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Application Process for Social Security
There are two ways that you can apply for disability benefits. You can:
1. Apply at www.socialsecurity.gov ; or
2. Call the toll-free number, 1-800-772-1213, to make an appointment to file a disability claim at your local Social Security office or to set up an appointment for someone to take your claim over the telephone. The disability claims interview lasts about one hour. If you are deaf or hard of hearing, you may call the toll-free TTY number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days. If you schedule an appointment, they will send you a Disability Starter Kit to help you get ready for your disability claims interview. The Disability Starter Kit also is available online at www.socialsecurity.gov/disability.
Parents or guardians usually can apply for blind or disabled children under age 18. In some cases, other third parties can apply for children.
You should bring certain items when you apply. Even if you do not have all of the things listed below, apply anyway. The people in the Social Security office can help you get whatever is needed. Please bring:
•Your Social Security card or a record of your Social Security number;
•Your birth certificate or other proof of your age;
•Information about the home where you live, such as your mortgage or your lease and landlord's name;
•Payroll slips, bank books, insurance policies, burial fund records and other information about your income and the things you own;
•The names, addresses and telephone numbers of doctors, hospitals and clinics that you have been to, if you are applying for SSI because you are disabled or blind;
•Proof of U.S. citizenship or eligible noncitizen status.
You also should bring your checkbook or other papers that show your bank, credit union or savings and loan account number so we can have your benefits deposited directly into your account. Direct deposit protects benefits from loss, theft and mail delay. The money is always on time and ready to use without making a trip to the bank.
If you are blind or disabled
If you work, there are special rules to help you. You may be able to keep getting SSI payments while you work. As you earn more money, your SSI payments may be reduced or stopped, but you may be able to keep your Medicaid coverage. You also may be able to set aside some money for a work goal or to go to school. In this case, the money you set aside will not reduce the amount of your SSI. Blind or disabled people who apply for SSI may get free special services to help them work. These services may include counseling, job training and help in finding work.
You can get more information in Working While Disabled—How We Can Help (Publication No. 05-10095).
Deciding whether you are Disabled
To decide whether you are disabled, they use a step-by-step process involving five questions. They are:
1. Are you working?
If you are working in 2011 and your earnings average more than $1,000 a month, you generally cannot be considered disabled. If you are not working, they go to Step 2.
2. Is your condition "severe"?
Your condition must interfere with basic work-related activities for your claim to be considered. If it does not, they will find that you are not disabled. If your condition does interfere with basic work-related activities, they go to Step 3.
3. Is your condition found in the list of disabling conditions?
For each of the major body systems, they maintain a list of medical conditions that are so severe they automatically mean that you are disabled. If your condition is not on the list, they have to decide if it is of equal severity to a medical condition that is on the list. If it is, they will find that you are disabled. If it is not, they then go to Step 4.
Note: They have two initiatives designed to expedite our processing of new disability claims:
Compassionate Allowances: Certain cases that usually qualify for disability can be allowed as soon as the diagnosis is confirmed. Examples include acute leukemia, Lou Gehrig's disease (ALS) and pancreatic cancer.
Quick Disability Determinations: They use sophisticated computer screening to identify cases with a high probability of allowance.
For more information about changes to their disability claims process, visit our Disability Service Improvement website.
4.Can you do the work you did previously?
If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then they must determine if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied. If it does, they proceed to Step 5.
5.Can you do any other type of work?
If you cannot do the work you did in the past, they see if you are able to adjust to other work. They consider your medical conditions and your age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied.
The Disability Determination Process
Most Social Security disability claims are initially processed through a network of local Social Security Administration (SSA) field offices and State agencies (usually called Disability Determination Services or DDSs). Subsequent appeals of unfavorable determinations may be decided in a DDS or by an administrative law judge in SSA's Office of Disability Adjudication and Review.
Social Security representatives in the field offices usually obtain applications for disability benefits in person, by telephone, by mail, or by filing online. The application and related forms ask for a description of the claimant's impairment (s), treatment sources, and other information that relates to the alleged disability. (The "claimant" is the person who is requesting disability benefits.)
The field office is responsible for verifying non-medical eligibility requirements, which may include age, employment, marital status, citizenship/residency and Social Security coverage information, and additionally, for SSI eligibility, income, resources, and living arrangement information.or Social Security coverage information. The field office then sends the case to a DDS for evaluation of disability.
The DDSs, which are fully funded by the Federal Government, are State agencies responsible for developing medical evidence and rendering the initial determination on whether or not a claimant is disabled or blind under the law.
Usually, the DDS tries to obtain evidence from the claimant's own medical sources first. If that evidence is unavailable or insufficient to make a determination, the DDS will arrange for a consultative examination (CE) to obtain the additional information needed. The claimant's treating source is the preferred source for the CE, but the DDS may obtain the CE from an independent source. After completing its development of the evidence, trained staff at the DDS makes the initial disability determination. The determination is made by a two-person adjudicative team consisting of a medical or psychological consultant and a disability examiner. If the adjudicative team finds that additional evidence is still needed, the consultant or examiner may recontact a medical source(s) and ask for supplemental information.
The DDS also makes a determination whether the claimant is a candidate for vocational rehabilitation (VR). If so, the DDS makes a referral to the State VR agency.
Then, the DDS returns the case to the field office for appropriate action. If the DDS found that the claimant is disabled, SSA completes any outstanding non-disability development, computes the benefit amount, and begins paying benefits. If the claimant was found not to be disabled, the file is kept in the field office in case the claimant decides to appeal the determination.
If the claimant files an appeal of an initial unfavorable determination, the appeal is usually handled much the same as the initial claim, except that the disability determination is made by a different adjudicative team in the DDS than the one that handled the original case.
New Graduate School for Global Inclusion and Social Development of Persons with Disabilities - UMass