If you worked in a job or jobs covered by social security, you may be eligible to receive benefits based on the average of the amount you earned during that employment. The initial process of getting approved can take months or years, and it is very likely that your first attempt will end in rejection. About 70% of applications are denied, leaving the applicants to choose to give up or ask for a hearing before an Administrative Law Judge (ALJ).
Important Questions to Ask
Once you do receive an award, does it last for as long as you have a disability? Do you have to notify the Court if there are any changes in your condition? Are there any other requirements you have to fulfill in order to remain eligible for your benefits? It is vital that you understand the answers to all these questions so that once you get benefits they are not interrupted, possibly leaving you to start over again with the process. You also do not want to fall afoul of the rules and be accused of fraud if you are not sharing information as you are supposed to.
Who Qualifies for Social Security Disability Insurance?
Before you even apply to receive SSDI, you probably filled out an evaluation that would help you figure out if you were eligible to receive disability benefits. In that evaluation, there are questions such as:
- Are you still working?
- Do you currently receive benefits from Social Security Insurance?
- How long are you expecting to be out of work because of your disability?
- Is your disability severe?
- Is your disability part of a list of conditions that are automatically approved as disabilities? These include disabilities such as heart failure, Marfan Syndrome, Raynaud’s Disease, Colon Cancer, Hepatitis, Wilson’s Dease, and Sinus Cancer.
- Can you do the work you did previously? You might not qualify for disability if your injury does not interfere with your ability to do your job.
- Are there other kinds of work you can do instead? You might need to choose a different profession and possibly go through retraining.
As a general rule, SSDI benefits will need to be renewed every 6 months, every 3 years, or every 7 years depending on your specific disability and your chances of recovering and being able to return to the workforce safely again. Some disabilities are only temporary, but even lifetime disabilities will require you to renew your SSDI benefits on a regular basis. You are responsible for keeping in contact with the Social Security Administration, keeping your contact information updated, and letting the SSA know if there are any changes to your condition.
How Does the SSA Decide How Often to Review the Case?
If your condition is expected to improve, you can expect a review about every 6 to 18 months, at which time you should be prepared to make your argument as to whether or not you should still be eligible for benefits. If improvement is possible but not necessarily expected, you may expect a review about every 3 years.
Even if the Court does not expect your condition to improve, you should expect a review about every 7 years. You will need to present your evidence that your condition is ongoing, although the Court already has the information that helped decide your initial award, so the process will not be as detailed and strenuous. While the Court needs to keep an eye on all the open cases, it would be a waste of court time to bring every person back every year for a review, and the courts are already very busy.
What Happens During a Review?
You may not even need a hearing to be approved for continued benefits. If the Court decides that there is a need for a full medical review, you will receive a letter about 30 days ahead of time letting you know to come to the local office.
Bring all the documentation you have since the case started, including the contact information of all the doctors who have treated you and any medications you are taking. If you have been working, bring documentation showing how many hours you worked, how much you earned, and what kind of work you were doing.
Who Approves the Continuation of Benefits at the Review?
Instead of pleading your case in court to an ALJ like during the initial application process, you will have your case sent to the Disability Determination Services located in your home state. The disability examiner from the DDS will work with a medical consultant, as a team, to review your records and make the final determination.
They might ask for more information if you have not provided everything, such as all the places you were treated and what kind of procedures were done. If there is not enough information, you may be asked to come to a special examination where you can make your case.
Other Reasons Your Benefits Might be Stopped
There are other situations where your benefits might stop either because you chose to stop them or involuntarily, or because of reasons out of your control.
Your Condition Improves
If the condition that caused you to be eligible for a disability improves enough that you are no longer considered disabled, your SSDI will be terminated and you will be required to return to the workforce.
Returning to the Workforce
Sometimes people become used to their own condition and decide that they would rather return to their job, often for financial considerations. At other times, individuals may be offered opportunities where the disability that caused them to leave the workforce will not affect them in a new and different job. In those cases, you can choose to voluntarily terminate your SSDI benefits and return full-time to the workforce.
Benefits do not stop automatically if you choose to return to the workforce, as you may find it impossible to keep up even though you thought you could. There is generally a trial period of about 9 months where you can work and see if you are able to do full-time work safely again. If you make the choice to voluntarily terminate, you will not be eligible to reinstate your SSDI once your benefits are terminated. However, you should still be eligible for SSI when you turn 65. Just keep in mind that your initial return to work is on a trial basis and that you will not be punished if you decide within the 9 month period that you can no longer cope with the duties of full-time employment.
You may lose your SSDI benefits if you are incarcerated for a period of time. After 30 days of being in jail, your benefits will automatically be stopped. However, if you get out of jail while your benefits are still active, you can still receive them again. Your benefits will not end permanently because of incarceration but may end if you are still incarcerated when you are supposed to be renewing your benefits.
When you turn 65, your SSDI benefits will automatically stop, but they will be replaced with SSI benefits. In order to keep a continuous flow of benefits, make sure you are keeping your renewals up-to-date so that your Social Security Insurance will kick in as soon as your Social Security Disability Insurance expires.
What Can I Do If My Renewal Is Denied?
There are four levels of appeal, and you have 60 days to ask for a hearing from one to the next.
- You can ask for your case to be reconsidered, and your case will be reviewed independently by people who were not part of the initial decision. You may appear before a hearing disability officer to argue your case.
- You can ask for a hearing before an Administrative Law Judge.
- If you disagree with a decision made by an ALJ, you can ask the Appeals Council to consider your case.
- If you disagree with the decision of the Appeals Council, you can appeal your case through the Federal Court System.
Winning your initial SSDI award is just the first step in having continuous benefits once you have become disabled. The process is lengthy and the paperwork can be complicated, and overall the experience can be intimidating. Most people who try to get benefits on their own are rejected, especially in the beginning.
Contact us today for help with your SSDI situation.