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  • Social Security Disability Application Process

    If you or a loved one is disabled from work due to a medical condition, you may be able to receive Social Security Disability Insurance (SSDI) benefits. In addition, Supplemental Social Security Income (SSI) might also be granted if you meet certain income requirements. Both are federal programs run by the Social Security Administration (SSA).

    Pennsylvania’s Bureau of Disability Determination (BDD) assists the SSA in determining whether a disabled citizen is eligible for disability benefits. The BDD employs case examiners, physicians, and psychologists to process case reviews for the following two programs:

    • SSDI benefits disabled or blind individuals who are insured by workers’ contributions to the Social Security trust fund. These contributions are the Federal Insurance Contributions Act (FICA) Social Security tax paid on their earnings or their spouses or parents. 
    • SSI provides cash assistance for aged, blind, and disabled people, including children under 18 years old, with limited income and resources. The federal government funds the SSA from general tax revenues.

    How Is a Disability Defined?

    Social Security has a stringent definition of adult disability. To be found disabled, by law:

    • You must be unable to do any substantial work because of your medical condition.
    • Your medical condition must have lasted or be expected to last at least one year or be expected to result in your death.

    Social Security also has a strict definition of disability for children:

    • The child must have a physical or mental condition that seriously limits their activities.
    • The condition must have lasted or be expected to last at least one year or result in death.

    Eligibility for Social Security Benefits

    There are strict eligibility requirements for both the SSDI and SSI programs. 

    To be eligible for SSDI, you must have worked and paid enough Social Security taxes to be covered under Social Security insurance. Some of the taxes must have been paid in recent years. In addition, you must:

    • Be the insured worker or the worker’s adult child or widow(er).
    • Meet the SSA’s medical disability criteria.
    • Not be performing any substantial work as defined by the SSA.

    To be eligible for SSI based on a medical condition, you must:

    • Have little or no income or resources.
    • Be a U.S. citizen or meet the requirements for non-citizens.
    • Meet the SSA’s medical disability criteria.
    • Not be performing any substantial work as defined by the SSA.

    If your impairment is other than blindness when you apply, you must not be working or working but earning less than the SSA’s substantial gainful activity level. If approved, your eligibility will continue until you medically recover or no longer meet a non-disability-related requirement.

    How Can I Apply for Benefits?

    You should apply for SSI and SSDI benefits as soon as you become disabled, as there are waiting periods. It may take several months for SSA to process your application. There is a five-month waiting period for SSDI benefits. Payments will not begin before the entire sixth month of disability. The SSDI waiting period begins the first whole month after the date SSA decides your eligibility. 

    Note that there is no waiting period if your disability is due to amyotrophic lateral sclerosis (ALS) and you are approved for SSDI benefits on or after July 23, 2020.

    SSI disability benefits are paid the first whole month after filing your claim or the date you become eligible for SSI.

    To apply for disability benefits, you must complete an application for Social Security Benefits and the Disability Report. You can complete the documents online if you:

    • Are 18 years old or older.
    • Are not currently receiving benefits on your own Social Security record.
    • Are unable to work because of a medical condition expected to last at least 12 months or result in death.
    • Have not been denied disability benefits in the last 60 days. 

    Those who cannot apply online can schedule an appointment at a their local Social Security office. 

    Once you have applied, the SSA first reviews the application to determine if the basic eligibility requirements of eligibility are met. Eligible applications are then forwarded to Pennsylvania’s Bureau of Disability Determination (BDD) to determine medical eligibility under Social Security law. 

    The BDD requests and reviews information from the applicant’s doctors, hospitals, and medical providers, including:

    • Nature of medical condition.
    • When the condition began.
    • Limitations due to the medical condition.
    • The outcome of medical tests.
    • Treatments you have received and outcomes.

    The BDD may also ask medical providers about your ability to walk, sit, lift, carry, and remember instructions. If additional information is needed, the BDD will schedule a consultative examination at no cost to you. The BDD makes its decision on whether to approve or deny your application. 

    What if My Benefits Are Denied?

    If your disability claim is denied, you have 60 days to file for Reconsideration. This can be done online or at the local Social Security Office. Once the reconsideration is received, the file will be assigned again to BDD but a new adjudicator will be in charge. They will review the matter again and make a decision within 90-180 days. 

    If BDD denies your reconsideration, you can appeal the decision and ask for reconsideration hearing before an Administrative Law Judge. You must request it in writing or online within 60 days. 

    Once your appeal is received, a hearing will be scheduled for you. An Administrative Law Judge (ALJ) will hear your case. It may take a year before a judge can hear to your case due to backlogs. 

    Before appealing a denial, it may be good to consult with a lawyer experienced with SSDI claims. They can ensure that your appeal is submitted correctly and thoroughly. As you wait for your hearing, they can also help you prepare for your testimony before a judge. They know the process, the problems, and the pitfalls. They can be a valuable resource. 

    If a judge rules against you, there are still options. A disabled person, in many cases, can ask the Appeals Council to reconsider the judge’s decision. Your lawyer will need to provide legal reasons why the judge’s decision was invalid or unfair under Social Security or precedent law. 

    Galfand Berger Icon If the Appeals Council rules against you, your final recourse is to file a lawsuit in the federal district court.

    Philadelphia Social Security Disability Lawyers at Galfand Berger LLP Can Help if You Are Disabled and Can No Longer Work

    Our Philadelphia Social Security Disability lawyers at Galfand Berger LLP advocate for those who can no longer work due to permanent injury or illness. If this is you or a loved one, we are happy to answer any questions and review your case. Call us at 800-222-USWA (8792) or complete our online form to schedule a free consultation. Located in Philadelphia, Bethlehem, Lancaster, and Reading, Pennsylvania, we serve clients throughout New Jersey and Pennsylvania, including Allentown and Harrisburg.