Frequently Asked Questions
What type of benefits should I apply for if I’m disabled?
The Social Security Administration (SSA) has 2 programs for those that are disabled. Social Security Disability Insurance (SSDI) is based off how long you’ve worked and paid into the Social Security program. The number of work credits you need to qualify for disability benefits depends on your age when you became disabled. Supplemental Security Income (SSI) is based off your current income and resources. The amount of income and resources you can have to be eligible depends on household size, living situation, and other factors. Generally, children are only eligible for benefits through the SSI program, however it is recommended that all adults apply for both SSDI and SSI.
What is the application process like?
For both SSD and SSI, an application will need to be filed online, over the phone, or in-person at a Social Security office. A representative through your local SSA office will need to contact you to collect more information to process your application. If you are determined to be eligible through either your work credits (SSDI) or income and resources (SSI), SSA will forward your application to the Disability Determination Services (DDS) for your case to be medically reviewed. An adjudicator will be assigned to your case and will request records from the medical sources you provided on your application. They will also take your past work, education, and limitations of daily activities into account when determining eligibility. A consultative exam paid for by SSA may also be scheduled for you if additional medical information is needed. The typical time frame for a decision to be made is 6-8 months.
How much does it cost to hire a representative for my case?
Non-attorney representatives that are certified through SSA must follow the fee structure that is facilitated by Social Security. This fee comes straight from SSA so it’s not an out-of-pocket cost to the claimant. Representatives cannot charge a fee for a denied case. Representatives are eligible for a one-time fee of 25% of their claimant’s back award, ONLY if they are approved for benefits. The claimant receives the other 75% of their back award as well as 100% of their monthly benefits. This fee structure allows representatives to receive payment for their services while also protecting the claimant from hefty fees.
What if my application is denied?
Claimants have 60 days to request an appeal from the date of denial found on the top of their denial letter. If an appeal is filed out of the 60-day window, the claimant must have a reason as to why it was filed untimely and SSA will review to determine if they will accept the appeal. If they do not accept it or an appeal isn’t filed at all, a new application will need to be filed.
Am I able to get health insurance if I’m approved?
You are eligible for health insurance if you are approved for SSDI and/or SSI through the Social Security Administration and are receiving monthly benefits. SSI recipients are automatically eligible for Medicaid through their state and should contact their local Job and Family Services office once approved. SSDI recipients will become eligible for Medicare 2 years and 5 months after their onset date, regardless of their age. They should also try to submit a Medicaid application while they wait for their Medicare to start, but it will not be an automatic approval.
I’ve already been approved for worker’s compensation or VA benefits because I’m disabled. Am I automatically eligible for SSA disability benefits?
No, Social Security deems claimants disabled or not disabled through their own set of guidelines. You will still need to file an application and go through the entire process to determine your eligibility. However, if you’d been found to have a 100% VA rating, SSA does have an expedited process for disabled veterans when they apply for either SSDI or SSI.