SSI Disability Claims FAQ
Find answers to common questions about SSI disability claims.
SSI stands for Supplemental Security Income, a need-based program for low-income and low-asset disabled indivduals. Adults who are unable to work, or no longer able to work, may file an SSI disability claim if they believe they are disabled. Children who have conditions that severely limit their daily activities can also apply for SSI.
Anyone who is considering filing an SSI disability claim probably has lots of questions. Here are just a few of the most common questions.
How long does an SSI disability claim take?
An SSI disability claim can take quite a long time from start to finish, and processing time can vary tremendously from one case to the next. For individuals who are pursuing SSI disability at the initial claim level, the time spent waiting for an initial answer can easily exceed three to four months. In fact, in cases where an individual has had a heart attack or surgery of various kinds (for example, heart surgery or eye surgery), the Social Security Administration (SSA) may actually delay a decision on the case until the claimant's medical outlook and prognosis has become clearer.
Waits of over a year for an initial decision on an SSI disability claim are a bit unusual, but cases have been known to take that long. In most cases, however, an initial SSI claim will probably be decided in 90 to 120 days.
Unfortunately, most SSI claims are denied after the initial application, and the disability claimant must appeal. The entire appeal process can stretch out to more than two years and perhaps as long as three years. Why so long? Partially because the first appeal (called a review, or reconsideration) can take just as long as the initial SSI disability claim, but mainly because the second appeal (a request for a hearing) can sometimes take over two years! Just getting a hearing date before a disability judge can take over a year.
Learn more about expediting your SSI claim and other public assistance that may be available while you wait.
What are the chances of winning SSI disability at a hearing?
Depending on the state you live in, your SSI disability claim may stand a 70% chance of denial when you file an initial claim (application). And, at the first appeal step (known as a review, or reconsideration), the chances of being denied for SSI disability benefits may be even higher, perhaps as high as 85%. At a disability hearing, however, the typical SSI disability claimant may see their opportunity for being approved rise. Without representation at a hearing (that is, not having a disability lawyer or representative who knows how to prepare a case to be heard by a judge), the chance of winning disability benefits is about 40%. With legal representation, the chance of winning SSI disability benefits is approximately 60%. Of course, individuals who are older (50 and up) will typically stand a better chance of winning, due to SSA disability regulations leaning in their favor. For this reason, also, younger claimants may find it even more advisable to confer with a disability lawyer or representative prior to attending a disability hearing.
Learn more about Your Chances of Getting Approved for Disability Benefits.
Do you get health benefits with SSI disability?
Individuals who are awarded SSI disability benefits are automatically eligible for Medicaid benefits. In the future, however, some states may decide to alter the benefits currently offered to Medicaid recipients, and this will likely affect SSI disability recipients who also receive Medicaid benefits.
Learn more about what comes with disability benefits.
Should you get a lawyer to start an SSI claim?
There are different schools of thought regarding this issue. Some individuals who file an SSI claim will be approved on their first application (about 30%, meaning 70% will not be approved and will have to appeal). It doesn't usually make sense for these individuals to hire a lawyer. And in truth, many disability lawyers won't tae acase until the initial application has been filed and denied. If you have a very strong case and believe you can be approved for benefits without having to appeal (for instance, you have ALS or esophageal cancer), it makes the need for representation a bit doubtful.
However, for individuals who receive a denial on an SSI claim, having a disability lawyer will usually help you get benefits on appeal. At the first appeal step (the reconsideration), a disability representative (an attorney or non-attorney representative) will manage your case and work to ensure that all necessary deadlines are met (submitting appeal paperwork and ensuring that requests by SSA for information are complied with). At the second appeal step (the disability hearing), a disability representative will work to gather all of the information that is needed to present a case before an administrative law judge (ALJ). And, typically, having legal representation at the hearing substantially increases an SSI disability claimant's chances of winning benefits.
How do you file an SSI disability claim?
Just contact your local Social Security office and advise them that you need to file for disability benefits. After you do this, you will be given an opportunity to be interviewed over the phone or in person for the purpose of filing for SSI and getting disability benefits from Social Security. You cannot file for SSI online.
Learn more about SSI (Supplemental Security Income) benefits.