Top 5 things to know about SSDI benefits

Winning Social Security Disability Insurance benefits is generally not as simple as just completing a disability application and sending it to the SSA. In fact, although millions of applicants apply for SSDI each year, up to 75% of claimants are denied the first time they apply. If you are one of the thousands of disability applicants who files their claim each year it’s important to understand the requirements BEFORE you apply.

With that in mind, let’s take a look at some of the most important facts you should know before filing a Social Security Disability application. 

Top 5 things to understand about SSDI benefits

1. Claimants are not entitled to SSDI benefits.

First, it’s important to understand that disability benefits are different than Social Security retirement benefits. Social Security Disability Insurance is not an entitlement program (i.e. you work, pay taxes, and at the specified time you request benefits). Instead, it’s an insurance program, which means you are insured in case you become disabled and cannot work.

So not only do you have to work, pay taxes, and earn work credits to be insured, you will also have to meet other very specific requirements. For example, you will have to prove your condition is severe, you are not working and making too much money, you cannot work your current job or retrain for new work, and your condition is expected to last for at least 12 continuous months or be expected to result in your death.

2. Most claimants are denied benefits.

As mentioned above, millions of applicants apply for SSDI benefits each year. Most of these applicants, however, are denied SSDI benefits. Denials occur for a variety of reasons. Some claimants lack work credits and are not insured, some claimants have a short-term condition, some claimants have a condition which is not considered severe, while other claimants should be approved but they lack medical evidence to prove they are disabled. 

If your case has been denied you will need to review your denial letter. Some denials can be appealed within 60 days of the denial letter. Other denials (i.e. technical denials) may be more difficult to appeal. For example, if you lack work credits and are not insured for SSDI benefits, it is difficult to appeal your denial unless you can prove the SSA lacks information about your work history or miscalculated your credits.

If you believe your application can be appealed, you must take the proper steps and file a reconsideration appeal (in some states you can immediately request a hearing). All appeals must be filed within 60 days from the date of the denial letter. If you miss the denial deadline and you do not have a good reason, you will have to refile your claim and start the process again. 

3. If you do not have enough work credits you will be denied.

Claimants must be insured to qualify for SSDI benefits. The number of credits you will need to be insured will depend on your age at the time you become disabled. For example, according to the SSA, “if you are disabled at age 31 or older, you generally need at least 20 credits in the 10 years immediately before you became disabled.” In 2017, a worker must earn $1,300 to earn one work credit. Workers can earn a maximum of 4 work credits per year.

Claimants who do not have sufficient work credits will be denied SSDI benefits, regardless of the severity of their health condition. Work credits cannot be bought or borrowed. They must be earned on your own work record.

4. Appealing your denial is better than applying over and over again.

Although not all disability applicants can appeal their denial, if you are able to it’s generally much better to enter the disability appeal process rather than simply applying for SSDI multiple times. In fact, generally a claimant’s best chance to win benefits is at the hearing level- the second level in the appeal’s process. The hearing will allow a claimant the ability to present their SSDI case to a judge who has the legal authority to make a disability decision.

5. You may have to hire a lawyer to win benefits.

Although claimants are hesitant to hire a disability lawyer to fight for benefits they believe they are entitled to receive, it’s often better to hire a lawyer. In fact, although a lawyer cannot expedite your disability claim or somehow move your case to the front of the line, they can improve your chances of winning benefits at every step in the disability process. Because of this, hiring a lawyer can sometimes speed up the disability approval decision.

Bottom line:

Failure to understand the disability process can reduce your chances of winning SSDI benefits