Disabilities can happen to anyone. Whether due to an injury or a serious medical condition, a disability could strike when no one is expecting it. In fact, the Social Security Administration reports that one out of every four 20-year-old adults will become disabled before they reach retirement.
Whether you were hurt on the job and no longer can work to support yourself or you developed an illness or injury that has disabled you, you may be interested in applying for Social Security Disability Insurance benefits. Social Security Disability Insurance benefits are benefits that you can receive if you meet the qualifications set by law. If you have worked for long enough and can no longer work to support yourself, SSDI may be a helpful method of getting the benefits you need to support yourself. Then, when you reach the age for retirement, your benefits will automatically convert to retirement benefits.
There are many myths about Social Security Disability as well as complex features of this system to discuss. Having a better understanding of what the Social Security Administration expects from you and what qualifies as a disability may help you make the decision about whether applying for benefits is right for you. Here is the ultimate guide to understanding if you may qualify for SSDI, what it takes to apply for SSDI, and more.
The Basics About Disability Benefits
If you have ever worked a job, then you may be familiar with the annual taxes that you pay to the Social Security Administration. Social Security taxes are used to support benefits systems such as retirement and Social Security Disability. SSDI coverage is coverage that workers earn by paying into this system. If you are terminally ill, disabled, and cannot work, then this coverage could provide you with financial support by replacing at least a portion of your lost wages.
The Social Security Disability Insurance (SSDI) program is designed to give assistance to those who are living with disabilities so that they can meet their basic needs.In 2021, the average monthly benefit paid out to recipients of Social Security Disability insurance was $1,280.
The system requires individuals to apply for benefits, but they need to meet certain qualifications before they can.
Generally speaking, the Social Security Disability Insurance program pays you and, in some cases, your family members if you are “insured” through the program. You’ll be insured through the program if you’ve worked long enough to qualify. You will have needed to have paid into the Social Security system through the taxes on your earnings and to have paid into the program for long enough to get assistance.
There is a secondary program called the Supplemental Security Income program, or SSI, that covers adults or children with disabilities when they have limited resources or income. For those individuals, the credit system and work requirements may not apply.
Social Security Disability Insurance can be difficult to qualify for, because there are medical requirements, work requirements and other qualifications that you will need to meet. If you can meet both the medical and nonmedical requirements and have an illness or injury that is terminal or expected to last for at least a year, then you may be able to qualify.
Additionally, even if you can work a small amount, you could still be able to qualify for SSDI so long as you are not earning more than the maximum monthly allowance. Once you’re on Social Security Disability, you won’t need to work. If you do and can slowly return to working enough to support yourself, you can opt into the Ticket to Work program, which helps you keep your benefits as you adjust to going back to work. This encourages people to try to return to work when it’s feasible to do so.
Some People Can Get Benefits Without a Wait
Usually, applicants waiting for Social Security Disability benefits do have to wait for a period of five months before they can receive their approved benefits. That means that if you’re hurt now, apply for benefits, and are approved in a month, you’ll still need to wait another five months after the date that the SSA decided your disability began before you’ll receive payments.
It is necessary to note that some people are able to get Social Security Disability benefits without having to go through the traditional application process or waiting period. There is no waiting period for those who are approved for SSDI benefits on or after July 23, 2020, and who have amyotrophic lateral sclerosis (ALS).
How You Can Qualify for SSDI
Before you can get Social Security Disability Insurance, you will need to be sure you qualify. Qualifying begins with making sure you have the work history necessary to seek benefits through this system. To qualify, you have to show that you:
- Worked jobs that were covered by Social Security
- Currently have a medical condition that meets the Social Security Administration’s definition of a disability
Usually, people who cannot work for at least a year are the ones who will qualify for disability insurance, because their condition is severe enough to make them unable to support themselves for the foreseeable future. Then, once they are in recovery and are starting to heal to the point of being able to work again (which may or may not happen), there is the possibility to keep those benefits until they are able to work on a regular basis again.
Work incentives are in place to encourage people to return to work when they are able to do so without losing all of their benefits. That way, they can try to transition back into the workplace but still have a safety net if they are unable to do so safely.
Remember that to qualify for SSDI, you will need to have enough work credits. The total number of credits you need will depend on your age at the time of your serious illness or disability.
The Disability Starter Kit Is Available from the Social Security Administration
It can be difficult to apply for Social Security Disability Insurance coverage, because it is such a long, multistep process. The good news is that the Social Security Administration understands how complex the process can be and has created the Disability Starter Kit for people who are thinking about applying.
These kits help people who wish to apply for SSDI prepare for their disability interview or online applications, so they can understand what to expect. These kits provide information on the documents that will be needed as well as what the SSA expects from you. Additionally, the kits include information on what the SSA considers when determining if your claim will be approved or denied.
Make Sure You Have Enough Work Credits
On the subject of work credits, you will need to show that you not only meet the definition of having a disability but also that you have worked long enough to qualify for support through the Social Security Disability Insurance system. If you have not worked long enough or paid in enough money, you may not qualify for benefits even if you are disabled.
How do social security credits work? In general, they are based on the total yearly wages you’ve earned. If you were self-employed in the past, the Social Security payments you made on your taxes will also apply towards earning the credits that you need for Social Security disability benefits.
Each year, the number of credits you need could change. How much you have to earn to equal one credit will change, too. For example, in 2022, you will need to earn $1,510 in self-employment income if you want to get a single credit.
You can only earn up to four credits each year, so it’s not difficult to earn enough to get credits for Social Security disability. If you’re short a few credits and can continue to attempt to work a little longer, you may be able to collect enough to qualify for the benefits that you need. You will need to show that you have the right number of work credits earned within a specific period of time determined by the Social Security Administration before you can qualify. If you qualified in the past but stopped working, not working could have a negative impact on your ability to qualify now.
How Work Credits Are Calculated
Work credits are calculated based on your age and how much you’ve worked and earned over the course of the last 10 years. Younger people may qualify with fewer credits since they may not yet have been able to work long enough to collect all the credits an older worker should have.
The number of credits you will need is, in general, 40. However, only 20 of those have to have been earned in the last 10 years (ending with the year when your disability started).
Since 1978, you’ve only been able to earn a maximum of four credits annually. For those who are under the age of 31, the qualifications vary a little.
- If you are younger than 24, you can qualify with as few as six credits as long as you earned them in the previous three years before your disability began
- If you’re between the ages of 24 and 31, you may be able to qualify by working half of the time between the time when you started working at age 21 and when the disability occurred. For example, if you’re 27, then you know that there were six years that you could have worked. During that time, you will have been expected to have worked three years. The maximum credits you’d have during that time (in three years) is only 12. So, at 27, you could qualify for Social Security Disability with just 12 credits.
- For those who are 31 or older, the requirement for 40 credits generally stands. At least 20 will need to be from the last 10 years.
How To Medically Qualify For Social Security Disability Insurance (SSDI)
Medically qualifying for Social Security Disability Insurance requires you to have a disability or illness that is expected to last for at least 12 months or longer. You need to show that you cannot work because you have a medical condition that meets that Social Security Administration’s definition of a disability, which can be found in the Social Security Administration’s Blue Book. The illness or disability itself doesn’t necessarily have to be in the SSA’s Blue Book, but it does need to be qualified based on its severity or the fact that it is terminal.
To qualify for SSDI, you will need to provide evidence to support your claim of being disabled. Your injuries or illness must not be only a short-term or partial disability. Instead, this kind of insurance benefit is paid out to those with severe disabilities or terminal illnesses when they can no longer work to sustain themselves.
You can look at the SSA’s Benefit Eligibility Screening Tool to determine if you may medically qualify for Social Security Disability Insurance.
To be eligible for disability benefits, remember that you must:
- Be younger than retirement age (62)
- Meet the Social Security Administration’s definition of a person with a disability
- Be unable to work due to the medical condition
- Not have a short-term or partial disability
This screening tool will go over information such as the day you were born, whether or not you’re married, which state you live in, and more to determine if you may be qualified to apply for SSDI. If you are not yet qualified or you think there is a mistake, this is when you may want to reach out to the Social Security Administration or an attorney for more support.
The Social Security Blue Book
Remember, too, that the Social Security Administration uses the Blue Book to determine who qualifies for Social Security Disability benefits. This book is important because it was prepared by physicians and other professionals in healthcare to create a basis for disability claims. Each part of the book gives details on how to qualify based on your symptoms and the conditions that affect your body.
The one thing to become familiar with is the Listing of Impairments, which has information about how the Social Security Administration decides if someone is disabled based on the specific reason for their application. For adults, the SSA considers:
- Past work experience
- The severity of the current health conditions
- Education level
- Age
- Work skills/qualifications
The listings are available for children (under 18) as well as adults.
The adult listings are called “Part A” and include illnesses and diseases that affect different parts of the body. They are broken down into 14 categories. Please note that you may still be able to qualify for SSDI even if your medical problem isn’t listed under one of these categories. This is because the Social Security Administration has compassionate allowances that may apply to rarer conditions and unique cases.
The following categories may contain your specific condition and the qualifications that you will need to meet if you wish to get Social Security Disability benefits:
- Musculoskeletal Disorders
- Special Senses and Speech
- Respiratory Disorders
- Cardiovascular System
- Digestive System
- Genitourinary Disorders
- Hematological Disorders
- Skin Disorders
- Endocrine Disorders
- Congenital Disorders Affecting Multiple Systems
- Neurological Disorders
- Mental Disorders
- Cancer (Malignant Neoplastic Diseases)
- Immune System Disorders
The Disability Application Process
The process of applying for Social Security Disability Insurance is relatively straightforward, but you do have to gather many documents and go through evaluations to see if you qualify. You can apply by phone, in person, or online, which is helpful for those who may not be physically able to apply in one way or another.
There is a helpful disability checklist available from the Social Security Administration that goes over the information that you will need to complete your application. You may also want to discuss your application with an attorney and your doctors, because these individuals will have experience helping people apply for and seek Social Security Disability Insurance.
A basic breakdown of what you need to do to apply for Social Security Disability includes:
- Gathering documents and information about your disability. Use the checklist mentioned above to gather as much information about your disability or illness as you can. If you complete all parts of the checklist, you should have a thorough collection of documents to support your claim.
- Complete the basic application. Be careful not to omit any details or make any errors, because doing so could hurt your chances of having your application approved.
- Submit your application and wait for the Social Security Administration to review it.
The Social Security Administration will go through your information to see if you have collected enough work credits to qualify for SSDI. The SSA will also look at any work that you are currently doing to see if you are working too much to qualify. Remember, if you can be gainfully employed to the point that you’re supporting yourself, you may not qualify for SSDI even if you have a disability of some kind.
How To Check The Status
If you have applied for Social Security Disability benefits, you may be eager to get those benefits paid out to you. You can check the status of your claim by going online and logging into your My Social Security account. There, you should find details about what your claim status is. If you cannot check the status of your claim online, then you have the option of calling the Social Security Administration directly.
You can reach the Social Security Administration by calling 1-800-772-1213. The TTY number is 1-800-325-0778.
If you would rather speak with someone in person, you can do so if you contact a representative at your nearby Social Security office. Others who may have information on the status of your claim could include your attorney (if you hired one to help with your application) or the disability examiner assigned to your case. The disability examiner will be able to talk to you about if the decision is still pending or if it is complete, but they won’t have information on approvals or denials.
How To Appeal An SSDI Decision
It is common for a person’s Social Security Disability benefits application to be denied the first time. If your application for Social Security benefits was denied, then you have a right to seek an appeal. An appeal needs to be requested within 60 days after you receive the notice of the initial decision. You can then go through up to four levels of appeal.
If you would like to have your application reconsidered, you have the option to ask for reconsideration online. You can also ask for a hearing with an administrative law judge or the Appeals Council online. It doesn’t matter if you live within the United States or not, these options are open to you.
To decide which level of appeal to select, look at the letter that explains the Social Security Administration’s initial denial. It will provide additional information on which level appeal is right for you based on the reason for the denial.
The four levels of appeal include:
- Reconsideration
- A hearing with an administrative law judge
- A review by the Appeals Council
- A review by the Federal Court
Reconsideration
One option you have is to request a reconsideration for a medical determination that you don’t agree with. You can use this if you’ve recently had your initial application for SSDI denied.
The reconsideration is always performed by someone who wasn’t involved in the original determination. That way, you can be sure that the person is unbiased.
They’ll go over the evidence that you originally submitted. If you submit new evidence before the reconsideration (which is usually a good idea), the person reviewing your claim application this time will consider that evidence as well.
Administrative Law Judge Hearing
The next option you have is to request a hearing with an administrative law judge. Like with the reconsideration, this judge won’t have any background knowledge of your claim before holding the hearing. They will conduct the hearing in an unbiased manner.
It is beneficial if you can come to this hearing in person, but if you cannot, there may be some cases where you can attend via video. For example, if you are in a hospital, your attorney could go to the hearing in person and you could attend through video.
Usually, this hearing is held within 75 miles of your home. Sometimes, you can choose a preferred location, too.
After you decide to seek a hearing with the administrative law judge, you should wait for a package that confirms what to do next and the first available date and time for the hearing at a location nearest to you.
Appeals Council Review
Your next opportunity to appeal is by requesting an Appeals Council review. If the administrative law judge decided to deny your claim again, you can request this appeal. The Appeals Council normally denies hearings if it believes that the hearing was held correctly and that all laws and regulations were upheld.
Federal Court Review
Your last opportunity to appeal is through a Federal Court appeal. This is the highest level of appeal and is uncommon. You use this type of appeal if you don’t agree with the third denial of your benefits. You need to file for this type of appeal in person or by calling.
Information You Need to Apply for SSDI
If you would like to apply for Social Security Disability Insurance benefits, then you will need to providing the right information on your application. There are several documents that are required by the Social Security Administration and that absolutely must be included with your application. If these are missing or filled out incorrectly, your claim could be delayed or denied.
The documents that you need to provide include:
- Proof of U.S. citizenship or that you are a lawful alien if you weren’t born in the country
- Your birth certificate (or other form recognising your birth)
- An Adult Disability Report, which collects information about the medical condition for which you’ll be applying as well as your work history and other medical information that you’d like to disclose
- Medical evidence of your disability, such as doctor’s reports, medical records, test results, and others
- W-2 forms for the last year. If you don’t have those because you’re self-employed, you’ll need your self-employment tax returns instead
- Discharge papers from the U.S. military if you were a military member before 1968
- Any pay stubs, awards, or settlement agreements you have to show that you received workers’ compensation or temproary benefits for your condition
For most of these items, a photocopy is going to be acceptable. For others, you’ll need to send the originals. For example, your birth certificate should be in its original form. If you don’t have some of these documents, you can reach out to the Social Security Administration or other organizations to get new documents.
The paperwork will also ask for some basic information. You should fill out the application with the following:
- Your name
- Your gender
- Your Social Security number
- Your birth name (if it’s not the same as your current name)
- Your citizenship status
- Details about any Social Security benefits that you or someone else has filed for in your name or on your behalf
- Details about other Social Security numbers if you have more than one
- Information about you and your spouse, such as if you’ve worked for the railroad
- Information about past military service
- The names of any children you have who are unmarried and under 18
- Information on any earnings made between 1978 and today
- Information about black lung, workers’ compensation, or other similar benefits
These are just some of the many things that will be asked for on your application. Prepare as much information as you can in advance, so you have the best opportunity to have your claim approved the first time.
Information About You
The Social Security Administration will ask for some basic information about you before you can make your claim. You’ll need to fill out the basics, such as your name, address, Social Security number, daytime phone number and an alternate phone number. If you cannot speak English, you should let the SSA know which languages you do speak, because interpreters are available to help you.
On the Adult Disability Report, the SSA also asks for contact information for people other than your doctors who can answer questions about you. Think of these people as references. You want to choose people who can give a good explanation of the condition you’re living with and how it affects you.
Information About Your Medical Condition
You do need to provide information about your medical condition to the Social Security Administration. The Adult Disability Report goes over many of the basic questions that you need to answer. Additionally, you should attach copies of any and all statements or medical documents discussing your injury for the SSA to go through.
On this report, list out every medical condition you have including both physical and psychological conditions. Mental health also plays a role in the SSA’s decision, so don’t think that only your physical symptoms apply.
Along with the basic information about your health, you will need to add any emotional or learning problems. This information gives the Social Security Administration more to work with to understand your circumstances.
Information About Your Work
Now that you have your basic information written down, you have to provide information about your work. If you have not stopped working yet, you need to let the SSA know at what point you started to believe that your injury or illness was too severe to keep working. If you did already stop working, then you should provide the date that you stopped working and the reasoning for doing so.
For example, some people may stop working completely because of their health. Others will push through until retirement. Still others may stop working because of being laid off or due to the business closing.
Along with this information, you should provide information about how your health condition impacts your ability to work. For instance, does it affect your pay? Does it impact the hours you can work? What kinds of job duties can you no longer do?
The Social Security Administration will also want to know if you’ve been able to earn more than $1,180 within a month at any time since you thought your were disabled. The reason for this is to determine if you can perform gainful employment. If you cannot, then it is clearer that you cannot support yourself easily without the benefits you’re looking to obtain.
Documents You Need to Provide
With any disability claim, your best bet is to provide as much documentation of your injuries or illness as you can. You’ll need basic documents such as:
- Your birth certificate
- Proof of citizenship or legal status
- Military discharge paperwork
- W-2 forms
These are important for proving who you are. The other documents that you will need are those that help support your claim. Some common documents to include with your application include:
- Copies of medical exam reports
- Copies of X-rays, MRIs, CT scans or other testing
- The stage of cancer that you’re living with and the prognosis (if applying with cancer)
- Letters from medical providers that detail what they think you can or cannot do
- Information from friends or family members that discuss how your health has impacted your ability to work and participate in normal daily activities
More or less, you’ll want to include as many documents as you can to show that you are truly disabled and cannot work. If the SSA finds that you can complete substantial gainful activity or that you don’t have enough evidence of a disability included with your application, then your claim may be denied.
How To Apply For Benefits Online
Applying for Social Security Disability benefits online is one of the easiest ways to start your application. You can go to this application page to get started. When you agree to the Social Security Administration’s terms and conditions, you will be taken to an application page where you can start a new application or return to an application that you already started.
The Social Security Administration points out that applying for benefits may take anywhere from one to two hours if you already have the paperwork and documents that you need. You are able to save your application while you’re working on it, so you can spread out the time it takes across multiple days or weeks if you wish.
Applying for Social Security Disability benefits is a multistep process. That means that you need to meet the requirements, gather information, and then apply. After you’ve applied, keep your username and password for the My Social Security account, so you can check on your claims’ status at any time.
Other Ways You Can Apply for SSDI
If you don’t want to apply for Social Security Disability insurance online, you have the option to do so by phone or in person. Many people choose to apply through methods other than going online, because they feel uncomfortable submitting personal information on the internet. For others, they may have questions that can be answered by the Social Security Administration admins at a local office.
If you want to apply in person or by phone, remember that representatives won’t be available around the clock. You will be able to call from Monday through Friday from 7:00 AM to 7:00 PM. The hours of your local Social Security office may vary, so you should search for it here.
If you are not currently living in the United States, you can still apply for SSDI. To do so, you’ll need to reach out to the local U.S. Embassy, a nearby Social Security office, or your local consulate.
How To Apply With Your Local Office
If you would like to apply for Social Security Disability, you can apply locally at your nearby Social Security office. You will need to make an appointment if you want to apply in person. To find your local office, type in your current ZIP code into this form. This will find all the local Social Security offices.
As of March 2022, all face-to-face services have been suspended at field offices and hearing offices. An alternative, until these offices reopen, is to apply online, by fax, or by phone.
How To Apply By Phone
Applying for Social Security benefits by phone is another option for most people. The national 800 number is 1-800-772-1213. The Social Security Administration does have a phone number available for those who are hard of hearing or deaf. They may call directly at TTY 1-800-325-0778.
Usually, these lines are open from 7:00 AM to 7:00 PM. Sometimes, they may not be available until 8:00 AM. Representatives are available to take calls every day from Monday through Friday. Their offices are closed on the weekends.
If You Do Not Live in the U.S. Or One of Its Territories
Did you know that any U.S. citizen can get Social Security Disability benefits so long as they qualify? It doesn’t matter if you live within the country or outside the United States.
There are some restrictions, though. For example, there are some locations that the SSA can’t mail checks to, and payments may not be able to be made to those in the USA who could get the benefits to you in a foreign country.
Remember that you do need to report if you’re going to be moving out of the United States for over 30 days. This is a requirement set by the Social Security Administration to make sure it has your change of address information.
Usually, you can continue to get your benefits while you live outside of the country. Dependents and beneficiaries are in a different position, though. In most cases, they may only continue to get benefits so long as they have not been outside of the United States for over six months (or have not been in a restricted country).
You absolutely cannot get benefits in:
- Cuba
- North Korea
There are no exceptions.
Mailing Your Documents
If you need to send mail to the Social Security Administration, you should include all your documents in a mailing envelope. You should not write anything on your original documents if you choose to mail them to the SSA. Instead, add your Social Security number to an additional sheet of paper included inside the envelope.
Keep in mind that you cannot mail certain items such as your birth records if you are an immigrant to the United States. This is because certain documents are required to be kept on your person at all times.
It is better to send documents digitally through the electronic mailing process or to take them to the Social Security office nearest to you.
Information for Advocates, Attorneys, and Third Parties
For others who are helping someone else apply for Social Security Disability, it is important to know that you can get help from the Social Security Administration. The SSA knows that it is often friends and family members who help people apply for SSDI due to their loved ones’ disabilities.
If you would like to help someone get assistance and they are aged, disabled or blind and on limited income, you may be able to help them get Supplemental Security Income and Social Security Disability benefits if they meet the qualifications.
To find out more about the basics of SSI and SSDI, you can visit these pages put together by the Social Security Administration.
If your loved one has a condition that meets the SSA’s Compassionate Allowances program, you may be able to assist them in getting benefits more quickly than through the traditional application process. To look into this, please visit the Compassionate Allowances program page. This program is designed for those with certain cancers, rare disorders, and brain disorders.
To get legal assistance or advocacy help, you can reach out to the local Social Security Administration office near you. It may have lists of legal referral services as well as the names of nonprofit organizations that help people in your situation.
If you have to represent someone throughout the claims process, this page provides more information on what you need to do. You will need to become an appointed representative and to sign an electronic fee agreement (e1693) with the Social Security Administration. With this process, up to six representatives can be named.
In Conclusion
To conclude, there is much to know about applying for Social Security Disability. Since the process can be confusing and require extensive documentation, it may be a good idea to work with an advocate who can assist you as you put together your claim. If you have worked for long enough and have a medical history that shows you have a real disability or terminal illness, these benefits are there for you. They’re designed to help you support yourself while you focus on taking care of your health.
