Who Should Apply for SSDI: Separating the Facts from the Fiction

If you have a disability and are unable to work or know someone in that situation, you may have heard of the Social Security Disability Insurance (SSDI) program. Depending on who you ask, though, you may be told that it's "impossible" to qualify or that it can take "years and years and endless rounds of denials and appeals."

Separate the fact from the fiction by asking an expert. In this case, our expert is Ed Swierczek, who has more than 37 years experience in the Social Security Disability Insurance (SSDI) program. Before joining Allsup, he was an examiner and supervisor for the Missouri Disability Determination Service (DDS) for 27 years, and also worked in quality assurance.

"I have worked for Allsup for more than 10 years. As an Allsup senior claimant representative, I represent clients at the hearing level and provide written briefs to administrative law judges in an attempt to have claims awarded based on the evidence-of-record. This precludes the need for a face-to-face oral hearing, as well as saving many months-often years--of waiting for an oral hearing. I also attend oral hearings to represent our clients," said Ed.

For Whom is SSDI Designed?

According to Ed, SSDI "is intended for individuals with a physical and/or mental impairment that prevents them from engaging in substantial gainful activity, or SGA. In 2010, the amount is $1,000 per month. The condition must be expected to last at least 12 months, has already lasted for 12 months, or is expected to result in death."

He contends that "if you have a medically determinable severe impairment that prevents all work, then you should apply for SSDI." Although some describe the process as a "waste of time" or say that it requires a personal representative, Ed disagrees.

However, he does feel that although it is "not required," "it is important that you have an experienced SSDI
representative to guide you through the process. In my opinion, the sheer complexity of the program demands expert representation. Just as taxpayers hire tax experts to help them file their IRS returns, people filing for SSDI benefits also need help. Statistics indicate that claimants who have a representative have a higher award rate than those who do not."

Going through the Process

The first step is filing for SSDI if you can't work or are working and making less than your SGA because of your impairment. Ed emphasizes that timing is important.

"The longer you wait to file, the more money you can lose. SSDI pays retroactive benefits only 12 months prior to the filing date. Therefore, if you became disabled on June 1, 2007, and did not file for SSDI until June 1, 2009, SSA will only pay retroactive benefits back to June 1, 2008. You would lose seven months of benefits (There is a five-month waiting period before payments are made; thus the reason for seven months rather than 12 months.)"

You can file for disability benefits in one of two ways: at your local Social Security office, or online, according to Ed. Prepare yourself to complete multiple pages of forms, including information about why you can't work, your past job history, your medical treatment, medications, and related details.

"If you are denied at the initial filing (about two-thirds are), then you must file for a reconsideration within 60 days," Ed notes. "There are some exceptions that are called "prototype states" that go immediately to
the hearing level, but most claimants do file for reconsideration." If your claim is denied at that level, you can continue the process through various hearings and appeals. As a result, "the entire filing process can take nearly four years," adds Ed.

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Source: First-person interview by Associated Content journalist Joanne Eglash with Allsup senior claimant representative Ed Swierczek.