You can apply for it after meeting certain conditions. The most important of these is the required number of years worked at the time the disability arose (it varies depending on the age of the person who became disabled due to illness). Another condition is the mandatory number of accumulated credits, which depends on the amount of earnings and employment history. Of course, it must also be shown that the disability results from an illness, and not from an inability to find suitable employment. And although federal law very rigorously defines disability, many conditions qualify for its recognition.
You can apply for disability benefits yourself. However, this is a multi-stage process, requiring the collection of many documents and the completion of multi-page questionnaires. It is necessary to precisely define the illness and its impact on the ability to undertake any work.
The application review can take three to five months. Errors in submitting the application or lack of required documents may result in a denial of benefits. Documents and all forms should be meticulously completed and accurately filled out.
Social Security first checks the length of employment and current employment. If these basic criteria are met, in subsequent stages the office will examine the patient’s health, the course of the illness, its impact on the patient’s fitness, the presented test results, and the treatment received.
To make this complicated qualification process a little more understandable, we present its individual stages below. There are five of them.
- First, the committee checks whether the person applying for disability benefits is working at the time of application.
If so, the office will additionally check the amount of their earnings. If their earnings exceed a certain amount (this amount is updated annually), the office will consider the applicant capable of working and deny benefits. However, if the amount of earnings is equal to or less than the established amount, the office proceeds to the second stage, i.e., checking the patient’s health. - A disability determination is granted to individuals whose illness significantly limits their ability to perform basic work-related activities, such as walking, sitting, or remembering. Additionally, this condition must persist for at least one year. If the condition proves to be that serious, Social Security proceeds to the next stage of verification.
- Here, the office checks whether the applicant’s condition is on the list of impairments that are considered so severe that they prevent work regardless of age, education, or vocational training. If the applicant’s illness is not on the list of recognized conditions, Social Security checks whether it is equally serious and whether it prevents them from working. If the condition is deemed serious, the application proceeds to the next stage of verification.
- At this stage, it is checked whether the applicant can perform their previous work. If so, Social Security denies disability benefits. If the patient has limitations that prevent them from performing their previous work, in the next stage it is examined whether they can perform any other work.
- The office assesses the applicant’s health, age, education, professional experience, and all skills, in terms of professional possibilities and their usefulness in undertaking any work. If at this stage it turns out that the sick person cannot perform any work, Social Security will recognize the applicant as disabled and issue a decision to grant benefits. However, if it turns out that there is work that this person can perform despite the illness, they will not be granted disability benefits.
As you can see, the Social Security office’s decision depends on many factors. Notification of the outcome of this complicated procedure is sent to the applicant by mail. It should be remembered that at every stage of processing the application, the office may ask the patient to supplement the documentation. If the office’s decision is positive, the letter sent will state the amount of the granted benefit and the date its payment will begin. The amount of disability benefits is calculated based on the applicant’s average past earnings, and its first payment occurs after the sixth full month from the onset of disability. However, if the application for disability benefits is denied, the letter from Social Security will contain the reason for the denial of benefits and information on how to appeal this decision.
Of course, a person receiving disability benefits can return to work at any time if they feel capable. However, Social Security must be immediately notified of this fact, stating the start date of work, scope of duties, working hours, and amount of remuneration.
It is worth knowing that Social Security has the right to periodically verify the patient’s health and check whether they can return to work. If during such verification it turns out that the disability still persists, the office continues to pay benefits. However, if the patient’s health has improved and the beneficiary can take up work, the benefit may be suspended. The same will happen if the applicant provided false information in their disability application, does not follow doctor’s recommendations, or does not cooperate with the office without a justified reason. The office’s verification may also concern a number of other issues, e.g., whether the beneficiary has taken advantage of additional training or treatment and whether they can therefore take up professional work, and if they have, what earnings they achieve from it and whether they are still entitled to disability benefits.
As you can see, the process of applying for disability benefits is long and complicated. And although one can apply for it independently, it is very easy to overlook something and then take a very long time to claim the rights due to the patient. Furthermore, the appeal process against a negative decision requires a detailed explanation of the reasons for the appeal and the provision of additional evidence confirming the patient’s right to benefits.
Law firms provide great assistance both in submitting applications and appealing negative decisions. Their experience helps avoid many basic mistakes and ensures that in the event of an unfair denial of disability benefits, one can count on their help in appealing the decision.
