Disability is much more common than most of us realize. According to the Social Security Administration (SSA), a 20-year-old worker has a 25% chance of becoming disabled before reaching retirement age.
Social Security disability insurance (SSDI) provides cash payments to individuals who are unable to work due to a serious illness or injury. Some examples of conditions that may qualify include musculoskeletal disorders, respiratory disorders, cancer, cardiovascular disease, and mental health disorders that are resistant to treatment.
After someone has received SSDI for 24 months, they also gain access to Medicare. Those who are in the 24-month waiting period often qualify for Medicaid.
Eligibility Requirements for Social Security Disability Benefits
Social Security disability benefits have both a work requirement and a medical requirement.
- Work requirement. You have earned sufficient work credits. This varies by age, but generally, you must have worked at least some part of 5 of the last 10 years before you became disabled.
- Medical requirement. You are suffering from an illness or injury lasting 12 months or more that limits your ability to do basic work-related tasks such as sitting, standing, lifting, and remembering instructions. You are unable to do the type of work you did previously or other work that your skills and education would reasonably qualify you to perform.
If you do not have sufficient work credits to qualify for SSDI, you may qualify for Supplemental Security Income (SSI). This program is for disabled or elderly individuals with limited financial resources and has no work requirement.
The Application and Appeals Process
The application for Social Security disability benefits can be completed online or at the local Social Security office. It will ask for detailed information regarding your work history and medical condition. Ideally, you should have your attorney complete the application on your behalf to make sure it best supports your claim for benefits.
Unfortunately, it’s estimated that the SSA denies about 70% of applications in the initial stages. Some of these people simply do not qualify for benefits under the law, but many do manage to win benefits on appeal.
The appeals process has four levels:
- Request for reconsideration. A reconsideration of your original claim is performed by a medical consultant and examiner who were not part of the initial case decision.
- Administrative Law Judge hearing. If your request for reconsideration is denied, you can ask for a hearing with an Administrative Law Judge (ALJ) who works for the Office of Hearings Operations (OHO).
- Appeals Council. If the ALJ denies your request for benefits, you have the option of requesting a review from the Appeals Council. Cases are randomly selected for review at this stage.
- Federal court review. If you’ve exhausted the SSA appeal options, you can sue in federal court. However, this option is rarely used because it is time-consuming and expensive.
Timeline to Receive Social Security Disability Benefits
You should apply for Social Security disability benefits as soon as you believe you may qualify. On average, it takes three to four months for your initial application to be reviewed. If your initial application is denied, the appeals process typically takes another three to four months. In some cases, it can take a year or more to gain access to benefits. Expedited processing is available for people with certain terminal conditions, but there is still a significant gap between when you apply for benefits and when you receive your first monthly benefit check.
The Value of Legal Representation
You are not required to have an attorney to apply for disability benefits. However, SSDI rules are complex and the majority of applications are initially denied. Without an attorney who can advocate for your rights, you risk not being able to access the benefits you need to provide for yourself and your family.
O’Connor Law PLLC helps New York residents apply for disability benefits and navigate the appeals process. We do not charge an upfront fee for our services. Under SSA law, attorney fees are limited to 25% of your back pay up to a maximum of $6,000 unless your case makes it to the Appeals Council or you sue in federal court. Then, your attorney must file a petition to charge more than the $6,000 maximum based on the level of time involved in preparing your case.Contact us today to schedule a free, no-obligation initial consultation to discuss how we can assist with your claim. Our offices are convenient to residents of Westchester, Nassau, Suffolk, Rockland, Putnam, and Orange counties, as well as those living in Brooklyn, Bronx, Queens, and Manhattan.