One of the most common questions asked by people with disabilities is, “How can a Chicago disability lawyer help you get benefits?” When filing a claim for Illinois disability benefits, an SSDI attorney can help ensure your claim is successful by making sure your claim complies with filing requirements, includes evidence of your disabling medical condition, and is supported by your medical records, documented income, and expert statements. Your lawyer can also present your case to the Administrative Law Judge if it is denied.
How Do You Apply for Disability Benefits?
In Illinois, a person who has a disabling condition because of an injury or illness can file a claim for disability benefits through two federal agencies, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). These Social Security and Supplemental Security Income disability programs are the largest of several federal programs that provide assistance to people with disabilities. The main difference between the two programs is who is eligible for benefits. Social Security Disability Insurance (SSDI) is available to workers who have accumulated a sufficient number of work credits, while Supplemental Security Income (SSI) disability benefits are available to low-income individuals who have previously worked or never worked.
Most Illinois SSDI and SSI applications can be filed online or through a local field office by filling out an application that asks a number of questions about the applicant’s income and disability. However, federal disability guidelines are strict, so it’s best to work with a Chicago disability lawyer who can review the application, gather pertinent information, and oversee the claim as it proceeds through the approval process. According to government records, many SSDI and SSI claims are denied because they lack the evidence required to support the claim. When this occurs, an applicant may file an appeal and request that the decision is reconsidered. Although most claims are also denied at the reconsideration phase, this is an important step that must be completed to move forward with the claim.
If your claim is denied during this phase, your Chicago disability lawyer will request a hearing with the Administrative Law Judge. Preparing for the hearing often includes gathering additional evidence, and questioning occupational witnesses, medical professionals, and the applicant. During the hearing process, the Judge will ask the applicant numerous questions to determine the following.
- The extent of the applicant’s impairment or disability
- The applicant’s work history
- The applicant’s medical records
- The success or failure of the applicant’s medical treatments
- The reasons for any inconsistencies in the medical records
The first step in applying for disability benefits starts with an application. It’s essential to support that application with credible, accurate facts that can be verified. Errors or mistakes can result in a denied claim and additional challenges in obtaining SSDI or SSI benefits through the Social Security Administration.
What Qualifies You for Disability Benefits?
In Illinois, the Bureau of Disability Determination Services (DDS) is the state department that makes the initial determinations about eligibility for disability. When an application is submitted, DDS reviews the application and gathers the applicant’s medical information. Following the review of the claim, DDS may schedule a consultative examination (CE) for the applicant. A CE is a medical examination that’s conducted by a licensed physician hired by the Social Security Administration.
Social Security Disability Insurance (SSDI)
SSDI pays disability benefits to workers and workers’ families when the worker has accumulated a sufficient number of work credits. The worker must also have worked long enough to pay Social Security taxes. This program is financed with Social Security taxes paid by workers, employers, and self-employed persons.
To be eligible for SSDI benefits, a worker must earn sufficient credits based on a taxable work history to be “insured” for Social Security purposes. If benefits are approved, they are payable to (1) workers who have a disabling condition or are blind and under 65 years old (2) their spouse or widower, (3) their children, and (4) adults disabled since childhood. The amount of monthly disability benefits is based on the Social Security earnings record of the insured worker. After receiving disability insurance benefits for two years, the worker will automatically get Medicare coverage.
When filing for SSDI benefits, certain questions and answers may impact eligibility:
How Long Will the Person Be Out of Work?
The worker filing for benefits must be out of work or expected to be out of work for one full year. If the applicant is working and his/her gross earnings average is more than the Substantial Gainful Activity (SGA) limit for each month, the applicant will not be eligible for benefits.
Does Disability Significantly Impact the Claimant’s Ability to Work?
A disability or medical condition must be severe enough to limit the applicant’s ability to perform routine work activities. Examples of this would be difficult with basic tasks such as standing, walking, sitting, reaching, or lifting.
Can the Person Perform His/Her Prior Work Duties?
A disability or medical condition must prevent the worker from performing the work duties he or she performed before the disability or medical condition occurred. If it does not, the applicant will not be eligible for SSDI benefits.
Can the Person Perform Other Types of Work Duties?
An applicant’s age, education, work skills, prior work experience, and medical condition will be evaluated to determine approval for benefits. If a worker is receiving treatment from a licensed physician and is not capable of performing other types of work duties, he/she may be considered disabled and eligible for benefits.
Is the Person’s Medical Condition Described in the List of Impairments?
A “List of Impairments” details severe medical conditions that may be defined as disabilities by law and the Social Security Administration. If the applicant’s medical condition is not on the list, Social Security will compare the condition to similar medical conditions on the list. Some common disability conditions include:
- Bipolar Disorder
- Cancer
- Carpal Tunnel Syndrome
- Fibromyalgia
- Heart Disease
- Traumatic Brain Injury
This is only a partial list of acceptable medical conditions that warrant disability benefits. A Chicago disability lawyer can research the complete list and ensure that a medical condition qualifies for benefits before filing a disability insurance benefits application for SSDI with the Social Security Administration. This process will help to ensure approval of benefits and prevent claim denials and appeals.
Supplemental Security Income (SSI)
Supplemental Security Income (SSI) eligibility is based on financial need rather than prior work history. SSI benefits are available to low-income individuals who have a limited work history or who have no work history. This program is financed through general tax revenues and does not relate to work credits.
To be eligible for SSI benefits, a person must be a United States citizen or national and have limited income and resources. Benefits are payable to people who meet these conditions and are (1) adults who are 65 years old or older, (2) adults who are disabled or blind, and (3) children who are disabled or blind. The monthly benefit payment varies up to the maximum federal benefit rate, which may be supplemented by the state. In most states, beneficiaries are also automatically eligible for Medicaid.
How Can a Chicago Disability Lawyer Help You?
Filing an SSDI or SSI disability claim can be a complicated and lengthy process due to strict federal regulations imposed by the Social Security Administration (SSA). A Chicago disability lawyer can provide help when filing for benefits. The lawyer can make sure the application contains the correct information, gather important medical documentation, submit the claim to SSA on time, follow up with SSA officials, and guide claimants through the appeal process if the claim is denied. Unfortunately, SSDI and SSI claim denials are common, so filing an appeal and getting through the SSDI appeals process is critical for a successful outcome.
SSA denies many applications for disability benefits, often because there is not sufficient medical evidence to prove a disability claim. If SSA denies a claim, it’s better to file an appeal than to wait and reapply with a new claim. More than 50% of appeals are successful. When filing an appeal, a disability lawyer can expedite three important appeal processes:
A Request for Reconsideration
If SSA denies a claim or reduces benefits, the agency will send the applicant a notice. The applicant then has 65 days from the date on the notice to make a written “Request for Reconsideration.” During the reconsideration stage, SSA may ask the applicant to submit to the further medical examination. At this stage, a disability lawyer can ensure that SSA receives all information regarding doctor’s visits, treatments and medications, and doctors’ and hospital records. If anything is missing, the lawyer can communicate with SSA to make sure all required information is received.
A Request for an Administrative Hearing
If a claim is denied after Reconsideration, SSA will send the applicant a second notice. The applicant then has 65 days from the date on the notice to make a written request for a hearing before an administration law judge (ALJ). ALJs are judges that are hired by SSA to conduct hearings. The ALJ may arrange for vocational and/or medical experts to attend the hearing and testify on pertinent matters.
A Chicago disability lawyer can be an asset to a disability hearing in Illinois because he/she is likely familiar with administrative law judges in the district, as well as how each judge conducts hearings and any biases toward certain medical conditions. This knowledge goes a long way towards winning benefits at the hearing level. A large percentage of cases are approved at the ALJ hearing stage of the appeal process.
A Request for Review by the Appeals Council
If an ALJ decision is not favorable, an applicant or his/her disability lawyer can appeal again to the Appeals Council. The applicant has 65 days from the date of the ALJ’s notice to make a written request for review by the Council. At this stage, a review is somewhat limited. Reasons for a review by the Appeals Council often include: errors made by the ALJ: an ALJ decision not supported by substantial evidence; an abuse of discretion in the ALJ hearing process.
A disability lawyer can explain all the reasons for requesting a review by the Appeals Council and request additional time to submit a written argument. The Appeals Council can then do one of three things: (1) say that the ALJ was correct in their decision, (2) send the case back to the ALJ with instructions on how to handle the case, or (3) approve the applicant’s claim.
