If you are disabled and unable to work, Social Security Disability Insurance (known as SSDI or SSD) may be available. Obtaining SSD benefits can be difficult, however, and many people who should qualify are initially denied. At The Terry Law Firm, we help disabled individuals with all legal matters related to SSD, from filing an initial claim to appealing a denied claim.
Don’t risk a denied claim. Get in touch with the experienced Pigeon Forge Social Security Disability attorneys at The Terry Law Firm, and let us help you pursue the full benefits you need to support yourself and your family. Call (423) 586-5800 or contact us online to discuss a Social Security Disability claim.
Understanding Social Security Disability in Pigeon Forge
Social Security Disability is a type of earned social insurance that provides partial income replacement benefits to disabled workers and their dependents. Workers earn SSD benefits by working and paying Social Security taxes on their earnings.
Approximately 10 million to 11 million Americans receive SSD benefits. The program pays out about $200 billion in benefits each year. Lifetime benefits average about $300,000.
A 20-year-old has a 1 in 4 chance of becoming disabled prior to reaching retirement age. The Social Security Act very strictly defines disability, and the reality is, more claims are denied than approved. But for those who rely on SSD, the modest benefits can make a huge difference.
Whether you qualify for SSD depends on two factors: your medical information and your work history.
Medical Information and Disability Definition
Applicants must meet the definition of disability under Social Security. A multi-step process is used to make this determination. It includes
- How much (if at all) you are currently working and earning
- The severity of your impairment
- Your ability to do the work you previously did
- Your ability to do any other type of suitable work
Special situations may apply to people who are blind or have low vision; for disabled widows or widowers; and for disabled children.
Work History and Social Security Credits
Provided that you meet Social Security’s definition of disability, you must also have worked long enough (duration of work test) and recently enough (recent work test) under Social Security to qualify for benefits.
When you apply for benefits, Social Security looks at whether you have the minimum amount of “credits” required. Credits are earned by working and paying Social Security taxes. Taxpayers earn a maximum of four credits per year. The amount of earnings required to earn a credit is subject to change each year. As of 2019, a worker must earn $1,360 in covered earnings to earn one Social Security credit and $5,440 to obtain the maximum of four annual credits.
The number of credits needed to qualify for disability benefits generally ranges between 6 and 40, depending on a worker’s age at the time he or she becomes disabled. Younger workers may qualify with fewer credits, while older workers generally require more credits.
In addition to passing the SSD duration of work test, a person must have worked for a certain number of years during the period immediately preceding the disability. For example, a worker who is disabled before turning 24 must have worked for 1.5 years in the previous 3 years (i.e., earned 6 credits in the last 3 years), while a worker who becomes disabled at age 31 or older must have worked for 5 out of the last 10 years (or earned 20 credits in the prior 10 years). Limited exceptions apply to people who are blind or were previously disabled before the age of 31.
SSD qualification criteria is complex. You may have questions or need help filing a claim. The knowledgeable Pigeon Forge disability lawyers at The Terry Law Firm are here to help. Get answers to frequently asked SSD questions.
The average monthly benefit paid to a disabled worker is approximately $1,250. Some workers receive less than this amount. The maximum benefit amount is roughly $2,800 per month.
Social Security bases your disability benefits on a complicated weighted formula that takes into account your average indexed monthly earnings (AIME). Using your AIME, Social Security calculates your primary insurance amount (PIA). If you have an online Social Security account, you can use benefit calculators to estimate benefit payments.
Receiving other government benefits, such as workers’ compensation, may reduce your SSDI benefits. If you receive private disability benefits from an insurance policy, this will not affect your SSDI benefits.
Approved claimants can expect benefit payment to begin for the sixth full month after the date the disability began. In other words, a disability beginning on June 15 would be paid for the month of December. Benefits are paid in the month following the month they are due. Thus, benefits due for the month of December are paid in January, benefits due for the month of January are paid in February, and so on.
Retroactive benefits (i.e. “backpay”) are available in most cases. The application date, the date of disability, and the mandatory five-month waiting period affect benefit backpay. Benefits may be available for up to 12 months prior to the application date, but not for any month prior to the disability period.
SSDI beneficiaries can continue to receive benefits until their medical condition improves and they are able to return to work. Beneficiaries whose condition is expected to improve may be subject to continuing eligibility reviews. If a review concludes that the beneficiary is able to return to work, this decision can be appealed.
For severe and permanent disabilities, payment can continue until retirement age, at which point Social Security retirement benefits replace Social Security disability benefits.
How Long Does It Take to Be Approved for SSD?
Unfortunately, there is no simple answer to how long it takes for a claim to be approved. The actual decision time depends on a number of factors, including the appeals process, the documents needed to process the claim, and the backlogs at a particular Social Security office.
It typically takes around 30 to 90 days for a decision on the initial disability claim. If the initial claim is denied, an appeal can be filed within two months.
From the time the appeal is submitted, the reconsideration period takes about 60 days. If a second denial is issued, the claimant can request a hearing.
Waiting for a hearing can extend the claims process to a year or more. Backlogs have forced some applicants to wait up to two years for a hearing in recent years, but different offices have different wait times.
Final approval rests on a doctor’s decision that the disability is severe enough to prevent an applicant from working. Although Social Security will request records for you from your treating physician(s), there’s no telling how long the doctor(s) will take to send in the records. You may be able to expedite the process by obtaining copies of the records yourself and submitting them with your application. Further review with a Social Security doctor may also be needed, which can prolong the process.
The average time from the hearing request date until a hearing is held ranges from 9 months to 23 months. You can see the waiting time at your local office here.
Social Security’s Compassionate Allowances program allows disability claims for severe medical conditions to be fast tracked. Individuals who have an approved condition can have their claim approved much more quickly.
Information You Need to File a Social Security Disability Claim
Applying for Social Security Disability involves extensive documentation. Be prepared to provide the following:
- Social Security number
- Birth certificate
- Proof of U.S. citizenship or legal residency
- Work history and education records
- Employment forms, including recent W-2s and tax returns
- Adult Disability Report
- Medical records, doctors’ statements, health care providers’ contact information, lab results, prescription information, dates of health care appointments, and other medical evidence related to your disabling condition
- Information on disability claims filed with workers’ compensation and/or similar benefit programs
- Military service records
- Information about your marriages, divorces, and children
- Your criminal history
- Direct deposit banking details
The SSDI application process places a lot of responsibility on the applicant to provide the right materials in a timely manner. For each type of supporting documentation, Social Security has strict rules on whether it must be an original or an official copy. Failure to include the right documents with your benefits application can cause your claim to be delayed or denied.
Our Social Security Disability lawyers understand that there is a lot riding on your SSD claim. We can help you gather all the paperwork and other appropriate information needed to file a complete claim. If your claim was denied, we can help you file an appeal or represent you in a hearing. Schedule a free consultation now to learn more.
SSDI Approval Rates by Adjudicative Level
About 45 percent of all SSDI claims are approved. The number of applicants awarded benefits at the initial claims level averages around one-third. The number of applicants awarded benefits at the reconsideration and hearing levels average around 3 percent and 13 percent, respectively. Denied disability claims average more than 50 percent.
Approval rates vary by state. Statistics show that Tennessee has initial and reconsideration approval rates near or below the national average, but the state’s hearing approval rate is higher than the national average.
Patience can be a virtue in the Social Security Disability claims process, since Appeals Council hearing approval rates are higher than reconsideration approval rates. If you take the rare step of appealing a case all the way to Federal District Court, the approval rate may be as high as 40 percent.
If you plan on appealing a council decision at the federal court level, a complaint must be filed with the court within 60 days of receiving the council’s denial letter. At this stage of review, no new evidence is considered. The federal judge will review the evidence that was previously provided to the Appeals Council and either change the council’s decision, uphold the council’s decision, or send the case back to the Social Security Administration for additional review.
How Our Pigeon Forge SSD Lawyers Can Help You
The experienced SSD attorneys at The Terry Law Firm handle all legal matters related to Social Security Disability, from the initial application stage through administrative hearings and federal court. We understand how important SSD benefits can be to you and your family. That is why we are committed to fighting every step of the way for the full benefits you need.
Since 1960, clients have chosen The Terry Law Firm for our award-winning lawyers, proven track record of success, and compassionate customer service. During a free initial case review, our legal team will take the time to discuss your concerns, answer your questions, and outline all of your options for moving forward.
For help with your Social Security Disability claim, please call us at (423) 586-5800 or send us a message online.