Social Security Disability Insurance, or SSDI

Social Security Disability Insurance, or SSDI, is a program designed to help people with significant, life-altering disabilities meet the expenses of everyday life if they cannot engage in meaningful employment. It is an entitlement program that is funded through payroll taxes.

What is Social Security Disability Insurance?

Although restrictions on a person’s ability to work may seem obvious to a person that is applying for assistance, and to the people that care about that person, getting approved for benefits can be a long process. Because a large number of initial applications are initially denied, it’s imperative that a person with disabilities have all of the necessary paperwork in order, and have all of the information required, when they submit their application.

Once an application is approved, SSDI can provide the security a person with disabilities needs to be able to live his or her life free of financial strife.

Social Security Disability Insurance – which is often referred to as disability payments – is an entitlement program that is funded through payroll taxes. The federal program is designed to provide income for individuals that are restricted in their ability to work because of a physical or developmental disability.

It’s a program that can be either temporary or permanent; depending on an enrollee’s needs. Although Cerebral Palsy is a permanent condition, it doesn’t always mean that SSDI payments will be needed long term. Many people with Cerebral Palsy enjoy gainful employment and do not need the assistance.

SSDI benefits are funded by payroll taxes paid by workers, because of this; a person’s ability to qualify for assistance is tied to a record of work. If a young person’s disabilities negate their ability to work, he or she may qualify to receive payments based on a parent’s record of paying these payroll taxes. Payout amounts are based on a person’s prior contributions; the contributions are based on a person’s income.

Another program that is designed to help people with disabilities that cannot work due to their condition is Supplemental Security Income, or SSI. This program is disconnected from an individual’s work history. SSI may be a more viable option for people with disabilities that have not worked, and have parents that have not contributed payroll taxes into the Social Security Trust fund in a significant way.

SSDI funds can be used to meet several expenditures, including:

• House payments or rent
• Utility payments
• Living expenses
• General expenses
• Leisure

Often, if a person qualifies for SSDI, he or she may qualify for the Supplemental Nutrition Assistance Program as well. Also, SSDI recipients will be enrolled in Medicare two years from the date they are deemed disabled.

Who administers the SSDI program?

The SSDI program is administered by the Social Security Administration, which will ultimately determine whether a person has met the qualifications to receive SSDI assistance, or whether he or she would be better off applying for SSI.

The administration will determine:

• Whether a person should apply for SSDI or SSI
• If a person’s disability affects his or her ability to work; i.e., his or her functional capacity
• How long assistance should last
• What amount an enrollee will receive monthly

How does a person qualify for SSDI assistance?

In general, a person with a moderate to severe case of Cerebral Palsy will qualify for SSDI benefits as opposed to SSI benefits because there is a provision in the law that allows individuals that are disabled before they are 22 years old to collect SSDI benefits from their parent’s work record. This is generally good news because if a parent has paid into Social Security for several years, the amount paid out will reflect that.

The general requirements an applicant will need to meet to collect SSDI benefits include:

• Be able to demonstrate that he or she has a physical or mental condition that prevents them from engaging in Substantial Gainful Activity
• Be able to show there is no work for which an applicant can be trained
• Applicant, or applicant’s parent must have worked at a job during the last 10 years in which Social Security taxes were paid
• Qualifying medical condition will last at least one year
• Be able to present medical evidence that the condition exists
• Have a measure IQ that is at, or less than, 70

SSDI benefits are not affected by the fact that an applicant has a child; in fact, the child may also be eligible for benefits.

What is the application process to receive SSDI benefits?

Applying for SSDI benefits takes place at an applicant’s local Social Security Administration office, or, he or she may request that forms by sent to their home by calling a hotline 800-772-1213. Also, an applicant may apply online for benefits. Applying online before an in-person interview with the local Social Security Administration office will help sped up the application process.

Much has been written about the fact that many first-time applicants for SSDI are denied. But there are some bases that an applicant should be able to demonstrate to Social Security Administration officials to improve his or her chances of being approved.

First, an applicant needs to be able to discuss, and be willing to provide evidence of, their disability. The verifiable information a representative has that supports an application, the greater the likelihood is that the application will be approved.

Some of the documentation that will be needed includes:

• Birth certificate
• Driver’s license
• Utility bill, or something with the applicant’s address printed on it
• Past medical bills
• Names and contact information for former employers
• Names and contact information for physicians and therapists

Generally, an applicant will receive a letter stating whether he or she is approved, or denied, for benefits within 90 to 120 days from the filing date. If approved, payments will be made retroactively to the applicant’s filing date.

What happens if an SSDI application is denied?

If an application is denied, the letter an applicant receives will outline why the application was denied, and if an applicant does not agree with the determination, he or she can file for an appeal of the decision.

The appeals process can take up to a year to cycle through; an applicant will need to prepare his or herself for a long process. Often, he or she will also have to provide more information – typically from treating physicians – that support his or her application. Often, the reason an application was denied is because of insufficient evidence, or the fact that the applicant did not make his or her case in an appealing way.

The first step is to fill out a request for redetermination form. This will give a Social Security Administration representative a chance to look at evidence initially presented, and new evidence, to see if an applicant fits into established SSDI guidelines. An applicant must file for reconsideration within 60 days of receiving a denial letter.

If the redetermination is denied, an applicant has the right to appear in front of an administrative law judge. At this fair hearing, the applicant and Social Security Administration representatives will present evidence, and answer questions about why the application was denied. An applicant has a right to have witnesses speak on his or her behalf. After the judge takes in all of the evidence, he or she will render a decision about the application.

If the judge denies the application, the applicant can request that the decision be reviewed by an appeals council. The council will review the entire process to determine that the facts of an applicant’s case were properly considered. The council may uphold the judge’s decision, or send it back to the judge.

If the council upholds a denial, an applicant can then request a review by his or her federal court. This is considered a rare step; most cases that meet SSDI requirements are accepted at the hearing level, where a judge can ask questions and follow up on evidence.

Should an applicant seek legal representation?

An applicant for SSDI is not required to retain legal representation during the process of getting an application approved. But in cases where there has been a denial, it’s often a good idea.

Attorneys that specialize in SSDI law know what evidence will be sought by Social Security Administration representatives; they understand how evidence should be presented to create the greatest likelihood of approval early in the process.

Hiring an attorney to assist an applicant also carries little risk; the fees that attorneys can charge to assist and applicant is currently capped at 25 percent of a person’s retroactive award amount. Hiring an attorney sooner in the process can minimize what an applicant would need to pay for representation.