During the application process for disability benefits, the Social Security Administration has strict regulations that must be met, or your claim can be denied. Working with an experienced disability lawyer who can oversee the application process will ensure that all filing requirements are met and that your claim has a higher rate of approval.
What Are the SSDI Benefits in Illinois?
In the Illinois, a worker who becomes disabled from an illness or injury is permitted to file a claim for Social Security disability benefits (SSDI). These benefits are available to all workers and certain family members when the worker (applicant) has a credible work history, has accumulated a sufficient number of work credits through employment, and has worked long enough to pay Social Security taxes. All Social Security disability benefits in Illinois are funded to eligible workers through Social Security taxes paid by Illinois employers, workers, and self-employed individuals.
If benefits are approved by the Social Security Administration (SSA), they are payable to disabled or blind workers under 65 years old, the spouse or widower, the children, and adults disabled since childhood. The amount of monthly disability benefits is based on the Social Security earnings record of the insured worker. After the worker has received disability benefits for two years, the worker will automatically receive Medicare coverage.
Eligibility Criteria for SSDI Benefits
In Illinois, the Bureau of Disability Determination Services (DDS) is the state department that oversees the application process for disability benefits and makes the initial determination about SSDI eligibility. When an application is submitted, DDS reviews the application and ensures that it contains all the necessary information necessary for eligibility including work history, work credits, and payment of Social Security taxes.
Following this review, DDS may require that the applicant schedule a consultative examination (CE) which is a medical exam that is conducted by a licensed physician who is hired by the Social Security Administration. This is done to get an unbiased medical report from a physician and to ensure that all requested medical evidence is submitted. When DDS reviews an applicant’s medical report, they look for information that may impact eligibility:
- How long will the applicant 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 or her gross earnings average more than $1,040 each month, the applicant will not be eligible for benefits.
- Does the disability impact the applicant’s ability to work?
A disability or medical condition must be severe enough to limit the applicant’s ability to do routine work activities. Examples of this would be difficulty with basic tasks such as standing, walking, sitting, reaching, or lifting.
- Can the applicant perform prior work duties?
A disability or medical condition must prevent the worker from performing his or her prior work duties before the disability or medical condition occurred. If it does not, the applicant will not be eligible for SSDI benefits.
- Can the applicant perform other 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 being treated by a licensed physician and is not capable of performing other types of work duties, he or she may be considered disabled and eligible for benefits.
- Is the applicant’s medical condition listed in the Blue Book?
The SSA has a Blue Book with a “List of Impairments” that details severe medical conditions defined as disabilities by the SSA and federal laws. If the applicant’s medical condition is not in the Blue Book listings, the SSA will compare the condition to similar conditions on the list.
Benefits of Hiring an SSDI Attorney
When you need to file for SSDI in Illinois, hiring Chicago Social Security disability attorneys can ensure better results with your application process for disability benefits. A SSDI attorney can help you through the application process from start to finish by:
- Helping you fill out your application
- Reviewing the application for errors and missing information
- Gathering all required medical documentation
- Submitting your claim in the required time frame
- Checking on delays and questions
- Communicating with the DDS on your behalf
According to statistics, about 60% to 70% of initial disability applications received by the Social Security Administration are denied each year due to errors, missing information, and insufficient medical documentation that’s required for the application process for disability benefits.
Knowledge of the SSDI Application Process
In Illinois, the application process for disability benefits can be completed online, by mail, by phone, or in a local field office. However, SSA guidelines are strict, so working with an experienced disability attorney will increase your chances of approval for disability benefits. When you work with a Social Security disability lawyer who handles these types of cases and knows what the SSA requires for approval, you don’t need to worry about a denied claim due to errors, missing information, and delays in filing that can impact your approval.
Gather and Organize Necessary Documentation
If you’re disabled due to a work-related injury, you may be experiencing a variety of health conditions that cause both physical and emotional pain. You may not have the energy to gather and organize the necessary documentation required to complete your application process for disability benefits. A disability attorney can do this for you and gather specific information required to support your claim. When you’re disabled and need SSDI, a disability attorney knows how to prove you can’t work.
Common Challenges in the SSDI Application Process
The processing time for disability applications varies depending on the nature of the disability, the required medical evidence and medical exams, and reviews by the SSA or the state agency like the DDS in Illinois. After you file your initial SSDI application, it may take 3 to 4 months of processing time before you know if your application is approved. In some cases, the application process for disability benefits can take as long as 6 to 7 months if the initial application is denied and the applicant has to file an appeal.
Understanding the SSA’s Definition of Disability
Under the Social Security Act, the definition of a disability is the inability to engage in any work because of physical or mental impairment. This physical or mental impairment must have lasted or must be expected to last for a continuous period of at least 12 months, or be expected to result in death. Social Security disability programs like SSDI and SSI only cover total disability. They do not pay partial disability or short-term disability benefits.
Dealing With Denials and Appeals
If you file for SSDI and your claim is denied, it’s best to file an appeal rather than file a new claim, which will start the application process for disability benefits all over again. When filing an appeal, a disability lawyer can expedite three different processes:
Request for Reconsideration
If the SSA denies your claim, you will get a notice of denial. You then have 65 days from the date on the notice to make a written “Request for Reconsideration.” During this stage, the SSA will ask you to submit to further medical examination. Your disability attorney can ensure that SSA receives all information regarding doctor’s visits, treatments and medications, and doctors’ and hospital records. If anything is missing, your attorney can communicate with SSA to make sure all required information is received.
Request for an Administrative Legal Hearing
If your claim is denied after Reconsideration, the SSA will send you a second notice. You then have 65 days from the date on the notice to make a written request for a hearing before an administration legal judge (ALJ). An ALJ is an administrative judge hired by the SSA to conduct hearings. During your hearing, the ALJ may call upon vocational or medical experts to testify on pertinent matters. A Chicago disability lawyer can be an asset to a legal hearing in Illinois because he or she is likely familiar with administrative law judges in the district and knows how they prefer to conduct hearings. This can be an asset for winning your appeal.
Request for Review by the Appeals Council
If an ALJ decision is not favorable, your disability lawyer can file one last appeal with the Appeals Council. You then have 65 days from the date of the ALJ’s notice to make a written request for review by the Council. However, at this point, a review may be limited. Reasons for a review by the Appeals Council usually include errors made by the ALJ, an ALJ decision not supported by substantial evidence, or some type of discretion with the ALJ hearing process.
