Social Security Library
The Social Security Disability Claims Process
1. File your application. The first step to obtaining benefits is to apply. An application for SSD or SSI can be made online, by telephone or in person at any local Social Security Administration office. If you plan to apply in person, we recommend that you call the SSA office and schedule an appointment if you feel that you are unable to work because of a serious physical or mental impairment. When you meet with a SSA representative, you should have a list of the names and addresses of your doctors and a list of each prescription medicine that you take and the name of the doctor who prescribed it. You will also be asked questions concerning the types of jobs that you have held for the past fifteen years and to describe the nature of your condition and why it prevents you from working.
After you complete the application, the SSA will gather your medical records and may ask you to undergo a consultative examination with a physician selected by the SSA. Once the medical evidence is collected and reviewed, the SSA will send you a notice of determination on whether you qualify for benefits. SSA’s statistics show that most claims are denied at the initial level so don’t be discouraged if your claim is initially denied.
2. Requesting A Hearing. If you live in Pennsylvania and your application for benefits is denied, you have sixty days to file an appeal requesting a hearing before an Administrative Law Judge (“ALJ”) from that decision. If an appeal is filed, the SSA will schedule your case for a hearing before an ALJ where you will have the opportunity to present medical evidence and testimony supporting your claim for benefits. The hearing before the ALJ provides an extremely important opportunity for you to present evidence in support of your claim and is the only time throughout the administrative process that you will have to speak directly to the person making the decision on your claim. Our attorneys regularly represent clients in social security cases before ALJ’s sitting in Pittsburgh, Greensburg, Johnstown, Erie and Seven Fields, Pennsylvania as well as Morgantown, West Virginia.
3. Appeals Council. If the ALJ denies your claim, you may file a further appeal to the Appeals Council which is located in Fairfax, Virginia within sixty days of the ALJ’s decision. The Appeals Council conducts a review of the ALJ’s decision and the evidence and testimony presented at the hearing to determine whether the ALJ erred in denying your claim for disability benefits. The Appeals Council will also consider any new evidence that you may submit supporting your claim.
4. Federal Court. If the Appeals Council denies your claim, you may file a further appeal into federal district court. This appeal must also be filed within sixty days of the Appeals Council’s decision. The district court’s review of the SSA’s decision is extremely deferential, and consists of a review of the administrative record to determine whether the SSA decision is supported by “substantial evidence” or whether the SSA committed an error of law.
How Is Disability Defined Under The Law
The law defines disability as the inability to engage in any substantial gainful activity due to a physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of at least 12 months.
Am I Insured For Purposes of SSD?
If you are over age 31, you will be insured for purposes of social security so long as you have worked five out of the last ten years immediately preceding your disability onset date. If you are under age 31, you will generally be insured so long as you have earned credits in one-half of the quarters elapsing after you reach age 21 up to the date that you became disabled. If you have questions about whether you are insured for SSD, call your local Social Security Office or the Social Security Administration at 800-772-1213.
In most cases, Disabled Widow’s and Widower’s Benefits are paid to individuals who are at least age 50 and who become disabled within a certain amount of time after the death of their husband or wife, so long as the deceased spouse was fully insured under the Social Security Act.
Dependent children of insured elderly, disabled or deceased workers are entitled to child’s benefits up to the age of 18 based solely on their relationship to the worker and their age. Dependent children who are disabled and cannot work can collect SSD benefits based on their parent(s) earnings so long as 1) he is the child of an insured worker; 2) was dependent on the worker; 3) files an application; 4) is unmarried and 5) must be under a disability that began before age 22.
Is Age A Factor In The Disability Process?
Yes, age matters in social security disability cases. If you are over age 50, you have a better chance of having your application for benefits granted because the SSA assumes that as people get older, it is more difficult for them to switch to a different job or learn a new job skill.
As a general rule, you will not be paid SSD benefits for the first five months of disability. SSI benefits are payable the first month after your application is filed.
How Long Does It Take To Get A Hearing?
Although the time it takes to schedule a social security disability hearing varies, in our experience individuals residing in Allegheny, Beaver, Butler, Fayette, Greene, Lawrence, Mercer, Westmoreland and Washington counties typically wait approximately one year for their hearing to be scheduled.