My Insurance Company Wants Me To Apply For Social Security Disability Benefits. Am I Required to Apply?
“We often hear insurance companies requesting that you apply for Social Security disability benefits. Always check your certificate or your policy for the offsets, the other income provisions. Your insurance company can offset, dollar for dollar, for the money that you received or that you’re eligible to receive from Social Security disability.”
“It helps if you apply and you’re found disabled, because if you’re in the own occupation period, where you’re protected because you can’t do your occupation, and Social Security finds that you’re disabled from any occupation, they must give that finding significant weight.”
“If, on the other hand, you don’t have a very good treatment record, you haven’t been able to afford medications or to see the doctor because you lost your coverage, probably not the time to apply for Social Security disability. One of those tricky areas that you probably should get some help before you do anything.”
Social Security Disability Insurance FAQ
I applied for Social Security Disability and I was denied. Does that mean I am ineligible?
SSDI denies nearly 60 percent of first-time applicants. If you are denied, it doesn’t necessarily mean that you’re ineligible. You may simply need to provide additional information to the state agency to allow it to properly reevaluate your application. An experienced Social Security lawyer can help you compile the convincing medical and financial evidence and properly and timely complete the paperwork needed for a successful application or appeal.
Why are people denied Social Security Disability?
Social Security may have denied you because:
- You did not work a sufficient amount of quarters
- Your condition was deemed not severe enough to prohibit you from working at your occupation as you did before
- Your condition does not meet or equal one of the Administration’s severe impairment listings
- You can perform the important duties of another occupation, given your age, education, and job skills
- You have an outstanding warrant for your arrest for certain felony crimes, you were convicted of a crime and will go to jail, or you violated your probation or parole
Special rules pertain to individuals who are blind. A Social Security Disability attorney can explain those rules to you.
How do I determine if I am eligible for SSDI?
Toqualify for Social Security Disability, you must work the required amount of quarters to meet the duration test. This amount of time may vary depending on your situation. A general rule is that, you must work a sufficient number of years, based on your age at the time of your disability:
- If you’re disabled before age 28: 1.5 years
- Age 30: 2 years
- Age 34: 3 years
- Age 38: 4 years
- Age 42: 5 years
- Age 44: 5.5 years
- Age 46: 6 years
- Age 48: 6.5 years
- Age 50: 7 years
- Age 52: 7.5 years
- Age 54: 8 years
- Age 56: 8.5 years
- Age 58: 9 years
- Age 60: 9.5 years
In addition to having worked a sufficient number of quarters, the Social Security Administration will review your application to ensure that you meet basic eligibility requirements, such as being at least 18 years old, and a U.S. citizen or legal alien. You must have a medical condition that will prevent you from working for at least 12 months and you cannot already receive benefits or have applied and been denied benefits within the last 60 days.
Your application will be forwarded to your state agency, who will evaluate your medical condition to determine your ability to work, how your condition limits your activities, and the medical treatments and care you have received. The doctors don’t determine whether you’re disabled, but provide information for the state agency to make its decision.
What information do I need to apply for benefits?
Applicants will need thefollowing information to apply for Social Security Disability:
- Your date and place of birth, as well as your Social Security number
- The name, date of birth, and Social Security number of your current spouse and any former spouses, as well as the dates and places of marriage and dates of divorce or death
- Names and dates of birth of any minor children
- Your bank account and routing numbers if you wish to have Social Security electronically deposit your benefits
- Detailed information about your injuries or illnesses, including contact information for all doctors, hospitals, and clinics that have provided treatment to you
- Names of any medicines you are prescribed and names of any medical tests you are ordered to undergo, as well as the name of the physicians who ordered these medications or tests
- The amount of money you have earned this year and last year
- A copy of your Social Security statement
- The beginning and ending dates of any military service you had before 1968
- A list of up to five jobs you had in the 15 years before you became unable to work and the dates you held those jobs
- Information on any additional benefits, such as workers’ compensation that you plan to apply for
Social Security may also require you to show documentation to prove your eligibility for benefits, including:
- Birth certificate
- Proof of U.S. citizenship or lawful alien status
- U.S. military discharge papers if you served before 1968
- W-2 or self-employment tax forms for last year
- Medical evidence, including doctor’s reports, medical records, and lab reports
- Proof of any temporary or permanent workers’ compensation-type benefits you receive
How can a Social Security Disability attorney help me file a claim?
Applying for Social Security Disability benefits is a complex process. Nearly 90 percent of applicants end up seeking assistance from an experienced Social Security Disability attorney during the process. Having a Social Security attorney help you with your application ensures that you provide the appropriate information and increase your chances of approval. An attorney can also help by remaining in communication with representatives from the state agency to promptly address any issues that come up during their consideration of your application.
If your application is denied, an attorney can assist you in filing an appeal and represent you during that process. You must request an appeal in writing within 60 days of the agency’s decision. After that, the application may pass through these levels of appeal, all of which your lawyer can help you through:
- Reconsideration by the agency
- A hearing with an administrative law judge
- A hearing before the appeals council
- Filing a claim in federal court
If your application is approved, your attorney will evaluate the Social Security Administration calculations to ensure that all information provided was used and that no errors were made. Your attorney can also answer any questions you have about your disability benefits.
How long will it be before I receive a decision on my application?
Thelength of time it takes to receive a decision on your application depends on
the nature of your disability
- How long it takes the Agency to receive medical evidence from your doctors and other medical sources
- Whether the Agency determines that it is necessary to send you for a medical examination
- Whether the Administration reviews your application for quality purposes