SSD Claims: Filing & Appeals

If you are no longer able to perform a “substantial” level of work due to a physical or mental impairment which can reasonably be expected to last at least 12 months, you may be eligible for Social Security Disability (SSD or SSDI). The Social Security Administration considers whether you can engage in “substantial gainful activity,” meaning whether you are making $1,220 or more per month before taxes.

If your impairment meets the level of severity as described in the Listing of Impairments from the Social Security Administration, then you may have already qualified in satisfying the definition of a disability, however most people must show their impairment causes limitations which are severe enough to keep them from earning a living. Add in to the mix that Social Security will determine whether you are capable of performing any job you’ve held in the past 15 years and whether you can perform another type of work, taking into consideration your current level of skills and education, your limitations and your age.

How Do I File a Social Security Disability Claim? In addition to meeting the medical requirements to qualify for Social Security Disability, you must have also paid Social Security payroll taxes over a specific length of time. That time will vary by your age; if you stopped working and paying Social Security payroll taxes, you must be able to show your disability began before your insured status ended. If approved, your benefits will be paid monthly for the length of your disability.

It can be difficult, however, to secure Social Security benefits—even when you are entitled to them. In fact, according to statistics gathered by the federal government, only about a third of all SSD applicants are initially approved.  If you have sufficient work credits, do not earn above the threshold allowed and have a qualifying medical condition, you can file a Social Security Disability claim for benefits.

You can apply online or you can make an appointment with your local Social Security office to apply. Because the initial approval rate is fairly low, it can be beneficial to have an experienced disability attorney Houston by your side from the very beginning of the process to assist you with your application. After your initial application, your condition will be evaluated, and a determination made regarding whether there is any type of job you could be expected to perform. You are eligible to apply for Social Security Disability benefits immediately after you become unable to perform substantial, gainful work.

Many people are under the mistaken belief that you must wait six months after you first become unable to work before you apply for Social Security Disability benefits.  This likely comes from the fact that Social Security Disability does have a five-month waiting period which begins on the date of your disability. You will not receive benefits for these five months, even if your initial application is approved. In other words, those five months will not be included in your back pay, if approved, however this just means that you should apply as soon as you become disabled.

Before you apply for Social Security Disability, you will need to have certain items on hand—your Social Security card, your original birth certificate (or a certified copy), any military service papers, proof your U.S. citizenship or lawful alien status, W-2 forms, 1099 forms or self-employment tax return for the past year, medical evidence related to your medical condition, pay stubs and an Adult Disability Report. If you are missing some of these items, you can go ahead and apply for Social Security Disability while you locate them.

How Do I Appeal a Social Security Disability Claim Denial? The process of filing a Social Security Disability claim is not particularly lengthy, however it can take a significant amount of time—one to three months—to have your initial application either approved or denied. If your initial application for Social Security Disability is denied, you can immediately file a request for reconsideration. Once your request for reconsideration is filed, you will likely wait another two months or more to find out whether your reconsideration appeal has been approved. A reconsideration appeal goes back before the same people who denied your initial application, therefore only about 10 percent of reconsideration requests result in an approval of your Social Security Disability benefits.

To improve your odds for approval when you file an appeal for reconsideration, it is important to have your own medical treatment sources, rather than relying entirely on the consultative exam you may be asked to undergo by the Social Security Administration. The Social Security Administration likes to have a full year of your medical history containing past and current medical treatments related to your disability. If your treating doctor can offer a concise statement which includes your diagnosis, prognosis, response to treatment and a description of your limitations, your chances of an approval during your reconsideration may increase significantly. 

It is also important for your reconsideration appeal that your work history is described in a thorough manner. Many disability applicants understate the specific demands of their employment—you must explain in a comprehensive manner how you performed your past work and why you can no longer perform the specific job demands. The Social Security Administration will determine whether you are capable of performing other types of work considering your current limitations, education, age, and the transferability of your job skills.

In other words, if you are a 60-year-old who has worked as a heating and air technician for the past 40 years, it may be determined that your job skills are not transferable, and that your age makes it much more difficult to obtain new job skills. If, on the other hand, you are a 30-year-old working the same type of job, the Social Security Administration may determine you are young enough to gain new job skills and/or education. If your request for reconsideration is denied, you can appeal this denial by requesting an administrative law judge disability hearing.

What is an ALJ Disability Hearing? If your reconsideration appeal is denied, you will next appeal that denial by requesting a hearing before an administrative law judge. This level of appeal can potentially be the longest—and the most frustrating—portion of your Social Security Disability application process. For many, it can take twelve months or more to get to the disability hearing before an administrative law judge.

While waiting for your ALJ disability hearing can be emotionally rough and financially distressing, this level of appeal offers the best chance of approval—particularly when you have a knowledgeable Social Security Disability attorney Houston in your corner. Although the rate of approval at this level varies significantly from state to state, the average national rate of approval at this level is almost 62 percent

As the claimant, you will be questioned by the administrative law judge regarding your disability. The questions you could be asked will revolve around your specific medical impairment, any medical treatments you have received for the impairment, your past employment, your educational background and how your impairment has affected your ability to work as well as your day-to-day life. Your disability lawyers in Houston, Texas can speak on your behalf and argue your case. There may be expert witnesses in attendance who will be asked about your condition as well as any work you can reasonably be expected to perform considering your limitations. The administrative law judge may ask if you want to make any additional comments.

You will not receive a decision the same day, rather it can take up to 30 days to be notified of the judge’s decision. Having a Social Security Disability lawyer Houston representing you at the hearing before the administrative law judge statistically gives you a higher chance of being approved for disability benefits. If your appeal before the administrative law judge is denied, you can appeal to the Appeals Council, and one more time to federal court.

Persistence definitely pays off for those attempting to secure Social Security Disability benefits. If you have a terminal condition, your attorney may expedite your case through the TERI process which allows the claim to be processed in less than 30 days. Your experienced disability lawyers in Houston, Texas from the law firm of Sullo & Sullo can help you navigate the SSDI maze, which can seem very complex at times. Our attorneys will answer your questions regarding how to file for disability as well as other questions regarding SSDI appeals and your chances for success. If you are unable to work due to a physical or mental impairment, securing Social Security Disability benefits can be crucial to your future. Do not wait—contact the Sullo & Sullo SSDI lawyers today.

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