How to Determine Social Security Disability Benefits

A person who suffers from a disabling injury or chronic, debilitating illness prior to retirement age may qualify to receive Social Security disability benefits. According to the Social Security Administration, statistics show that workers currently in their early 20's have a three-in-10 chance of becoming disabled before being old enough to retire. However, an individual must have worked long enough and paid in social security taxes to apply for Social Security Disability Insurance benefits. A person must also meet specific medical criteria in order to qualify. In most cases, the application process can be long and involve several appeals before benefits are finally awarded.

Instructions

Application Process

• 1

  Assist the claimant in completing an application to file a claim for Social Security disability. Answer any of his questions, and manage the paperwork to be forwarded to the state agency responsible for determining disability. Usually a person seeking disability benefits begins the process by talking to a representative at a local Social Security Administration field office.

• 2

  Take the applicant's information in person or by telephone, mail or from an application submitted online. The first step in the process involves verifying the applicant's non-medical eligibility requirements.

• 3

  Ask the applicant for details about household income and employment history. An individual must be employed for at least five of the last ten years to be considered. Evaluate both present and previous work experience and education. Even if a person can no longer continue to work at his current job, his condition might not prevent him from being able to perform another type of work. An applicant may be considered a candidate for vocational rehabilitation.

• 4

  Forward the claimant's application to the state agency responsible for making an initial determination. The agency is often known as the Bureau of Disability Determination. Processing of a person's claim may take only several weeks, or as long as six months or more depending on the complexity of the individual's case.

• 5

  Evaluate the claimant's medical records. The job of a claims examiner is to look for evidence that the applicant is receiving ongoing medical treatment. A past medical history of a disability is not enough to substantiate a claim. Types of medical evidence taken in account include detailed statements from physicians, medical treatments, medication compliance, lab results, X-ray and other imaging reports, and doctor's notes. If the medical information provided is not sufficient to render a decision, the evaluating agency may require that the claimant undergo a consultative examination or may contact the claimant's physicians to request additional information.

Appeal Process

• 6

  Notify the applicant once the evaluating agency determines whether to award him benefits based on his medical condition. Advise claimants who are denied benefits of their right to file an appeal within 60 days. Provide the claimant with the paperwork he must complete if he decides to ask for reconsideration of his claim.

• 7

  Inform the claimant that he may request a hearing before an administrative law judge. This is the protocol if a claimant's application is denied for the second time following review of a reconsideration appeal. While the request for a hearing before an administrative law judge is submitted to the Social Security Office, the appeal forms along with the claimant's file must be forwarded to the nearest Office of Hearings and Appeals. Advise the claimant of his right to be represented by legal council at the hearing

• 8

  Mail a notice to the claimant once the administrative law judge has determined the outcome of the case. The claimant will receive a letter that either states he has been approved for benefits, or explains why his claim was denied. At this time, the claimant will also be advised of his right to take the appeal to the Appeals Council, or file a new claim with the local Social Security Administration office and start the process again.