You’ve Applied for Social Security Disability Benefits Now What Happens?

1. You’ve Applied for Social Security Disability BenefitsNow What Happens? Shareen Young-Chavez Quality Assurance Specialist/Case Consultant Social Security Disability Determination Services

2. Disability: The inability to work for a period of twelve (12) months in a row, or your condition must be so severe that it is expected to end in your death.

3. Social Security Disability differs conceptually and fundamentally from other forms of disability to include: Short term disability, Long term disability, Workman’s Compensation, Partial or Temporary disability. The criteria is extremely different. Think of Social Security Disability in terms of a Fund of Last Resort.

4. “but I’ve paid into the system. I’ve worked since I was 16 and now I’m 50. I know I’ve accrued enough money, and it’s my money, why won’t they just give it to me?” • There is no account set up in your name reserved for you for the day that you become disabled so that you may draw from it.

5. You have applied for disability and your assets, income, and resources have been reviewed at your local Social Security office and you have been found eligible to go to the next step. • Disability Determination Services office • Case Developer • Analyst Note: You only have ten days to respond to any letters sent from your adjudicator.

6. Sequential EvaluationSequential Evaluation is a formula used to make a decision onyour claim. It is comprised of five levels. • Substantial Gainful Activity (SGA) • Medically Determined Impairment (MDI) • MEETS or EQUALS • Past Relevant Work (PRW) • Other Work (OW)

7. SGA (Substantial Gainful Activity)“Is the claimant working?...Can he support himself with the amount of money that he is making?”

8. MDI (Medically Determinable Impairment)“Does the claimant have a Medically Determinable Impairment?”

9. MEETS or Equals Social Security Disability uses a book that lists various physical and Mental Health Impairments. This Book is called ‘The Blue Book’. If a claimant has any condition that is listed in this book, they automatically meet the criteria to receive SSI/SSDI benefits.

10. Past Relevant Work “Is the claimant capable of completing or returning to any of the jobs he had within the past fifteen years?”

11. Other Work “Can the claimant complete any work other than the work he has completed within the past fifteen years?” “Is the claimant 55years of age or older?” “What is the claimant’s past work?” “What is the claimant’s education level?” “Does the claimant have any transferrable skills?”

12. Appeals Process • Initial Level • Reconsideration Level • Hearing Level (Administrative Law Judge Level-ALJ) • Appeals Council Level • Federal Court Level

13. RECONSIDERATION LEVEL • If you have applied for disability and your claim was denied at the initial level you will have sixty days to file an appeal keeping your initial claim open. You are asking Social Security Disability to reexamine your claim.

14. ADMINISTRATIVE LAW JUDGE (ALJ) LEVEL • You have the opportunity to explain before a judge why you feel you are disabled and unable to work. • Some at this level seek representation from a third party agency or lawyer representation. • You have 60 days to appeal the decision.

15. APPEALSCouncil • If you are denied at the ALJ you may petition the Appeals Council to review your claim.

16. FEDERAL COURT • If your claim was denied at the Appeals Council level or if your claim was rejected you have the right under the law to file a law suit in a Federal court.

17. Questions?

18. Thank You! For more information visit our website at: www.ssa.gov