The Complete Guide on How to Qualify for SSDI

Applying for Social Security Disability Insurance (SSDI) is a difficult process. There are many reasons you can face challenges when you apply for disability benefits, often due to the government’s focus on finding fraudulent claims. As a result, the rules to qualify for social security disability insurance are designed to help avoid approval for those who are not qualified to apply.

Unfortunately, this impacts the honest people who have a right to apply and who actually do qualify for SSDI. To reduce the risk of being rejected, we offer our complete guide on how to file and qualify for SSDI and get the benefits you deserve.

Make Sure You are Eligible

There is no point going through the application process if you don’t actually qualify for SSDI benefits. Your condition must adhere to the Social Security Administration (SSA) definition of a “disability” which is a severe impairment that will or has caused issues for at least a year, or worse leads to death. Typically you also have to be below the age of 66 or 67, the average age for retirement. As well your FICA taxes must be paid for five of the last 10 years.

Always File Right Away

If at all possible, you, a loved one or disability advocate such as Princeton Disability should begin the filing process as soon as you are told you are unable to work. It is a lengthy process taking from three to six months to finally see the approval and then payments. An application can be made online, and you’ll need all your records in order to avoid delays. A Princeton disability advocate can assist you in gathering your medical records to ensure you have everything you need.

Compassionate Allowances

In the case where you have a severe condition such as terminal cancer, or brain disorders, your application can be expedited. This is based on the Social Security Administration’s (SSA) Compassionate Allowances (CAL). Compassionate Allowances are designed to identify diseases and other medical conditions meeting Social Security’s standards for disability benefits. We speak more about how you can fast-track your application below.

Be Prepared Before Applying

By being prepared you can ensure you follow the process step by step to reduce the risk for denial. This is no easy feat as only one in three applications are approved for receiving benefits at the first filing. While this is discouraging, if you ensure you have all the paperwork, records and information required before you apply, you are already ahead of the game. Denials are almost guaranteed when you have an incomplete, or inaccurate application. The more information missing, and the less organized and clear your application, the more questions there are during the processing of your application. This means you will either be denied or delayed in receiving approval and ultimately your payments. Depending on the specifics of the situation, applicants may not need all of the following information, but you should try to get as much as possible:

• Your complete medical history
• Information about all of your doctor and hospital visits, and as many of your medical records as possible
• Validation of your claims and work history
• Information supporting the severity of your disability
• The last couple of years of tax information
• Information about your current and past spouses
• Other sources of income since you became unable to work
• Criminal record related information including outstanding warrants
• Information about any workers’ compensation or similar benefits you filed, or intend to file
• Birth certificate/proof of birth
• Proof of U.S. citizenship/lawful alien status
• U.S. military discharge paper(s) prior to1968
• W-2 forms(s)/self-employment tax returns for last year
• Award letters, pay stubs, settlement agreements or proof of other workers’ compensation-type benefits you received

An advocate will know exactly what information and records are required to make it easier for reviewers to approve your claim. They will make sure your application clearly explains how your condition is impacting your ability to work and/or care for yourself.

Have Answers to Common Questions

You will also have to prepare yourself to answer a lot of questions such as:

• Have you applied for Social Security benefits or other forms of supplemental income before?
• Were you active in military service before 1968 and as a result received benefits from a military or Federal civilian agency?
• Are you qualified to receive a pension or annuity due to employment with the Federal or state government?

Being prepared to answer these questions will help you meet the requirements and appear honest during the application process.

Consider a Disability Advocate

A disability advocate understands the process and how to improve outcomes for acceptance. They also put everything together to avoid delays. You can present them with your paperwork, so they can review your records and look for areas that might prove troublesome before filing. This way you’ll have time to put together the missing information, so the application is processed without delay.

The Fast Tracking Process

As mentioned above, fast-tracking SSDI applications is possible if your condition is listed as one of the 254 conditions on the CAL program. If you are eligible for fast-tracking, it can reduce a process that takes months to just a few days. Again, your best bet, in this case, is to work with a disability advocate who understands the CAL program and can determine if you qualify. You might qualify for fast-tracking based on other conditions that meet the diagnostic and symptoms criteria on the list such as certain Musculoskeletal, Cardiovascular, and Mental Health conditions. Veterans can also often have their applications fast-tracked.

Veterans

Many veterans think their disability must be related to military action. However, even disabilities that happen while on leave can qualify. If you have a 100% Permanent and Total (P&T) disability rating from the VA, your application could also be fast-tracked. Be sure to identify yourself as a “Veteran rated 100% P&T” and include your VA rating notification letter.

As well, if you suffered disabling mental or physical health injuries on or after October 1, 2001, while on active duty, you are also eligible for expedited SSI/SSDI application processing under the Wounded Warrior program. This applies to all injuries, not just those that took place during combat. Be sure to inform the SSA your injuries are related to active duty when applying.

Disability Offset Rules

If you receive disability payments from private pensions or insurance this is separate from your monthly benefit payments from SSDI. However, workers’ compensation and other public disability benefits can reduce the benefits you receive from SSDI. Some examples of other types of public benefits that could offset your SSDI payments include compensation paid by federal or state workers’ compensation agencies, or by a federal, state, or local government related to disabling medical conditions that are not job-related such as:

• Civil service disability benefits
• State temporary disability benefits
• State or local government retirement benefits based on disability

Generally speaking, if you receive other types of public disability benefits in hand with SSDI, your payments can’t exceed 80% of your average current earnings before you became disabled.

When you work with an advocate to apply for social security disability benefits, we will collect the necessary medical documents and test results to prove you suffer from a severe medical condition. This can help speed up the application process so you can receive your money sooner.

Princeton Disability is here to help you receive the benefits you deserve. Schedule a free consultation today to learn more!