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If you have been injured or are too sick to work for a lengthy period of time, you might want to consider filing a Social Security Disability Insurance (SSDI) claim. While most people think of social security only when it comes to retirement, the Social Security Administration (SSA) is also responsible for administering payments to those who qualify for disability benefits.

Like many government bureaucracies and programs, navigating the SSA and SSDI process can be time-consuming and difficult. On top of that, it is not uncommon for many claims to be denied at first.

If you are too injured or sick to work, you may also be too injured or ill to see your claim for SSDI benefits through to success.

For this reason, it might be beneficial to hire an SSDI lawyer, such as an attorney from Kirkendall Dwyer LLP, who specializes in filing airtight SSDI claims. If your claim has already been denied, a lawyer may even be able to successfully appeal your case and get you the SSDI benefits you are counting on.

How the SSA Defines Disability

For the purposes of social security disability insurance, the SSA’s definition of a disability includes the following: “the inability to engage in any substantially gainful employment or SGA (as of 2020 SGA was considered employment that paid no more than $1260/month) due to any medically determinable physical or mental impairments which are likely to result in either death or have lasted or will last continuously for 12 months.”

Filing a successful SSDI claim hinges on your ability to prove that you are disabled according to the above definition. In addition to ensuring that your claim is accurate, a competent SSDI lawyer will be able to advise you on your claim and help you put forth your evidence of disability in a compelling manner.

This might include obtaining and organizing the medical records pertaining to your disability. It could also include conducting interviews with your physicians and other medical professionals who can testify to the severity of your injuries.

SSDI Eligibility

Being disabled is not the only factor the SSA will consider when determining whether or not you are eligible for SSDI. Other factors taken into consideration include:

  • Age (in order to qualify for SSDI benefits, an applicant must be under the age of retirement)
  • Ability to do other work based on the applicant’s age, education, and work experience
  • Whether or not the claimant is a widow or widower (a widow or widower between the ages of 50-60 may qualify for SSDI benefits if their deceased spouse was insured under Social Security)

Children who were injured before the age of 22 and are a dependent of a parent eligible for SSDI benefits or a deceased parent eligible to receive SSDI benefits may also qualify.

SSDI Determination Process

Individuals can apply for SSDI benefits in a number of ways, including online or in person at an SSA field office. The field office will then conduct what is called the “sequential evaluation process.” This five-step process reviews:

  • Current work activity of the person applying for SSDI benefits
  • How severe their injuries or ailments are
  • Whether or not the claimant’s injuries meet certain requirements
  • Whether or not the claimant can perform the same work they did before they were injured or became sick
  • Whether or not they are able to do other work based on their age, education level, and previous work experience

Throughout this process, the opinions of medical professionals are given great weight. Typically, the claimant will supply the SSA with their own medical records indicating their inability to continue working.

The SSA, however, may in some instances wish to include the medical opinion of “consultative examiners” (medical professionals such as physicians or psychiatrists).

If you are deemed eligible to receive SSDI benefits, you will receive payments based on how much you were previously making. Typically, this ranges from the low hundreds up to a little more than $2000 a month.

Finally, it should be noted that benefits will typically not be paid out until six months after disability is determined. To see if you qualify for one of the narrow exceptions to this rule, you may want to consult an SSDI lawyer.

Reasons for a Denied SSDI Claim

Unfortunately, there are many reasons the SSA might deny an initial claim. Some of the reasons for denial include:

  • The person applying for SSDI is currently working and making more than the SGA limit
  • The claimant’s injuries or ailments do not meet the requirements as set forth by the SSA
  • The claimant’s injuries or ailments are not likely to last for twelve continuous months
  • It is determined that the claimant’s injuries or ailments are the result of alcohol or drug abuse
  • The claimant is determined to be able to seek substantive gainful employment based on their age, education, and/or work experience
  • The claimant failed to follow therapy recommendations and requirements
  • The claimant committed fraud

It is essential that you answer all questions truthfully and never submit false records or statements about your health when applying for SSDI. A skilled SSDI lawyer from Kirkendall Dwyer LLP can help you prepare your application and ensure everything is done properly and ethically.

Appealing a Denied SSDI Claim

As noted above, there are many possible reasons for an SSDI claim to be initially denied. The good news is that with effective legal counsel, you may still have a chance to get your claim awarded via the SSA appeals process.

The appeals process is comprised of four stages:

  • Reconsideration. At this stage in the appeals process, your lawyer will request an appeal on your behalf. That request will then be examined by an SSA examiner who was not a party to the initial denial. The examiner will consider your case and any new evidence you and your lawyer submit.
  • A hearing at the Office of Hearing Operations (OHO). If your claim is denied, you can request a hearing before an administrative law judge. Your SSDI lawyer will make your case before the judge by submitting relevant evidence and conducting interviews with medical professionals testifying to your inability to work.
  • Social Security Appeals Council. If the administrative law judge also denies your claim, you can appeal to the Social Security Appeals Council. It should be noted that upon initial review, the Social Security Appeals Council may refuse to hear your case if they believe the administrative law judge made the correct determination.

If your claim is still denied, the last course of action you and your SSDI lawyer can pursue is to file a lawsuit against the SSA in federal court seeking the benefits you believe you are due. Unlike the previous three steps which are all handled within the SSA, this final stage is handled in court just like any other lawsuit.

Hiring an SSDI Lawyer

The SSDI claims process may seem complicated and confusing to those on the outside. This is why it can be beneficial to work with an experienced SSDI lawyer who can help prepare a claim and/or fight a wrongly denied claim.

A good SSDI lawyer will know all the details about the SSDI claims process such as filing deadlines and evidentiary thresholds and requirements. Finally, if your claim is denied, an SSDI lawyer will walk you through the appeals process, helping you get the benefits you need.

Contact the SSDI lawyers at Kirkendall Dwyer LLP today for a free legal consultation to see how we might be of help to you. You will only pay for our services if and when we recover compensation for you.