The process of receiving disability benefits starts with the application. The information you provide enables the Social Security Administration (SSA) to assess whether or not you meet their disability requirements. It also helps them evaluate any current work capabilities and activities you may have. You’ll also need to fill out a Social Security Disability Report in which you identify your disability and provide proof you are disabled. If you meet their requirements, the SSA forwards your application and disability report to your state’s Department of Disability Services (DDS) for local processing.
Before you start to fill out the forms, be sure you qualify by reviewing the following requirements.
Disability Benefits Checklist
Information You Will Need for Your SSD Application:
- Your full legal name, plus any other names you may have used.
- Name(s) and date(s) of birth of your spouse and minor children, if any.
- Military service discharge information (Form DD 214) for all periods of active duty, if any.
- W-2 Form (or your IRS 1040 and Schedules C and SE if self-employed) from last year.
- Your account number and the bank (or S&L or credit union) routing number of your checking or savings account, so that monthly benefits can be paid via direct deposit, since no check will be mailed to you. If you don’t have an account, you can request a Direct Express® debit card and have it credited each month, or open a low-cost (about $3/month) Electronic Transfer Account (ETA).
Information You Will Need for Your SSD Disability Report:
- Name, address and phone number of someone the SSA can contact who knows about your medical condition and can help with your claim.
- Names, addresses, phone numbers, patient ID numbers, and dates of treatment for all doctors, hospitals and clinics you went to in regard to the disability you’re claiming. Or, refer to any medical records you’re sending.
- Names of any relevant medicines you’re taking and who prescribed them. (Refer to the labels on the medicine bottles.)
- Names and dates of medical tests you’ve had and who sent you for them.
- A list of up to five jobs you’ve had in the 15 years before you became unable to work. If possible, include the dates you worked at those jobs.
- Information about any insurance or workers’ compensation claims you filed, such as claim number and the name, address and phone number of the insurance company.
Note: The SSA may contact you for additional or more detailed information after you submit your application and report. Be sure your contact information is current and correct. If you lack any of the above information, don’t delay filing your claim until you can find it or obtain it.
The sooner you apply, the sooner you may receive your SSD benefits.
Your state’s DDS completes the disability decision for the SSA.
They will review your application and disability report and, if necessary, ask your doctor(s) and/or medical facilities for further details on your disability.
Using the medical evidence provided, they want to know:
- What your medical condition is
- When it began
- How it limits your activities (especially those pertaining to generating income-)
- What your medical exams and tests have shown
- What treatment you’ve received
- Whether any additional exams or tests are needed to determine your eligibility for SSD benefits.
If the DDS needs additional medical evidence of your disability, they will ask you to have a special exam or medical test, and they will pay for it; they will also pay for certain related travel expenses. If a doctor who is not your regular doctor performs your exam or test, the DDS can send a copy of the results to your regular doctor if you ask them to do so.
The SSA warns: “It is your responsibility to take the exam or test and cooperate with the doctor examining you. If you cannot keep the appointment we make for you, let the DDS know right away. If you do not let the state agency know that you cannot keep the appointment, it will make a decision based solely on the information already available in your case file. This may result in a decision that you are not disabled.”
When you take the exam or test, the doctor or medical technician who sees you will only obtain the specific information requested by the DDS. He or she will not take part in deciding whether or not you are disabled, and will not prescribe treatment or medication for you. A report of the exam or test will be sent to the DDS.
The SSA and the DDS need to know the answer to this question:
Are you able to do any other type of work?
If you cannot do the work you did in the past, the state agency looks to see if you would be able to do other work. It evaluates your medical condition, your age, education, past work experience and any skills you may have that could be used to do other work. If you cannot do other work, they will decide that you are disabled. If they assess that you can do other work, they will decide that you are not disabled and you will not be eligible for SSD benefits.
Special rules for blind persons
If you are blind or have low vision, the SSA has special rules that allow you to receive benefits when you are unable to work. They consider you to be legally blind if your vision cannot be corrected to better than 20/200 in your better eye (if there is one), or if your visual field is 20 degrees or less in your better eye. But you can get disability benefits even if you are not legally blind, if your vision problems alone, or combined with other health problems, prevent you from working.
For SSD benefits, you must have worked long enough in a job where you paid Social Security (FICA) taxes, or if self-employed, you paid SE taxes. By doing so, you earn credits that count toward future Social Security benefits. If you are legally blind, you can earn credits anytime during your working years. Credits for your work after you become blind can be used to qualify you for benefits if you do not have enough credits at the time you become blind. Also, if you do not have enough credits to get SSD benefits based on your own earnings, you may be able to get benefits based on the earnings of one of your parents or your spouse, if any.
There is a special rule—called a “disability freeze”—that may help you get higher disability or retirement benefits someday. You can use it if you are legally blind but are not getting disability benefits now because you are still working. If your earnings are lower because of your blindness, the SSA can exclude those years when they calculate your Social Security disability or retirement benefit in the future. Because Social Security benefits are based on your average lifetime earnings, your benefit will be higher if the SSA doesn’t count those years.
[To be eligible for Supplemental Security Income (SSI) benefits based on blindness, you need not have worked, but your income and resources must be under certain dollar limits, which change annually.]
If you are applying for a disabled child
Children from birth up to age 18 may get Supplemental Security Income (SSI) benefits, rather than SSD benefits, if they are disabled and have little or no income and financial resources. The family’s household income and resources are also considered and cannot exceed certain dollar limits.
- The child must have a physical and/or mental condition that very seriously limits his/her activities. The application should include a statement that describes the child’s functional limitations, compared to children his/her age who don’t have impairments in acquiring and using information, in attending and completing tasks, interacting and relating with others, moving about and manipulating objects, caring for himself/herself, and regarding his/her health and physical well-being.
- The condition(s) must have lasted, or be expected to last, for at least 12 months, or result in death. For a list of childhood medical conditions that commonly result in disability, refer back to the How to Apply for SSD Benefits section.
The state agency (DDS) makes the disability decision by reviewing the information in the application and, if needed, by obtaining further information from medical and/or school sources and others who know about the child. If they need more information, they will arrange an exam or test, paid for by the SSA. The decision typically takes three to five months.
Social Security Income (SSI) is not a medical assistance program. If one is needed, your state’s Medicaid agency, local health department, social services office or hospital can help you find a health care agency. Also, the State Children’s Health Insurance Program (SCHIP)—available in every state—provides insurance for prescription drugs and for vision, hearing and mental health service. Ask your state’s Medicaid agency for details.
Benefits for Adults Disabled Before Age 22
An adult disabled before age 22 may be eligible for child’s benefits if a parent is deceased or starts receiving SSA retirement or disability benefits. This is considered a “child’s” benefit because it’s paid on a parent’s Social Security earnings record. The “adult child”—including an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild—must be age 18 or older, unmarried, and have a disability that started before age 22. He or she must meet the definition of disability for adults, as described above.
What to Expect After Mailing in Your SSD Benefits Application and Medical Report
SSDI was started to help people who are unable to work due to severe disability. Unfortunately, many people who are not completely disabled and are able to work, flood the system with applications, because they are misinformed or fraudulently trying to claim disability benefits. This keeps those who truly are disabled from getting their benefits quickly.
To cut down on fraudulent claims, or claims that are made with little understanding of the qualifications, the application process has become complex, the requirements have become strict and the process of proving your claim is time-consuming. Unless you are eligible for expedited processing via the Compassionate Allowances program described elsewhere on our website, it can — and usually does — take five months or longer, if additional medical evidence is required, for an application to be reviewed and either accepted or denied.
If an initial application for SSD is denied (as the majority of them are) it’s often because of an error or omission on the part of the applicant. Then, if the application and accompanying medical records are corrected, revised or otherwise improved, it can take another three to five months before a decision is made by the SSA and DDS.
If you want to improve your chances of having your application accepted, the wise thing to do is to have legal assistance in preparing it. Statistics show that applications and appeals prepared by a professional are more likely to be approved.
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