Getting approved for Social Security Disability Insurance (SSDI) is difficult, not just because of the complex application process. SSDI benefits have a very low acceptance rate and you may find yourself wondering what you can do to get your SSDI benefits approved.
There are a few things you can do to increase the likelihood of getting your SSDI benefits approved. These include checking to see whether your application is complete, maintaining detailed and accurate health records, establishing a positive rapport with your doctor, tracking the progress of your claim, and ensuring that you follow all treatment recommendations.
Before we go into further details about getting approved, let us first have a look at the criteria for SSDI benefits and whether you are eligible to receive them.
Do You Qualify for SSDI?
Two requirements must be met before you can get SSDI:
(i) You must have worked for a certain period of time in positions that are covered by Social Security, and (ii) you must have a medical condition that qualifies under the Social Security Administration’s definition of disabled.
If you meet both of these requirements, then you may be eligible for Social Security disability benefits.
To meet the first requirement, you need to have worked in a Social Security-eligible occupation for at least the minimum number of years specified by the SSA. It is much more challenging to meet the second part of the qualifying criteria, which is to have a debilitating condition so severe that you can’t work.
SSDI Medical Criteria
The Social Security Administration defines disability narrowly, and Disability Determination Services are state-run organizations that make determinations on applications. The primary requirements for receiving assistance are:
- Disabled and unable to return to your previous occupation.
- Unable to work other occupations.
SSDI only provides benefits for total disability, which is defined as a disability that is expected to persist for more than a year or result in death. No benefits are paid out by SSDI for temporary or partial disabilities.
If your initial application is complete and in order, the Social Security Administration will forward it to the state’s Disability Determination Services (DDS) office. The office conducts a review of the medical records and decides whether or not the applicant is disabled.
It takes into account information provided by medical professionals and facilities regarding your health and ability to do work-related tasks like walking, sitting, lifting, and remembering instructions.
The state agency will review your application and evidence and determine whether you are eligible for the program. If your claim is approved, you will receive a letter with details about your benefits, including the amount and the start date of payments.
If your application is not approved, the letter will explain the reasoning behind the denial and include instructions for filing an appeal. The rejection rate for first-time applicants is 62 percent.
Applying for Disability Insurance Benefits from Social Security
To apply for Social Security Disability Insurance, you must submit Form SSA-16 to the SSA. Social Security Disability Insurance and Supplemental Security Income (SSI) use the same application and have identical processes.
Now, you may be wondering where to send in your application after filling out the form or how to apply from anywhere. There are four application options:
- Through the Social Security Administration’s online portal
- By telephone at (800) 772-1213
- In person at a Social Security Administration office
- Through a lawyer or advocate who specializes in Social Security Disability Insurance
Going in person to your local SSA office is a must if you’re applying without the aid of legal counsel. You may want to call to set up an appointment beforehand.
Although they cannot provide legal counsel, SSA employees can answer any questions about the application itself. A disability attorney can either complete this application for you or advise you on how to complete it most effectively.
Additional Paperwork Requirements
The first stage in the application process is to fill out the primary application. The Social Security Administration will likely request more documentation detailing your disability and your incapacity to work. Other paperwork you may need to fill out includes the following:
- Function report (Form SSA-3373-BK) an explanation of how your condition restricts your activities and how it affects your daily life.
- Work history report, (Form SSA-3369-BK), to describe the work you’ve already done in previous years and the reasons why you can’t do that work now.
- Work activity report (Form SSA-821-BK), which will include details regarding your job-related income as well as any special accommodations you might have gotten at work.
- Third-party function report (Form SSA-3380-BK), which you give to another person so that they can describe how they have seen your condition restrict your activities and impact your life.
- Additional pain questionnaire for you to describe your discomfort and how it affects your daily life.
Tips for Getting SSDI Approved
Following are some tips to follow to increase the likelihood of getting SSDI approved.
1. Check to See That Your Application Is Complete
It’s important to get organized and have all the necessary paperwork together before you start the disability application process. The Social Security Administration has produced a printable checklist that can be quite useful. Using the list will help you assess your information and identify any gaps.
You should be ready to answer questions concerning your health in addition to the more typical personal details such as citizenship, date of birth, names, and dates of marriages and divorces, and the names and ages of any children you may have.
You will be asked to give detailed information about your health history, including diagnoses, treatments, doctors, hospitals, and healthcare facilities visited.
Finally, you will be asked to provide details about your education and work experience during the past 15 years.
2. Maintain Detailed and Accurate Health Records
Experts in the field of disabilities will tell you that having sufficient medical proof is crucial to a successful SSDI claim. Gather your medical documents and paperwork before beginning the application procedure.
Doctors’ offices and hospitals are swamped with patient care and paperwork. The Social Security Administration will make the request directly to the healthcare provider. Self-request and self-organization of medical records are the best ways to guarantee that all relevant information is transferred to the appropriate parties.
You should also continue to acquire whatever additional medical data you can after submitting your application. Make sure to follow up and inquire about the outcomes of any additional diagnostic tests you may need, such as blood work, imaging, or treatment records.
If you want to strengthen your case even further, start keeping a log of your interactions with medical professionals. Even if you don’t think it’s relevant to your case, it’s still important to involve all health professionals.
For instance, if you are applying for cancer but are seeing a psychiatrist for anxiety, you should mention this information in your paperwork.
3. Keep a Positive Rapport with Your Doctor(s)
Before 2017, the SSA gave a lot of weight to a claimant’s treating doctor’s view. It was unusual for a claims examiner or administrative law judge to disagree with a patient’s doctor’s diagnosis. However, as of a 2017 rule change, the SSA no longer takes only a patient’s doctor into account when making decisions.
Instead, the SSA will evaluate the consistency and backing of each medical opinion on its own merits; that is, how closely does the viewpoint line up with the medical records that have been compiled.
You must continue to have positive interactions with your treating providers despite the new regulation. As a first step, you can ask your doctor for a statement detailing your health and how it prevents you from working.
If you want to strengthen your claim, you should have your doctor do a Residual Functional Capacity (RFC) assessment. In addition, it may be beneficial to have your doctor testify as an expert witness if your case goes to trial. You may also include a note from your doctor supporting your disability claim.
4. Track the Progress of Your Claim
Every year, the Social Security Administration handles claims from millions of people. You may be seriously ill and in need of assistance, yet you are just one of many people in our country who could benefit from government assistance. Maintain continuous communication with the SSA to guarantee proper case management.
Talk to a claims rep if you need answers about your claim’s progress. It is helpful to keep a record of your conversations, noting the time, day, and identity of those with whom you’ve communicated.
Monitoring the progression of your claim can help you meet any future deadlines. If your claim is rejected, for instance, you may only have a limited amount of time to file an appeal.
5. Make Sure All Treatment Recommendations Are Being Followed Up On
Follow your doctor’s orders to the letter, whether that means taking medication exactly as recommended, going to all scheduled appointments, or making any suggested changes to your daily routine. Try to make it to every one of your appointments. Maintaining a regular schedule of checkups with your doctor might bolster the medical evidence supporting your case.
The Social Security Administration needs evidence that you’re making every effort to get better. Disobeying medical advice may result in a denial of SSDI benefits.
6. Avoid Work During the Application Process
Those who are disabled and unable to work are the only ones eligible for SSDI benefits. The Social Security Administration (SSA) may reject your application for disability payments if they find evidence that you are working while your application is pending.
Although part-time employment is possible after starting SSDI benefits, it is recommended that you do it during a Trial Work Period.
Things to Know Before Applying for SSDI
The following are some things to know before you apply for SSDI benefits.
1. Purpose
The purpose of the disability application is to demonstrate that you are unable to work due to a medically determinable disability. If you’re over a certain age, you need to show that you’re unable to perform the same tasks you once did. You must demonstrate that your impairment prevents you from performing any type of work if you are under the age of 50.
2. Age
If you are over the age of 50, you will have an easier time qualifying for Social Security disability benefits. While all applicants should treat the application process equally, the Social Security Administration has certain rules about adapting to new work and is more likely to approve claims from those over 50.
3. Relevant Details
Your application for disability payments does not have to include every detail of your life or disability. The Social Security Administration (SSA) doesn’t care about some details that may be important to you. The following should be avoided in your application:
- The psychological and emotional toll of your medical condition
- Details about your background that aren’t part of the application
- Whether or not you are entitled to a benefit because of your character or history
4. Relevant Impairment
The SSA does not take into account every illness, symptom, or impairment. Only include circumstances in your application that:
- Impact your productivity right away
- have been diagnosed and are receiving treatment from a medical expert
5. Relevant Work Details
Keep in mind that the SSA is only interested in learning whether or not your disability stops you from working, and, if so, what kinds of employment you are unable to perform because of your impairment.
The Social Security Administration will not take into account the following factors when determining your employability:
- Whether or not you can be recruited for a position that you are qualified to do.
- How well you can get by with the jobs you qualify for.
Other obstacles, such as the fact that you are currently providing care for someone or that you do not possess a driver’s license, which prevents you from finding alternative employment opportunities, are not considered in the determination.
Conclusion
While it is not possible to predict or guarantee whether or not you will be approved for SSDI benefits, there are some things you can do to increase the likelihood of your SSDI approval. We’ve listed some of these tips in this article, which should give you an advantage when applying for SSDI benefits.
