Applying for Social Security Disability Insurance (SSDI) can be a daunting task. Understanding the evaluation process is essential for a successful claim. SSDI provides financial support to individuals who are unable to work due to a disability. Knowing what to expect and preparing adequately can significantly increase your chances of approval. Below, our friends at Cohen & Cohen provide an overview of the steps involved in the SSDI evaluation process and how you can prepare effectively.
Understanding The Basics Of SSDI
Before delving into the evaluation process, it’s important to understand what SSDI is. SSDI is a federal program that provides benefits to disabled individuals who have paid into the Social Security system through their work history. Unlike other benefits programs, SSDI is based on your work credits and medical condition rather than financial need.
Initial Application
The first step in the SSDI process is submitting an application. This can be done online, over the phone, or at a local Social Security office. The application requires detailed information about your medical condition, work history, and personal details. It’s crucial to provide accurate and thorough information to avoid delays or denials. It can be helpful to work with an attorney on this application from the start so that you know everything is one hundred percent correct before submitting it.
Reviewing Work Credits
Once your application is submitted, the Social Security Administration (SSA) will review your work history to determine if you have enough work credits to qualify for SSDI. Generally, you need to have worked for at least five of the last ten years, but this can vary based on your age. If you do not have sufficient work credits, your claim will be denied at this stage.
Medical Evaluation
If you meet the work credit requirements, your application will move to the medical evaluation phase. The SSA will review your medical records to determine if your condition meets their definition of disability. This involves evaluating whether your condition is severe enough to prevent you from engaging in substantial gainful activity (SGA).
Consultative Exam
In some cases, the SSA may request a consultative exam (CE) if they need more information about your medical condition. This exam is conducted by a doctor appointed by the SSA. It’s important to attend this exam, as failure to do so could result in your claim being denied. The results of the CE will be used to make a final determination on your medical eligibility.
Assessing Residual Functional Capacity
The SSA will assess your residual functional capacity (RFC) to determine what level of work, if any, you can perform despite your disability. This involves a detailed evaluation of your physical and mental limitations. The SSA considers all medical evidence, including statements from your healthcare providers, to determine your RFC.
Vocational Assessment
If the SSA determines that you cannot perform your past work, they will conduct a vocational assessment to see if there are other jobs you can do. This takes into account your age, education, work experience, and transferable skills. If the SSA finds that you can adjust to other work, your claim may be denied. If at any stage of this process you are unsure how to proceed, it is in your best interest to contact a lawyer for help.
Final Decision
After completing the medical and vocational assessments, the SSA will make a final decision on your SSDI claim. You will receive a letter stating whether your claim has been approved or denied. If your claim is approved, the letter will detail your benefit amount and when you can expect to receive payments. If your claim is denied, the letter will explain the reasons for the denial and outline the steps for appealing the decision.
Appeals Process
If your claim is denied, don’t be discouraged. Many initial SSDI claims are denied, but successful appeals are possible with the right approach. The appeals process includes several stages, starting with a request for reconsideration, followed by a hearing before an administrative law judge, a review by the Appeals Council, and potentially a federal court review. Having a skilled attorney by your side can significantly improve your chances of success during the appeals process.
Understanding the SSDI evaluation process and preparing thoroughly at each step can greatly increase your chances of a successful claim. For those undergoing this complex process, it is recommended that you seek the assistance of an attorney to ensure your rights are protected and your claim is given the best possible chance of approval.