Each year, hundreds of thousands of individuals apply for the financial protection afforded to them by Social Security Disability Insurance (SSDI) benefits. The process to apply for benefits is often long and complex, with most applicants receiving at least one denial before receiving an approval, if ever approved.
While applying for SSDI benefits, many applicants will also be navigating the application process for additional sources of income such as Workers’ Compensation payments, public disability benefits, Supplemental Security Income (SSI) benefits, or private short-term (STD) and long-term (LTD) disability benefits. While the application process and eligibility requirements for each benefit are not the same, many features do overlap. For examiners and adjudicators in charge of making decisions on whether to approve a claim for benefits, appreciating the complexity of the SSDI process is important to help support claimants as they navigate an already difficult time, and also to understand the impact on the benefits they are administering.
Filing the initial application
When applicants first file for SSDI benefits, they are responsible for providing the Social Security Administration (SSA) with a wide variety of information, including personal and marital information, medical providers, conditions, and treatments, recent work history details such as types of jobs, physical requirements, and rate of pay, and information about any sources of income received since becoming unable to work. The application is quite lengthy, and can require applicants to provide information that may not be readily available to them.
When filing their initial application, individuals will typically have the option to do so in one of three ways:
- Submitting an online application directly through the Social Security website.
- Speaking with and completing the application in-office or over the phone with a Social Security representative.
- Utilizing the services of an attorney or non-attorney representative to complete the application on their behalf.
For each method, applicants are required to attest to the application confirming it is being submitted with their knowledge and that the information provided is accurate.
Shortly after submitting their applications, individuals may receive questionnaires from SSA asking for additional information about the impact their conditions have on their daily life, or request more detailed information about their conditions or work history. It is imperative that any questionnaires received are completed with as much accuracy and detail as possible and submitted timely.
The importance of medical records
Medical records are the most vital pieces of evidence to support a SSDI application. Without substantiating medical evidence, SSA cannot make a favorable decision on an application. Despite the submission of proper authorizations, medical record requests may not be answered by the provider in a timely manner, or at all. If evidence is missing or incomplete, an examiner may find inconsistencies in the record or simply feel there is not enough information to make a determination on the claim. In some instances, an individual may be asked to assist in obtaining the records or even be scheduled for a Consultative Examination (CE) with an outside provider.
While receiving an approval is a relief to many individuals applying for benefits, there are still a couple of steps that will need to be completed after the award. Upon being approved, individuals must learn to navigate their “new normal” as an SSDI beneficiary and all that encompasses. This may include filing for supplemental benefits for any eligible dependents, including children, parents, or a spouse. In addition, most individuals will need to evaluate their health care coverage options, including extending COBRA coverage or choosing a Medicare health plan that will provide them with the best possible coverage.
Individuals filing for SSDI benefits who work directly with Brown & Brown Absence Services Group receive guidance and support from our experienced team of client advocates throughout every step of their SSDI journey. We have helped over 200,000 individuals apply for and receive SSDI benefits, and we welcome the chance to work alongside you in support of your claimants.
Nothing in this post is intended as advice or a suggestion to elect or not elect to claim benefits of any kind, including Social Security benefits, nor is it intended as financial advice in any way. The decision to claim benefits is a personal one that is contingent upon each individual’s unique circumstances. Nothing herein is considered medical advice, diagnosis or treatment.