DISABILITY APPLICATION PROCESS

Filing for disability insurance isn't necessarily a "crisis" in itself.  But job loss for many people is.  Thus you may need to apply for help at a time when you are otherwise in the middle of a mess.  You might find yourself dealing with a lot of distractions while you're trying to get financial help for  your day-to-day expenses.  

The disability process is different from country to country.  In the US, it is also different for private disability insurance (which you have paid for, or which was provided through an employer) versus for Social Security Disability Insurance (SSDI).  The central "contract" is the same.  In return for having paid in a monthly insurance premium, an insurance company or government agency will partially replace your income for some identified period of time, after a medical condition makes it impossible for you to work.

For both public and private insurance, there is a waiting period after you have been forced to stop working, before you can apply for disability compensation (for SSDI it is five months).  To qualify for disability under SSDI, you'll need to go through an evaluation called "Residual Functional Capacity" or RFC, and demonstrate a level of disability which will keep you from working for at least a year. There is also a maximum amount of money that you are allowed to earn from occasional or part time employment, without a decrease in your SSDI benefit.  Disability payments and allowances for other outside income are generally not high.  But everything helps.

In the US, it is important to know that the SSDI application process may involve as many as three stages which might require a year or more to get through.  To start, you need to go to your nearest Social Security Administration office for pamphlets which describe what you do and what documents you need at each of these stages.

For the first two rounds of the process, you won't need a lawyer and in my opinion you might be well advised not to hire one.  What the attorneys don't want you to know is that a Social Security representative can assist you with the paperwork by asking you the questions and then they fill in your answers, either in person or in a phone interview.  You don't have to do anything.  Then the Social Security personnel send requests to your doctors for your records.  You are not involved in that process at all.  Additionally, your attorney actually doesn't do anything until a denial is made and you request a hearing and they don't even spend a moment filling out your paperwork - their paralegals do.  I was able to be approved on my first application without an attorney and it saved me thousands of dollars.  

A lawyer' fee for representing you in the SSDI process can be determined in one of two ways, both of them set by the Social Security Administration, not State law. The nominal fee is 25% of any award that you get of SSDI payments previously denied, up to a maximum of $6,000 dollars.  However, the lawyer may also petition the Social Security Administration for some other level of compensation after an award is made. 

If you must change disability lawyers in the middle of a case, things can become both complicated and expensive.  For background reading see The Social Security Insider.    Be aware also, that some lawyers don't support first-time applications because they feel the awards may not be large enough to cover their expenses.  In any event, if you and/or a family member can do this process for yourself without a lawyer's help, you might come out better financially.

Your disability application will need to be backed by letters from your doctor (or doctors).  These letters must identify your medical diagnosis and describe any past or present treatments that have a bearing on your ability to work.  The doctor will also describe your symptoms and reactions to treatment, showing how these symptoms make it impossible for you to take regular employment -- even working from home.  Many patients report being required to be interviewed by another doctor who is appointed to evaluate you and confirm that the symptoms and issues in your application actually exist.  To be awarded disability, you must demonstrate that you are expected to be unable to work for at least a year.  And the doctors who support your application need to be considered mainstream practitioners.   The findings of a Chiropractor or Herbalist will have much less credibility than those of an MD, Doctor of Osteopathy or Ph.D. Psychologist.

About a third of all first-time SSDI applications are granted on the first try.    Another 10-20% are granted on a reconsideration application. The rates of successful application vary sharply from US State to State.  Numbers quoted on the website of  "The Ultimate Disability Guide" vary from a high of 52% approval on a first application in Hawaii, to a low of 23% in South Carolina.  

If you apply for SSDI and are denied, and then you apply for reconsideration and are again denied, there is a second level of review before an Administrative Law Judge.  At this level you should be represented by an attorney.  There is yet a third level of review in an Appeals Council.  Theoretically, you could go even higher than the Appeals Council in Federal Court, but such legal actions are quite rare.

Be aware that once you have "won" an SSDI case, you also need to be mentally prepared for a periodic review by the Social Security Administration to determine whether you continue to be disabled.  If all of this looks like an obstacle course to you, then you have a lot of company among disability applicants.

For additional information and insights, I suggest that you visit the Ultimate Disability Guide, above.

More links:

"The Social Security and Disability Resource Center.

How Do I Submit and Support a Disability Claim?