Applying for Social Security Disability Insurance
Written by: Amy Stein, MSW, LCSW, Health Navigator
During my years of working as a social worker in hospitals, a common question among my patients was “should I apply for disability?” There is no “one answer fits all” reply to this question. Did the patient mean a disability policy through their job? Through their State or territory? Through a private policy they purchased? For this blog, I am only going to discuss Social Security Disability Insurance as it was the most common concern among my most debilitated and distressed patients. These patients were concerned about not being able to work for several months due to a serious health condition and needed a way to replace their lost income. While I am in no way an expert on this topic, I feel that I can offer some real-world explanations, as well as tips, to help you get started on your journey to receiving Social Security benefits.
If you have a social worker already involved with your care, ask them to help. I would encourage my patients to ask a family member or friend that they trust to accompany them to any appointments with this process.
If you want professional help from start to finish, then contact an attorney who specializes in disability law. There are law firms completely dedicated to this type of practice. I recommend asking if they have represented patients with GBS, CIDP, or MMN in the past. Assistance from an attorney does come with a price, typically, 25% of the first disability check you may receive or $7200, whichever is less. This first check is usually several months of “back pay” lumped together, so it might be substantial.
For many of my past patients, they just couldn’t afford to pay this type of money and thus chose to go through this process on their own. You are not alone in wondering about how this works. These are the most common questions I have received over the years with my real-world answers. I hope you find them helpful.
What is SSDI?
First, Social Security Disability Insurance is often better known by its abbreviation SSDI, or even just SSD. You should only be thinking of applying for SSDI if you are below retirement age as specified by the Social Security Administration (SSA.) To find out what your retirement age is, visit here https://www.ssa.gov/benefits/retirement/planner/agereduction.html. If you are of full retirement age, then the SSA will prompt you to apply for retirement. If you are of the age when you can apply for early retirement, generally you will receive more by applying for disability benefits.
How do I apply?
Once it’s confirmed that you haven’t reached your retirement age, the next step is to make sure that you have Social Security disability benefits to tap into. There are a few ways to do this. If you are computer savvy and have an email address, then start by creating an account on the Social Security website, www.ssa.gov. You will need to go through several steps to verify your identity. It is also beneficial to have a cell phone that can get text messages as one of the easier ways for you to prove you are you is by getting a test message. I would encourage anyone to create an account with Social Security even if they aren’t applying for benefits. It’s the easiest way to request a replacement Social Security card and to view how much you may get in retirement benefits one day.
Once your account is created, you will be on the “my Social Security” website. Scroll about 2/3 of the way down the page to “More Benefits.” If you have earned enough credits to potentially be eligible for SSDI, it will say “You can qualify for Disability Benefits if you become unable to work due to a medical condition that’s expected to last at least one year or result in death.” The amount that you could get monthly will also be listed. If you do not have enough credits, this will also be noted in this section. At this point, you can immediately start an online application from this page. You should now be prepared to sit in front of your computer for at least an hour to begin the application process. You can save and return to the application at any point. In addition to entering all of your contact details, you will indicate the people in your household, your military services, your employer information, your past employment information, your salary amounts, your education, your medical conditions, your medical providers, your medical testing, any surgeries and hospital stays, and your medications. Be sure to list all your medical conditions, including mental/behavioral health issues, especially any depressive or anxious symptoms you are experiencing. Your mental health is as equally as important as your physical health and will support your need for SSDI benefits.
At the end of this application, you will sign consents allowing the SSA to contact your health care providers for your medical records. If you have a social worker or another health care provider helping you, ask them if they would gather and mail the records they have access to. You will need to sign any consents required by each provider. This step could save you valuable time. Otherwise, you will wait for the SSA to receive your consent, and then mail or fax a request to your medical providers. Sending your records can take hospitals and physician offices weeks. They do not make this a priority. If you are doing this yourself, contact all your providers to give them the head’s up to expect the request from the SSA and to respond as soon as possible.
What if I don’t have a computer?
If you don’t have access to a computer with internet access, and don’t have anyone that can help you, you can do all this pre-work with a call to Social Security. If you try to google the phone number for your local Social Security office, best wishes. Most likely you will only find the national phone number 1-800-772-1213. This is the phone number to use. When you decide to call, try to call from a phone with a speaker so you can do something else at the same time. Wait time can be anywhere from minutes to hours, depending on when you call. Calling first thing in the morning when they open at 9am or waiting until about 3:30pm may help with the wait time. You also need to call yourself. A friend or family member cannot call for you unless you have previously designed that person to speak on your behalf with Social Security. If you have someone sitting with you while you call, this is ok, and you can appoint them while you both are on the call.
The Social Security representative should be able to verify whether you are eligible to apply for benefits and then will set you up with a phone appointment for the next step of completing an actual application. Again, make sure you have plenty of time set aside for this appointment and all the documents you have been instructed to collect. This may include past addresses, past employers, employer addresses, your medical problems, and health care providers. Again, include every kind of medical condition you have, including mental and behavioral health issues.
What happens next? Am I guaranteed approval if I have a rare condition such as GBS, CIDP, or MMN?
After you have completed either the online application, or a telephone appointment, you now will wait to receive a packet in the mail from the SSA. Again, if you have a social worker or another professional helping you, make an appointment with them to fill out this packet. You will be asked to describe your day-to-day functioning from the moment you wake up until you prepare to go to bed, along with how you sleep. This is your time to describe all your limitations and how they relate to your inability to work. Some questions to think about:
- Do you have pain when you first wake up?
- Are your feet tingly?
- Did you not sleep well?
- Do you need help reaching for things in the kitchen?
- Do you use a cane or walker?
- Are you ever short of breath?
- Can you lift a carton of milk?
- Do you ever drop things?
- Do you need to rest after being awake for an hour?
- Can you go up and down stairs?
- Do you still drive?
- Has your vision been affected?
- Is your condition causing memory issues, difficulty concentrating, following instructions or are you feeling overwhelmed?
- Can you write, type, and talk as you did before your diagnosis?
- Do any of your medications cause side effects, such as drowsiness, dizziness, headaches, nausea, or other gastrointestinal issues?
Even if you are having trouble with these tasks due to a condition other than your GBS, CIDP, or MMN, still describe them. You aren’t going to get approved for SSDI simply because of having a diagnosis, you will be approved based on not being able to work. And not being able to work might be related to several different diagnoses individually or their cumulative effect.
How long will this take?
Mail the packet back and then the waiting begins. If the SSA feels that you meet their criteria for being unable to work for 12 months or more, then, hopefully, you will be approved. I have helped patients get approved in as quick as 4 months. You will get a letter in the mail explaining your approval date, your monthly payment, the date of your payment, and the amount you will receive of your “back pay.” Back pay covers the months between the dates you submitted your SSDI application and were approved for benefits, following a five-month mandatory waiting period.
Will I also be able to get Medicare?
You will also now know when you will qualify for Medicare. Persons receiving SSDI qualify for Medicare after a 24 month (about 2 years) waiting period. The 24-month clock begins the first date you were eligible for SSDI payments. While waiting for Medicare, you may continue to use your prior insurance. Please note: if you are on Medicaid or receiving a subsidy through the Affordable Care Act, you must inform them of any change in income, including receiving SSDI payments. I have seen patients on Medicaid suddenly become ineligible when they start receiving SSDI payments as it makes their income higher than the threshold.
What do I do if I am denied benefits?
Do not give up if you feel you are truly unable to work. Many times, there can be a simple reason for your denial, such as one of your medical providers not supplying your records by the deadline given by the SSA. If you are denied benefits, now may be the time to consult with an attorney. An attorney specializing in disability law will have the time and resources to move forward with filing an appeal. This process may be long and frustrating, but remember, you paid into this system and are entitled to receive the benefit back to help you move ahead with your life.