If you are not able to work because of a medical condition, you may be eligible for disability benefits through the Social Security Administration. Unfortunately, the process of proving eligibility and receiving benefits can be long and complicated.

The Anderson Hunter Law Firm has put together a legal guide to help answer your questions about Social Security Disability (SSD) insurance benefits, Supplemental Security Income (SSI) benefits, what to expect during the application process, and more.

Do You Qualify For Social Security Disability Benefits?

Do You Qualify For Social Security Disability Benefits

The Social Security Administration’s criteria for whether you qualify for disability benefits can be broken down by these three questions:

1. Are you working?

In order to be eligible for disability benefits, you must not be working at a level where you are earning substantial gains. This means you are not earning over $1,310/month in gross earnings as of the time of this writing.

You are most likely to qualify for benefits if you are not working or are earning a very minimal amount. Regardless, you must prove that you have been unable to gainfully work for 12 months or that your disability will prevent you from working for 12 months.

However, do not let these restrictions prevent you from applying for benefits if you think that you will not be able to work for the next year. The application process is lengthy, and often claimants will be out of work for more than 12 months by the time they receive a resolution in their case.

2. Do you have a physical and/or mental disability that is preventing you from working?

If you are under age 50, you must be unable to perform any job in the national economy in order to meet this qualification. The Social Security Administration is concerned with whether you can perform not only your past work but also any other work in the national economy.

It is not enough to prove that you cannot perform your past work. You must show that there is no work that you can do because of your disability regardless of whether you have ever performed that work before. However, SSA has more relaxed rules for claimants who are age 50 or older (and even more after 55), which make it easier to prove disability in these cases.

3. Are you eligible for benefits?

There are two main types of social security benefits for people with disabilities: Social Security Disability (SSD) and Supplemental Security Income benefits (SSI).

In order to qualify for SSD benefits, you must have earned enough work credits, which are earned through working and paying Social Security taxes. The general rule of thumb is that you will be eligible if you have worked full-time for at least half of the past 10 years. Social Security uses a credit-based system where you earn one credit for every $1,470.00 you earn (up to a maximum of four credits per year). You must earn 20 credits to be eligible for benefits.

Check the SSA guide to learn more about how credits are calculated.

SSI is based on being both disabled and in financial need of benefits. This means that you have limited income and assets. SSA will consider your spouse’s income, regular contributions from friends or family, and money received from a settlement when determining whether you are eligible. To determine whether you are eligible for SSI, you can contact SSA directly.

Rules for adults over 50

Rules for adults over 50

The Social Security Disability rules change in your favor after the age of 50, and again at the age of 55. If you have a physical disability or a combination of physical and mental disabilities that prevents you from working a job that requires being on your feet most of the day, then you may be eligible for benefits through Social Security.

In essence, Social Security may consider you to be disabled if you are over 50 and only able to do sedentary work (defined as work that allows you to sit most of the day and requires you to lift no more than 10 pounds). You may be found disabled if you have not done sedentary work before or have not learned skills that would allow you to perform skilled sedentary work.

Even if you have learned certain skills from past jobs that allow you to perform a sedentary job, Social Security may recognize that you are unable to mentally perform the requirements of certain types of skilled work due to depression, loss of concentration from pain, or pain medications.

Rules for adults over 55

After age 55, the social security disability rules change again in your favor.

The Social Security Administration may consider you to be disabled if you are 55 years old and only able to do light work. Light work is work that requires you to stand most of the day and lift up to 20 pounds. You may be found disabled if you have not done light work before or you have not learned skills that would allow you to perform certain types of skilled work.

Even if you have learned certain skills from past jobs that allow you to perform a light job, Social Security recognizes that you may not be able to mentally perform the requirements of certain types of skilled work due to depression, loss of concentration from pain, or pain medications.

The rules for providing social security disability are complex, and proving your physical and mental disabilities can be challenging. You need a knowledgeable lawyer on your side. At Anderson Hunter, we will work with you from the very beginning of the application process to maximize your chances of winning your case.

 

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The Social Security Disability Process

The Social Security Disability Process

There are several complex steps in the process of applying for social security disability benefits. You may have to ask for your case to be reconsidered more than once before you are determined to be eligible.

1. Complete an application for disability.

You can do this step in several ways:

To complete an application, you will need to gather any important information for filing your claim, including:

  • medical facilities where you have had treatment—particularly since you stopped working
  • your work history
  • your reports and your family or friend’s report about how your disability affects you

2. Initial determination (roughly 3-4 months of wait time)

The claim will be assigned to your local field office. The field office will determine your eligibility and then send your claim to an agency called Disability Determination Services (DDS). A medical consultant at DDS will determine whether you are disabled under SSA’s rules.

This process usually takes about 3-4 months, but can take longer, especially if your case is more complex.

3. Reconsideration determination (roughly 3-4 months of additional wait time if you were denied during initial determination)

If your claim is denied at the initial level, then you have 60 days to file a request for reconsideration. Your claim will then be reviewed by another medical consultant at DDS. This medical consultant will determine whether you are disabled under SSA’s rules.

This process usually takes about 3-4 months, but can take longer — especially if your case is more complex or if DDS decides that they need more information. They may send you to an independent medical examiner for a consultative examination.

4. Hearing level (roughly 10 months of waiting if you were denied during reconsideration)

If your claim is denied at the reconsideration level, then you have 60 days to file a request for an administrative law hearing. The hearing will be scheduled approximately 10 months from when you make the request for it if your case is in Washington State. It can be shorter or longer than that — this is just an average wait time in the region.

The hearing will be before an Administrative Law Judge. At the hearing, you will be able to present evidence and the ALJ will take testimony, meaning they will hear from you about your claim.

The pertinent evidence is:

  1. Your medical records
  2. Statements and evaluations from your medical providers
  3. Statements from friends, family, or former employers
  4. Your testimony
  5. Testimony of experts the ALJ will request attend your hearing

If you are considering applying for benefits, contact the Anderson Hunter law firm for a free in-person consultation. We will be proactive in representing you from the beginning.

 

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Social Security Disability FAQs

Social Security Disability FAQs

Q: Do you need a lawyer to apply for social security disability benefits?

A: No, you are not required to have a lawyer. However, applicants are strongly advised to get legal advice from a professional before submitting the application. You must fill out extensive amounts of paperwork, keep all your medical records on hand, and obtain access to sensitive personal information to develop a compelling case.

Mistakes are extremely common when filling out the application, and more than half of initial applicants are denied. An attorney can help you organize all the required records and accelerate the process of getting your benefits.

Q: What can I do to make my case better and increase my chances of winning benefits?

A: The best thing you can do is gather as much evidence as possible about your condition and how it affects your abilities. In the world of Social Security disability, less is not more. This means that you should try and get as much treatment as you can for the disabilities that prevent you from working. SSA will look at your medical records very closely as evidence of your disabling conditions. If you are getting limited medical treatment or are not getting any medical treatment, then you will not have any evidence to show the nature of your condition and how it is affecting you.

Also, SSA is supposed to rely heavily on the opinions of your doctors and medical providers. You should mention this to your doctor and see whether he/she will be supportive of your claim and your inability to work. Later on in the process, we can reach out to your doctor or medical provider to obtain supportive evidence in an effort to strengthen your case.

Q: I haven’t had much treatment because I don’t have medical insurance. What can I do?

A: You may be eligible for medical benefits through the Washington State Department of Social and Health Services. You would need to contact them directly and begin the application process: https://www.dshs.wa.gov/food-cash-medical

Q: Will I win my case if I hire a lawyer?

A: We wish we could answer yes to this, but there is no way to guarantee you will win your case, even if you hire a great lawyer with many years of experience to represent you. Whether you are disabled is a question of law. An experienced lawyer knows the law and knows how to present your case in the best possible way in order to win. Therefore, you increase your chances of winning your case if you hire a lawyer who understands the law, and who is familiar with the entire process.

Q: If I decide to hire a lawyer and we win the case, how much will my lawyer be paid?

A: Social security disability lawyers are paid a percentage of your past-due benefits directly from SSA. You will not have to calculate this yourself. SSA has what is called an automatic fee approval process. They will approve your lawyer’s fee agreement as long as it fits their rules, and then they will pay your lawyer directly if you win your case.

Q: How long does it take to hear back from social security about disability benefits?

A: Most initial determinations are made between 3-4 months after you submit your completed application. If you are denied as a result of the initial determination, then you can file a request for reconsideration and SSA will reconsider your claim. On average that decision takes about 3-4 months.

If you are denied as a result of a reconsideration determination, then you can file a request for an administrative law hearing. The hearing is scheduled by region and certain regions have different wait times for scheduling hearings. On average in the Seattle metro area, this hearing will be scheduled within 10 months from when you made a request for it.

Q: I heard that Social Security denies everyone’s disability claim at first, and you have to keep appealing the case if you want to win your benefits. Is that true?

A: Not necessarily. While statistics are always subject to change, the current statistics are that SSA grants about 50% of the initial and reconsideration applicants who apply. This means that about half of those who apply will be granted disability benefits prior to ever going to an actual hearing.

Q: How much back pay will I get if I win my case?

A: This will depend on your specific case. If you win a claim for Social Security disability, which is based on your work history, then the maximum amount of back pay or past-due benefits you will receive is 1 year prior to the date of your application. If you win a claim for Supplemental Security Income benefits, meaning you are disabled and in financial need of assistance, then the SSA can pay you benefits as of your application date, but no earlier.

You may have previous applications that you never appealed. In some circumstances, previously denied claims can be re-opened. You may even receive more past-due benefits as a result. It depends on the facts of your case and when your previous applications were filed and denied.

For a previous Social Security disability claim denial, SSA can reopen a claim that was denied 4 years prior to the date of the current application. For a previous Supplemental Security Income denial, SSA can reopen a claim that was denied 2 years prior to the date of the current application.

Q: Can I get partial disability through Social Security?

A: No. Social Security only pays for total disability, which is defined as being unable to work due to a disabling condition for a period of 12 months or more.

Q: Can I get disability benefits while I’m still working?

A: Maybe. The Social Security Administration will first determine whether you are working and earning enough for them to consider you as having substantial gainful activity. In 2021, substantial gainful activity is defined as $1,310/month. If you are earning this amount or more, then you will not be eligible for Social Security disability benefits.

There is an exception for those who are working at a job where they may not be performing the work competitively. This is something that an experienced lawyer would have to go over with you, as it depends on the specific facts of your situation.

How to Find a Great Social Security Disability Attorney

How to Find a Great Social Security Disability Attorney

Applying for Social Security Disability Insurance (SSDI) benefits can be a daunting experience. If you’re considering whether or not to hire a Social Security Disability Insurance attorney, it is important to know that your chances of being approved significantly increase when you work with a legal professional.

A good attorney can help accelerate your claim, which saves you time and money. They can ensure that all your medical records and paperwork are organized and up to date and speak with your doctor to get a letter of recommendation. Choosing a local disability attorney who is eager to help you, practices clear communication, and exercises compassion is likely to help you receive the benefits you need much faster.

How a Social Security Disability Attorney Can Help

When initially applying for your SSDI benefits, your social security disability attorney can help you decipher what your alleged onset date (AOD) is, which determines when you were first eligible for benefits. This date can be claimed as far back as 12 months before the date of your application.

Your attorney can also help you argue that your medical condition meets the official list of conditions covered by the Social Security Administration (SSA), called the Listing of Impairments. At the first level of appeal (the reconsideration review) and second level of appeal (the hearing), your lawyer can collect and present pertinent medical records and evidence, interview your doctors, and generally support you during all steps in the legal process.

Once in court, your social security disability attorney can assist you by successfully presenting your testimony to the judge and cross-examining experts to better support your case.

Hiring a social security attorney before submitting your application can increase your chances of being approved and, in turn, help you steer clear of a long and drawn-out appeal process. If you’ve already sent in your application and you were denied, you will definitely want an attorney’s help with your next attempt. In addition to helping you improve your application, your legal professional can ask the judge for an “on-the-recond” (OTR) decision, which allows you to receive your benefits without ever having a hearing in court.

How Long Does It Take to Get Social Security Disability Benefits With a Lawyer?

Social security disability attorney

The path to benefits is a lengthy one. A lawyer may be able to help you save time while filling out your application or reduce your chances of needing to reapply, but they can’t do much about SSA wait times.

After your initial application is sent to the Social Security Administration, government data suggests that the average wait time to receive a decision is about three and a half months. If you’re denied and continue onto your reconsideration review, you can expect to wait about another three months for that decision. If your reconsideration is denied and you want to schedule a hearing, you will likely wait between one and two years before you can present your case to a judge.

Once you do get your hearing, you’ll have to wait on the judge’s decision, which may be the quickest part of the whole process. Most people hear back from the court within two months of their hearing. The entire process from start to finish averages about two to three years total, with some applicants waiting even more than three years to get their results.

How Much Does a Social Security Disability Attorney Cost?

In most cases, you will not need to pay your social security attorney unless you are awarded your benefits. In order to charge you after you’ve won your case, your representation first needs to file a fee agreement with the SSA. If an attorney skips this step or charges more than they were approved for, they can be banned from representing any other clients in front of the Administration.

The written fee agreement must be signed by both you and your disability attorney and be approved before the court makes a decision on your claim. Then, the SSA will send you an approval of the agreement in writing, deciphering how much your attorney can charge you. This fee can’t be more than 25 percent of past-due benefits or more than $6000, whichever is less.

Your SSDI attorney can give the SSA a fee petition after filing your claim or claims. This request lays out precisely what services your representation provided you, as well as how much time it took to complete each task.

If you review your attorney’s petition and disagree with any of the information on the document, you can contact Social Security within the first 20 days for reconsideration. They will then take a look at the petition and respond with their new approved fee. If you once again disagree, you have 30 days to respond with your argument.

How to Find a Social Security Disability Attorney Who Will Fight For You

How to Find a Social Security Disability Attorney Who Will Fight For You

It is of utmost importance to find a local disability attorney that you trust and respect. You’ll want to make sure you feel that there is an open line of communication that can be reached at any point during your process. Your SSDI attorney’s genuine and caring attitude can be just as important as their experience and knowledge.

Before choosing to hire a social security disability attorney, you may want to ask yourself a few questions to make sure they’re the right professional to help with you and your case:

  • What level of involvement do you expect from your attorney?
  • How does the attorney charge for their services?
  • How much prior experience does your potential attorney have with SSD claims?
  • Will your attorney take your case to court if you’re denied?
  • Does your attorney have experience and prior knowledge of how to handle your specific medical conditions?
  • How will you and your attorney prepare for your hearing?

Applying for SSDI benefits with an excellent legal professional can make all the difference. With legal help, you can vastly improve your chances of winning your case in a timely manner and getting the benefits you need. We encourage you to begin the process of finding the right social security disability attorney today.

 

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