Disability Benefits Claim Denied? Here Are 5 Reasons Why
If you are applying for Social Security Disability Insurance (SSDI) payments, you may be wondering what are common reasons fo...
Read moreThe Social Security Administration pays disability benefits through the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program.
Applying for disability benefits through the SSDI or SSI programs can be daunting. Here is a brief overview of how the application process works and what you can expect after you’ve applied.
Supplemental Security Income (SSI) has been a federal program since the 1970s. It provides modest monthly payments to assist seniors, people with disabilities, and others who have limited income.
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To qualify, you must be unable to work, and your income and assets must meet very specific restrictions. In 2024, the standard monthly SSI benefit is $943 per individual.
Social Security Disability Insurance (SSDI) is another federal program offering cash assistance. People with disabilities can benefit from SSDI regardless of how much they have in terms of income or assets.
In 2024, SSDI payments average $1,537 a month per individual.
You can apply for federal benefits through SSDI and SSI as a result of a disability. Your personal circumstances will dictate which program is right for you. In some circumstances, you can apply for both.
The SSDI program pays disability benefits to those who can't work due to a medical condition that is expected to last at least one year or result in death. SSDI does not give money to people with a partial disability or short-term disability.
To apply for SSDI successfully, a person must meet two different earnings tests:
You can apply for SSDI by:
As part of this process, you have the right to be represented by an attorney or other qualified person.
The SSA recommends that applicants apply for disability benefits as soon as they develop a disability. Gather the following documentation to apply for SSDI:
You must provide specific details regarding your disability and medical condition in your application. The SSA can assist the applicant with getting the information.
Another way to apply for benefits is through the SSI program. SSI provides financial assistance to people with limited means and who are either over 65, blind, or have a medical condition that keeps them from working. Similar to SSDI, the applicant’s medical condition must be expected to last at least one year or result in death.
If you are applying for SSI, be prepared to provide financial information about yourself and potentially your spouse’s or family’s income and assets.
You can apply for SSI online on the SSA website.
If you’re over age 18 with a disability and intend to file for both SSI and SSDI, you can apply online for both benefits simultaneously as long as you:
You should expect to provide your personally identifying information, contact information, birth certificate, as well as information on the following:
If you apply via phone or online, you will need to send the SSA additional supporting documentation to prove US citizenship or residence. Once the application is complete, the SSA begins reviewing your application to decide whether you are eligible for benefits.
In order to receive concurrent benefits, you typically must be under certain income and asset levels. An example of when this may occur is when your resulting SSDI award is under the current SSI monthly payment amount. If you are below the SSI thresholds, you may also be entitled to an SSI payment.
The SSA initially rejects approximately 70 percent of disability applications. Its most common reasons for denying applications for benefits are when:
If SSA rejects your application, it’s important to retain a competent attorney immediately to advise you about the next steps in the appeals process. Whatever you do, do not delay; failing to file a timely appeal could jeopardize your chances of obtaining retroactive disability benefits that you might otherwise be entitled to receive based on the date of your initial application.
The appeals process can be demanding, but is worth it if it opens up your access to these federal benefits and the medical coverage that comes with them. In the first stage of an appeal, called a request for reconsideration, the disability agency that made the initial determination gets a second look at your application. Very few appeals are won at this level.
If rejected for reconsideration, you go to a hearing before an administrative law judge to plead your case. Applicants who make it this far have a roughly even chance of winning the appeal – a chance that grows larger if competent counsel represents you. If the judge rejects your appeal, you can file for review by the Appeals Council, which approves only between 2 and 3 percent of all appeals.
Your final recourse is to file suit in federal court, which can be costly.
Because the disability application process can take months, the SSA awards successful applicants back payments that they would have received in the months between the date an application for benefits was filed and a final determination is made.
In addition to back payments, SSDI (but not SSI) recipients can receive retroactive payments going back one year from their application date if they were disabled during that time. However, the SSA takes five months off of a successful applicant’s established disability onset date when calculating retroactive payments. So, an applicant would have to have been disabled for 17 months before applying to receive the full 12 months of benefits.
If all these rules seem complicated, that’s because they are. It is important for you to discuss the disability application process with a special needs planner near you before applying to have an accurate picture of what is needed and what your chances are before you begin.
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