What Is Social Security Disability Insurance (SSDI)?

Social Security Disability Insurance (SSDI) is a federal program funded by social security taxes that pays monthly benefits to you if you have a severe physical and/or mental disability that prevents you from working, and if you become disabled before you reach retirement age.

Do You Qualify for Social Security Disability Benefits?

Social Security pays monthly benefits if you are disabled and if you paid Social Security taxes for a sufficient time. The basic requirements for qualification are:

  1. Functional Disability: This is determined by a physician and requires a medical statement of functional disability as documentation for SSDI eligibility. 
  2. You must have accumulated sufficient “work credits” with Social Security. Exactly how many credits you need depends on your age and the year you became disabled. Generally, you must have worked at least five out of the last 10 years before you became disabled.

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How Much Is Your Monthly SSDI Payment?

If your application is approved, you will receive monthly Social Security disability income payments in an amount based on your personal earnings record. Social Security benefits statements are sent by post at 5-year intervals to workers who haven’t signed up for statements online. (You can view your benefits statements online at www.1.usa.gov/1d3xvuZ). Approved SSDI applicants also receive Medicare benefits after 24 months, beginning the month of first eligibility for a monthly disability benefit.

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How Does Social Security Define Disability?

Disability is defined by documentation of a physical and/or mental condition which prevents you from performing  “substantial gainful activity” (SGA). SGA basically means work performed in exchange for payment. A disability is defined as a mental and/or physical condition expected to last at least 12 months or to result in death. Whether one is eligible for disability is a matter subject to some interpretation. Although your doctor may have advised you not to work, or you may feel too ill to work, the Agency will not necessarily agree that you are disabled. Social Security initially evaluates disability based on a catalog of physical and mental conditions called a “Listing of Impairments.” These are available on the Social Security Administration website, www.ssa.gov (search for “Listing of Impairments”). Even if you can’t show that your condition is exactly as described in the listing, it is still possible to prove that you are disabled. Furthermore, even if you are denied benefits because Social Security says you are not disabled, you have a good chance of winning on appeal. An attorney can be very helpful at a hearing.

How Long Does A Social Security Disability Claim Take?

Any Social Security disability claim can take quite a long time from start to finish, and processing time can vary widely from one case to the next. For individuals pursuing disability at the initial claim level, the time spent waiting for an initial answer can exceed three to four months. Waits of over a year for an initial decision on a disability claim are a bit unusual, but cases have been known to take that long. In most cases, an initial claim will probably be decided in under 120 days. Unfortunately, most claims are denied after the initial application, and the disability claimant must appeal. The entire appeal process can stretch out to more than two years and perhaps as long as three years for a hearing.

How Much Is The Social Security Disability Attorney's Fee?

Social Security disability lawyers’ fees are limited to 25% of past-due benefits, up to a maximum of $6,000. An attorney will be paid only out of your past-due benefits, or “back pay.” If no back benefits are awarded, the attorney will not receive a fee. This is called a contingency fee agreement. You and your attorney sign the agreement and file it with Social Security to ensure that it satisfies the Agency’s guidelines. Some attorneys ask you to pay a nominal amount for costs at the beginning of your case. We generally do not ask for costs upfront, and do so only when we must pay for your medical records or your doctor’s opinions.

When Do You Have To Pay The Attorney's Fee?

Usually, you don’t. Social Security deducts the attorney’s fee (up to $6,000) from your first disability check (your award of back pay), before the Agency sends the award of back pay to you.

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The Five Possible Levels of Administrative Review in a Social Security Disability Claim

In Level 1--following the initial application--the agency will make an initial determination of whether you are disabled under its guidelines. If that decision is unfavorable to you, the process proceeds to…

Level 2, in which you have the right to request reconsideration, and in which a different group of people will review your case. Throughout the appeals process, each appeal must be filed within 65 days (60 days plus 5 days for processing through the mail) of the date of the notice of decision. 

If the reconsideration decision also goes the wrong way for you, you may choose to move on to…

Level 3, in which you request a hearing before an Administrative Law Judge. If, after the hearing, the Judge denies your claim…

You have the right to progress to Level 4, requesting review with the Appeals Council in Falls Church, Virginia. If the Appeals Council denies your claim, that ends the administrative process. But…

If the Appeals Council goes against you as well, the administrative process is concluded. The only way to overturn the decision of the Administrative Law Judge is to take your case to Federal Court. 

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