Social Security Disability Benefits FAQ
Montagna Klein Camden represents people seeking Social Security benefits in Virginia and North Carolina.
Social Security pays benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death. Federal law requires this very strict definition of disability. While some programs give money to people with partial disability or short-term disability, Social Security does not.
In general, to get disability benefits, you must meet two different earnings tests:
- A “recent work” test based on your age at the time you became disabled; and
- A “duration of work” test to show that you worked long enough under Social Security.
Certain blind workers have to meet only the “duration of work” test.
There are two ways that you can apply for disability benefits. You can apply at www.socialsecurity.gov; or call 1-800-772-1213, to make an appointment to file a disability claim at your local Social Security office or to set up an appointment for someone to take your claim over the telephone. The disability claims interview lasts about one hour.
If you schedule an appointment, the Social Security Administration will send you a Disability Starter Kit to help you get ready for your disability claims interview. The Disability Starter Kit also is available online at www.ssa.gov/disability/disability_starter_kits.htm.
If you are deaf or hard of hearing, you may call our toll-free TTY number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days.
You should apply for disability benefits as soon as you become disabled. It can take a long time to process an application for disability benefits (three to five months). To apply for disability benefits, you will need to complete an application for Social Security Benefits and the Disability Report. You can complete the Disability Report at www.ssa.gov/disability/disability_starter_kits.htm. You also can print the Disability Report, complete it and return it to your local Social Security office.
Other information needed includes:
- Your Social Security number
- Your birth or baptismal certificate
- Names, addresses and phone numbers of the doctors, caseworkers, hospitals and clinics that took care of you and dates of your visits
- Names and dosage of all the medicine you take
- Medical records from your doctors, therapists, hospitals, clinics and caseworkers that you already have in your possession
- Laboratory and test results
- A summary of where you worked and the kind of work you did
- A copy of your most recent W-2 Form (Wage and Tax Statement) or, if you are self-employed, your federal tax return for the past year.
In addition to the basic application for disability benefits, there are other forms you will need to fill out. One form collects information about your medical condition and how it affects your ability to work. Other forms give doctors, hospitals and other health care professionals who have treated you permission to send the Social Security Administration information about your medical condition.
The Social Security Administration reviews your application to make sure you meet some basic requirements for disability benefits, checks whether you worked enough years to qualify, and evaluates any current work activities. If you meet these requirements, the Social Security Administration will send your application to the Disability Determination Services office in your state.
This state agency completes the disability decision. Doctors and disability specialists in the state agency ask your doctors for information about your condition. Using the medical evidence from your doctors and hospitals, clinics or institutions where you have been treated, they will consider all the facts in your case.
The state agency staff may need more medical information before they can decide if you are disabled. If more information is not available from your current medical sources, the state agency may ask you to go for a special examination. Social Security will pay for the exam and for some of the related travel costs.
Social Security uses a five-step process to decide if you are disabled.
- Are you working?
If you are working and your earnings average more than a certain amount each month, they generally will not consider you disabled. The amount changes each year. For the current figure, see the annual Update (Publication No. 05-10003). If you are not working, or your monthly earnings average the current amount or less, the state agency then looks at your medical condition.
- Is your medical condition “severe”?
For the state agency to decide that you are disabled, your medical condition must significantly limit your ability to do basic work activities—such as walking, sitting and remembering—for at least one year. If your condition is that severe, the state agency goes on to step three.
- Is your medical condition on the Listing of Impairments?
The state agency has a Listing of Impairments that describes medical conditions that are considered so severe that they automatically mean that you are disabled as defined by law. Similarly, if the severity of your medical condition meets or equals that of a listed impairment, the state agency will decide that you are disabled.
If it does not, the state agency goes on to step four.
- Can you do the work you did before?
At this step, the state agency decides if your medical condition prevents you from being able to do the work you did before. If it does not, the state agency will decide that you are not disabled.
If it does, the state agency goes on to step five.
- Can you do any other type of work?
The state agency 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, the state agency will decide that you are disabled. If you can do other work, the state agency will decide that you are not disabled.
Special Rules for blind people
There are a number of other special rules for people who are blind. For more information, ask for If You Are Blind Or Have Low Vision—How We Can Help (Publication No. 05-10052).
The Social Security Administration will tell you their decision.
When the state agency reaches a decision on your case, Social Security will send you a letter. If your application is approved, the letter will show the amount of your benefit and when your payments start. If your application is not approved, the letter will explain why and tell you how to appeal the decision if you do not agree with it.
If you disagree with a decision made on your claim, you can appeal it. The steps you can take are explained in The Appeals Process (Publication No. 05-10041), which is available from Social Security.
You have the right to be represented by an attorney or other qualified person of your choice when you do business with Social Security. More information is in Your Right To Representation(Publication No. 05-10075), which is also available from Social Security.
Certain members of your family may qualify for benefits based on your work. They include:
- Your spouse, if he or she is 62 or older;
- Your spouse, at any age if he or she is caring for a child of yours who is younger than age 16 or disabled;
- Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be younger than age 18 or younger than 19 if in elementary or secondary school full time; and
- Your unmarried child, age 18 or older, if he or she has a disability that started before age 22. (The child’s disability also must meet the definition of disability for adults.)
If you are getting other government benefits, the amount of your Social Security disability benefits may be affected. For more information, you should see the following:
- How Workers’ Compensation And Other Disability Payments May Affect Your Benefits (Publication No. 05-10018);
- Windfall Elimination Provision (Publication No. 05-10045); and
- Government Pension Offset (Publication No. 05-10007).
You must tell Social Security if you have an outstanding warrant for your arrest, are convicted of a crime, or violate a condition of parole or probation.
You will get Medicare coverage automatically after you have received disability benefits for two years.