SSDI is a lifeline for many people who, through no fault of their own, can no longer work and support themselves or their families. But in Oklahoma—as in other states—applying for disability insurance can be an overwhelming and tedious process. And because the annual number of applications for SSDI is at an all-time high, the SSA is struggling under a backlog of claims.
So try to be aware—before you begin the application process—of the requirements and qualifications necessary for SSDI. Your claim is then much more likely to win approval.
The following overview will help give some guidance.
In order to qualify for disability insurance, you must suffer from a permanent disabling condition that prevents you from seeking gainful employment.
How do you pay for it? Through your Social Security taxes.
The program is funded as follows: during the years you were employed, you should have paid payroll taxes and thereby earned Social Security “work credits”. Assuming you have worked long enough—and recently enough–to achieve sufficient work credits, you and certain dependants with disabilities qualified for SSDI because you contributed towards Social Security.
To summarize: the basic qualifications required for SSDI are 1) disability and 2) adequate Social Security work credits.
Now for the specifics.
First, the strict definition of how the SSA defines “disability”:
- You cannot do work that you once performed before.
- The SSA decides you cannot adjust to other work because of your medical condition(s); AND
- Your disability has lasted or is expected to last for at least one year or to result in death.
SSDI pays only for claims of total disability. No benefits are payable for partial disability or for short-term disability because the SSA assumes working families can access other resources, such as workers’ comp or savings, during periods of short-term unemployment or disability.
If your claim for disability insurance is approved, you are allowed to continue to earn an income of no more than $1,000 per month.
To determine whether an individual is disabled, the SSA uses a five-step process:
- Are you working?
- Is your condition “severe”?
- Is your condition found in the list of disabling conditions?
- Can you do the work you did previously?
- Can you do any other type of work?
The second specific detail is work credits. Every year you worked, you earned up to four credits. Those credits were based on your total yearly wages or self-employment income. To qualify for SSDI, the SSA normally requires 40 credits, 20 of which must have been earned in the ten years prior to the onset of disability. However, the exact number depends on the age when you became disabled.
A total of 40 credits usually means that you must have had a fairly consistent employment history, and have worked (and paid Social Security taxes) for a combined five of the ten years prior to becoming disabled. Younger workers may qualify with fewer credits, as parents’ work credits can be applied to applicants under the age of 22.
THE APPLICATION PROCESS
Now that you know about qualifying for disability insurance, you are ready to apply. The SSDI application itself includes employment and other forms for the SSA as well as your medical records, which will help the SSA make a decision about whether or not you meet the criteria for disability.
Oklahoma’s Disability Determination Services says it makes decisions on disability benefits claims based on:
- Medical Records
- Medical and Psychological Evidence
- Continuing Disability Review
- Applicant’s Statement
To find out whether you qualify for disability, check with the Social Security Administration for some basic guidelines regarding the following conditions:
- Back Problems
- Bipolar Disorder
- Cerebral Palsy
- Chronic Heart Failure
- Cystic Fibrosis
- Mental Retardation
- Multiple Sclerosis
- Personality Disorders
- Somatoform Disorders
- Spinal injuries
If you have a mental condition that makes you unable to work, lasts for more than 12 months, and you are under 65 years old, you are eligible for SSDI.
DECISION ON CLAIMS
Unfortunately, denial of first-time SSDI claims is common in Oklahoma. Nationwide, the turndown rate is more than 60 percent.
If your initial claim is denied, you can appeal to The Oklahoma Offices of Disability Adjudication and Review, which is responsible for appeal hearings, for releasing SSA decisions, and for granting SSDI benefits. However, well over 80 percent of applicants who appeal are also denied.
You also can consult a qualified Social Security attorney or advocate to help you handle your application and the potential appeals process. Since many disability claims are turned down because of suspected fraud, it’s a smart idea to have an attorney check your application for errors or omissions before you submit it to the SSA.