
Step 1 of SSDI Process – Initial Application
To qualify for SSDI, a person must meet the Social Security Administration’s strict criteria for disability. This includes proving that their condition is severe enough to prevent any substantial gainful activity. The SSDI application process can be complex, and many initial applications are denied.
That’s why, if you are thinking about applying for Social Security disability benefits, it is important to understand the process. The Social Security Administration has divided this process into 5 basic steps or stages. This article will review the first stage: the initial application.
For Ohio residents, seeking assistance from experienced attorney Mark L. Newman can be extremely helpful in navigating the SSDI application process and ensuring all requirements are met to improve the chances of approval. To learn more about Stage 1 of the SSDI application process or to speak directly with a Cincinnati SSDI attorney, call Attorney Newman at (513) 533-2009 today.
What is Social Security Disability Insurance?
Social Security Disability Insurance (SSDI) is a federal program designed to provide financial assistance to individuals who are unable to work due to a significant disability. Funded through payroll taxes, SSDI benefits are available to people who have accumulated enough work credits by paying into the Social Security system through their previous employment.
Unlike needs-based programs, SSDI is an insurance program, meaning eligibility is based on an individual’s work history and contributions rather than financial need alone.
SSDI vs SSI
Before covering the basics of Stage 1 of applying for SSDI, it’s important to explain the difference between SSDI and SSI. Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are two distinct disability programs that provide financial support to individuals with disabilities, but they operate under different eligibility criteria and funding sources. SSDI benefits are based on lifetime average earnings covered by Social Security, meaning only individuals who have worked and contributed to the Social Security system through payroll taxes are eligible. The monthly benefit amount for SSDI is determined by the recipient’s work history and earnings.
On the other hand, SSI benefits are needs-based and do not require a work history; instead, SSI provides support to individuals with limited resources and income, including the elderly, blind, or disabled who may not qualify for SSDI. Unlike Social Security Disability Insurance, which is funded by Social Security taxes, Supplemental Security Income is funded through general tax revenues.
While both programs provide monthly benefits, they serve different groups, with SSDI focusing on insured workers with disabilities and SSI offering financial aid for those with minimal income and assets.
Am I Eligible for Social Security Disability Benefits?
To be eligible for disability benefits, you must meet specific criteria under the Social Security program rules, which focus on work history, medical condition, and ability to work. For starters, SSDI requires that you have worked in jobs covered by Social Security and paid Social Security taxes over a certain period, earning enough work credits to qualify.
Additionally, SSDI uses a strict definition of disability: your medical condition must be severe, expected to last at least a year, or be terminal. Unlike short-term disability or partial disability benefits, SSDI only provides coverage for total disability, meaning the condition must prevent you from any substantial gainful activity. Common medical conditions covered by SSD include:
- Musculoskeletal disorders (e.g., severe back injuries, degenerative disc disease, arthritis)
- Cardiovascular conditions (e.g., chronic heart failure, coronary artery disease, arrhythmias)
- Respiratory disorders (e.g., chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis)
- Neurological disorders (e.g., epilepsy, multiple sclerosis, Parkinson’s disease, traumatic brain injuries)
- Mental health conditions (e.g., depression, PTSD, bipolar disorder, schizophrenia)
- Cancer
- Immune system disorders (e.g., lupus, rheumatoid arthritis)
- Digestive system disorders (e.g., IBD, Crohn’s disease, liver disease)
- Endocrine disorders (e.g., uncontrolled diabetes, thyroid disorders)
- Sensory disorders (e.g., low vision or legally blind, loss of hearing)
The SSA evaluates your ability to work based on medical criteria and may require documentation to confirm that your condition meets these standards. If you meet these disability requirements, you may be eligible to start receiving SSDI benefits.
Understanding SSDI Benefits
SSDI benefits provide benefits to individuals who cannot work due to severe, long-term medical conditions. These monthly benefits are calculated based on the individual’s work history and prior earnings, offering financial support proportional to the recipient’s contributions to Social Security during their career.
In addition to Social Security benefits, recipients may also be eligible for other disability benefits, depending on their unique circumstances. For example, some SSDI recipients may qualify for Medicare coverage after a waiting period or, in certain cases, family members may be eligible for additional Social Security benefits based on the disabled individual’s earnings record.
How To Start Disability Process
There are a few different ways you can apply for SSDI. Many applicants choose to apply online through the SSA website, where the online application is available 24/7. You can find that here.
Alternatively, you can apply in person by visiting your local Social Security office, where a Social Security representative can assist with the application and answer questions specific to your case.
If visiting an office isn’t an option, you can also apply by calling the SSA toll-free at 1-800-772-1213 and speaking directly with a representative.
Stage 1: Initial Application
Stage 1 of the SSDI application process forms the foundation for your claim and influences all future decisions, including appeals if necessary. At this stage, you must provide detailed and accurate information about your medical condition, work history, and how your disability limits your ability to work. This includes submitting comprehensive documentation, and any errors or incomplete details here can lead to delays or even denial, so it’s essential to be thorough and ensure every aspect of your claim is clear.
Social Security Disability Application Form
The Social Security Disability application form is a detailed document that collects information needed to evaluate your eligibility for SSDI benefits. The form requests personal identification details, work history, and a complete list of your medical conditions. It also asks for contact information for doctors, hospitals, and clinics involved in your treatment, along with records of medical tests and treatments related to your disability.
What Documents Do I Need to Apply for Social Security Disability?
There is a large amount of detailed information that you will be required to provide when filing for SSDI, including but not limited to:
- Proof of Identity and Age
- Birth certificate or other proof of birth
- Social Security number card
- Government-issued ID or driver’s license
- Work History
- Detailed employment history with names of employers, dates worked, salary, and job duties
- Recent W-2 forms or self-employment income tax returns if you’re self-employed
- Medical Documentation
- Detailed medical records from the date the disability started, including all related hospital and clinic records
- Contact information for doctors, hospitals, and clinics that have treated you
- Laboratory and test results, including imaging and other diagnostic tests
- Medications
- List of current medications, dosages, and the prescribing doctors
- Income and Financial Records
- Pay stubs
- Information about workers’ compensation or any other disability benefits
- Any settlement agreements if applicable
- Family Information
- Proof of marriage or divorce, if applicable
- Social Security numbers and birth certificates for any dependent children or spouses (if applying for family benefits)
- Military Service Records (if applicable)
- Military discharge papers (Form DD-214) for veterans
These documents, as well as the SSA-specific forms listed below, help provide a complete picture of your disability, work history, and financial eligibility, helping to ensure a thorough evaluation of your SSDI claim.
SSA-16-BK
Form SSA-16-BK is known as the “Application for Disability Insurance Benefits.” This form helps the SSA determine whether you meet the qualifications for disability benefits by collecting information about your personal details, work history, medical conditions, and how these impact your ability to work.
SSA-3368-BK
Form SSA-3368-BK, titled “Disability Report – Adult,” requires more detailed information regarding your medical condition. This form goes beyond basic personal and work details, asking for specifics on how your disability affects daily activities and limits your ability to work. It includes sections to list all medical providers, treatments, medications, and diagnostic tests related to your condition.
SSA-827-BK
Form SSA-827-BK, known as the “Authorization to Disclose Information to the Social Security Administration,” is another very important form in the SSDI application process. By signing this form, you give permission to the SSA to request and obtain your medical records, treatment history, and other pertinent health information from your healthcare providers.
SSA-1696
Form SSA-1696 refers to the “Appointment of Representative,” and is used when an individual chooses to appoint someone, such as an attorney or other qualified person, to represent them in their claim. By completing this form, the applicant authorizes the representative to act on their behalf, communicate with the Social Security Administration, and access information related to their claim.
SSA-3369-BK
Form SSA-3369-BK is the “Work History Report.” With this form, the SSA asks for specific information about the types of jobs you held, the tasks you performed, and the physical and mental demands of each role.
SSA-3373-BK
Form SSA-3373-BK, called the “Function Report – Adult,” is another form that asks detailed questions about your ability to perform routine tasks, such as cooking, cleaning, personal care, and social interactions, as well as any limitations in physical or mental activities. This helps the SSA better understand how your disability impacts your everyday life.
How Long Does it Take to Process SSDI Applications?
The processing time for SSDI applications usually takes between three to five months, but there is also a five-month waiting period after approval before benefits begin. This initial timeframe can vary based on factors like the complexity of the applicant’s medical condition, the thoroughness of the medical records provided, and the workload at the local Social Security office.
The key here is to be patient. If contacted to supply additional information, do not delay in responding to the request. Being slow to respond may delay any decision, and if you do not answer their requests for information, you may end up with a denied disability claim.
What are the Chances of Getting Approved for Disability the First Time?
If you get a notice from the Social Security Administration stating that your application has been “disapproved”, don’t feel rejected. In fact, 65% of all initial applicants are denied, and all for many different reasons. The denial letter you receive will contain information about your rights to appeal the initial decision, which will take us to Stage 2: First Appeal or Reconsideration.
How To Get Approved for Disability the First Time
To improve your chances of being approved for disability the first time, the most important thing you can do is submit a thorough and well-documented application. Begin by gathering detailed medical records, including doctor’s reports, test results, and statements that clearly demonstrate how your condition prevents you from working. Complete all required forms accurately and provide specific information about your symptoms, daily limitations, and work history.
Consulting other resources, such as an experienced disability attorney like Mark Newman, can help ensure that your application meets the Social Security Administration’s standards and increases the likelihood of getting approved to receive benefits.
Need Help With Disability Application? Call Cincinnati SSD Attorney Mark L. Newman Today
If you have questions about SSD or need guidance on the application process, don’t hesitate to reach out to Cincinnati workers’ compensation attorney Mark L. Newman. With decades of experience in both Social Security Disability and workers’ compensation cases, he can provide support tailored to your unique situation and help ensure you’re on the right track to receiving benefits.
Contact Mark L. Newman today by calling (513) 496-1417 or complete a simple online intake form to discuss your SSD claim and explore how he can help you achieve a positive outcome.