's a lot more to it than deciding whether or not a person has a disability that greatly limits his or her ability to perform simple job tasks.

With a long history of hard, arduous work, an applicant can qualify for Social Security disability. The following are some examples: (1) a person with a limited education had a long history of arduous, unskilled manual labor, and (2) a person who is advanced in age, has a limited education, and has no work experience.

Many individuals who are trying to win their case for Social Security payments face the dilemma of not having adequate medical evidence to support their arguments. One reason is that many people have been out of work for almost 2 years or more by the time their hearing date arrives, and they lack the financial resources to pay for individualized medical treatment from a private practitioner.

Many people have been reduced to only being able to visit a county emergency department if their symptoms worsen. As a result, it is difficult for an client to pick out one doctor who would be able to provide more medical evidence to support this client's case. 

To resolve this question, the claimant may want to begin keeping a daily record of how their conditions affect their daily activities. You see, if you can't fulfill the medical listing for your condition, you'll have to demonstrate how it affects your ability to function. This is often demonstrated by how long you can walk, stand, or even carry something heavy, or how well your fingers can manipulate small things like a pen or type on a keyboard.

A daily journal is one of the tools you can use to achieve this. It is, however, important to demonstrate how your condition affects your everyday activities. Simply stating that you were exhausted and spent the whole day in bed is not enough.

What you should write is if getting out of bed was painful, what part of your body hurt, and that you were unable to make breakfast that morning because your back hurt so badly that you had to sit down after just 10 minutes.

Or maybe you attempted to carry a 20-pound bag of pet food or an 8-pound gallon of milk but were unable to do so due to the pressure on your hands and back. These are the kinds of things you should be writing down every day. These examples are your “residual functional ability.” This residual functional ability is what Social Security considers when making a decision on your disability. The same with mental health concerns.

Your mental health residual ability is also measured by Social Security. As a result, you should be keeping track of how your mental illness or illnesses prevent you from going outside, driving a car, caring for a pet or loved one, coping with stress, managing money, and so on. As a result, your daily diary should be telling a story from the time you woke up to the time you went to bed.

As well, many people have a tough time sleeping because their disability affects them, and they worry about the financial side of it. If this is the case, you can keep track of the days when you can't sleep, which causes you not to be able to get up in the morning and go to work, even if you have to.

I hope this information has been useful. If you have solid medical evidence to back up your point, it will only strengthen your argument.