How do I know if I am eligible for Social Security Disability?

The rules can be found here:

In short, Social Security determines disability in a 5 step sequential evaluation.

Step 1, are you engaged in substantial gainful activity? If you are working close to 40 hours a week, or making over $1, 350.00 (2022) then you may not qualify. Ultimately you are proving to the Social Security Administration that you are unable to functionally work full time.

Step 2: Do you have a medically determinable psychological or physical impairment? If yes, it must be severe and objectively proven through medical records through testing and must last or be expected to last at least 12 months or result in death.

Step 3: Social Security has a listing of impairments that considers the medical severity of the conditions. One may meet or equal a “listing”. Please see the listings of impairments here :

Step 4: If you do not meet or equal a listing at step 3, SSA will determine your residual functional capacity (what you can still functionally do, despite your impairments). An assessment of your past work and its exertional and non-exertional demands will be evaluated, to determine if you can still do that type of work, SSA will find that you are not disabled if you are able to return to past work.

Step 5: Is an assessment of your residual functional capacity and your age, education, and work experience to see if you can make an adjustment to other work. If you can make an adjustment to other work, SSA will find that you are not disabled. If you cannot make an adjustment to other work, SSA will find that you are disabled.

What kind of benefits are available to me?

There are two types of disability from the Social Security Administration, Social Security Disability (SSDI) and Supplemental Security Income (SSI). SSDI is disability that you pay into, through full-time gainful employment. Once you stop working, your work credits begin to expire. If your work credits are in the near past, you may still be eligible to apply for this benefit. Call your local Social Security office to find out what your “Date Last Insured” is. In addition under SSDI, you may be able to receive benefits under another number holder, including: Widows benefits, Disabled adult child benefits and Parents benefits.

Supplemental Security Income (SSI) is available for people who do not have enough work credits, are indigent, or for a child who is disabled. SSI is an income based program. This means that if you have income below a certain amount, you may qualify for SSI financially. If you receive food stamps it will not count toward income. If you receive cash aid or GR, it will count, and if approved benefits, your back pay in SSI or SSDI will be used to pay back what GR gave you. SSI can be supplemented with SSDI, if your payments for SSDI are below a certain threshold. For both benefits, SSDI and SSI, you must prove disability through recent medical records as well as records from your alleged onset date (the date you became disabled) that are objective (testing and imaging).

What is the application process?

First thing to do, is go online to to apply for disability benefits. If you are an SSI only candidate, you will need to call your local office to schedule a telephone appointment for a new application, as they do not have an online application for SSI yet.

What is your fee?

There is NO FEE unless the case is approved. This is because all representatives and attorneys who are hired, get paid through retroactive back payments. Social Security has set all attorney and representative fees to be 25% of retroactive payments and is not to exceed $7,200.00. If there are multiple attorney/representatives on file, then the administration requires all representatives to write a detailed fee petition to submit to the Judge, or local SSA office for review and approval which could exceed that amount.

Are my children eligible for benefits under my disability income?

You can apply for additional child auxiliary benefits under SSDI. They must be under 18 years of age or under 22 and still attending high school. Auxiliary benefits awarded to a disabled parent's child are 50% of the parent's monthly SSDI benefits. The guidelines are listed here:

Does workers compensation and/or short term disability affect my social security benefits?

Yes. SSA will deduct Workman’s Compensation and EDD short term disability from any money due to you paid in the form of SSDI. The windfall elimination act prevents “double dipping”. Social Security will determine your average work earnings and your combined benefit which cannot exceed 80%.

Will I be entitled to Medicare?

You are entitled to Medicare at 65 years old, or are entitled to Social Security (SSDI) benefits after a 24 month period.

Can I still get benefits if I have never worked?

Yes, SSI benefits are available, if you are disabled and financially qualify.

What if I was denied by an Administrative Law Judge can I re-apply?

If you are denied by an ALJ, you have 65 days to file an appeal with the Appeals Council. Depending on the letter of denial and what the ALJ considered in the decision about your medically determinable impairments, you may file the appeals council appeal and prove why the decision should go back to the judge for a remanded hearing. If the ALJ made no error in their decision then you could file a new application if you do not fall under Chavez law. You can start a new claim if you received the denial notice at the age of 18-49 and are now 50. This is because the age category changed at age 50 and Social Security rules are much more different than that of a person who is considered a “younger individual”. Who said age is a bad thing?

What can I do if I am denied by Social Security Administration?

You have 60 days plus 5 days mailing time to get in an appeal by mail fax or computer. Make sure you complete the online appeal and write down your re-entry number, if you choose to save the appeal and work on it at a later time.

What if I passed the 60-days allocated to appeal my claim?

If you passed the 65 day period, there’s still hope. You are allowed to write good cause of missing the deadline, in a form Social Security called SSA-795 “statement of claimant”. However, not all reasons are accepted. For SSDI you are allowed up to 4 years with good cause and SSI is set at a 2 year limit with good cause. It’s best to hire a representative to deal with this part.