The Social Security Administration (SSA) and state agencies will consider you disabled and eligible for benefits if:

1. You have a physical impairment or mental disorder, and
2. Your impairment or disorder prevents you from doing substantial gainful activity (SGA) for at least 12 months.

The SGA requirement is measured by the wages you earn. If you are earning over a certain level, then you will not be considered disabled.

The durational requirement means that injuries that will heal in less than a year (for example, a sprained ankle or broken bone) will not qualify you for SSD or SSI.

While many people do not distinguish between SSD and SSDI, they are in fact two different programs.

• To qualify for SSD benefits, you must have earned a sufficient number of “work credits”. In general, you receive one credit for each $1,200 of earnings, to a maximum of four credits per year — though there are exceptions for certain kinds of work and workers.
• SSI benefits are available to those who have not earned enough work credits to qualify for SSD, or who have never worked. In other words, it is primarily for low-income individuals with disabilities.

Both programs are managed by the Social Security Administration, and the criteria for medical eligibility is the same (see above).

Each state has an agency that decides disability claims — it is usually called Disability Determination Services, or DDS.

When you apply for Portland SSI or SSD benefits, the Social Security Administration will send your claim to the DDS, which will decide whether you are “disabled” and therefore qualify for SSD or SSI benefits.

Your state’s DDS offices can provide information about why your application was denied and answer your related questions.

To avoid financial hardship, it is best to apply for SSI or SSD benefits as soon as you are eligible.

When you do receive benefits, they will be backdated to the date of your initial application, not to the date of your injury or onset of illness.

If you believe you may qualify for benefits, do not wait to apply.

There are currently three ways to apply for benefits:

1. Online (SSD only),
2. Calling the Social Security office to set up an appointment to apply for SSI and SSD benefits in Portland, and
3. Walking into the local Social Security office without an appointment.

When you call or walk into an office, you will be given an appointment for an interview, and you will complete your application with the interviewer. If you are not comfortable with computers, or will need help completing your application, this is the best choice for you.

An online application can be completed from any computer, does not need to be completed all at once, and allows you to check the status of your application after you submit it.

The Social Security Administration estimates that most initial applications will be assessed within 90-120 days, but it often takes longer — sometimes as long as six or eight months.

Approximately 70 percent of initial applications are denied, so it is safest to assume you will have to go through the appeals process.

A reconsideration — the first level of appeal — takes an average of three to four months, though a case could be decided much sooner or much later.

We will do everything we can to help you win benefits earlier rather than later in the appeal process. The sooner you contact us after you have been denied  SSI or SSD benefits, the sooner we can help. 

Contact us for help!

The first step in the appeals process is called a reconsideration.

Once you receive your denial, you have 60 days to request a reconsideration. It is important to observe this deadline for if you miss it, you lose your right to an appeal and must file a new application.

The second level of appeal after requesting a reconsideration is an appeal to an Administrative Law Judge (ALJ) .

It usually takes at least six months for a judge to hear your appeal, but the wait for a hearing can be as long as 18 months in some parts of the country.

Some factors that affect appeal time include:

• Your location,

• The workload of your local claims examiners,

• The condition of your medical records, and

• The type of claim you are making.

If you have a very severe illness with a clear diagnosis, you may be able to get an expedited decision through one of Social Security’s expedited disability benefits programs.

The time it takes to receive a decision from the Appeals Council for a SSD appeal can vary from several months to two years. The length of time depends on the complexity of the appeal and the backlog of cases at the Appeals Council

The medical evidence needed to assess your disability may include:

• Examination and treatment notes from your doctor(s)

• Bloodwork panels and other tests results

• Reports of imaging studies (MRI, CAT scan, and X-rays)

• Mental health records

You can save yourself a lot of time and frustration by gathering this medical evidence from the doctors who are treating you. Presenting sufficient evidence when you apply for SSI and SSD benefits in Portland (or another location) will help you get a faster determination on your disability claim.

Perhaps, yes. Unfortunately, if you are denied on your initial claim for disability benefits, odds are that you will be denied on your first appeal (reconsideration) as well — which means you will have to proceed to the next step in the appeals process. SSDI and SSI claims that are denied at the initial level will almost always need to be heard by an Administrative Law Judge (ALJ) at a hearing before they can be approved.

Social Security disability benefits are entirely separate from the workers’ compensation system.

The criteria for evaluation are very different, so being compensated in one system does not guarantee your compensation in the other.

Workers’ comp is a type of insurance, and applies only to work-related illnesses and injuries, and assesses the severity of the injury to determine your ability to return to work.

Social Security, on the other hand, is primarily interested in your ability to pursue “substantially gainful activity” (SGA) and covers any illness or injury that will prevent you from holding SGA for at least 12 months.

Yes. Disability claimants who fulfill the severity criteria for one of the conditions on the List of Impairments (“the listings”) can be approved for benefits somewhat easily.

However, the disability evaluation process, even for these “listing-level” impairments, is never automatic, and with Social Security, nothing is ever guaranteed.

Yes, but be aware of the “substantially gainful activity” (SGA) requirement. If you can earn more than a certain amount per month (which is adjusted annually) when you apply for SSI and SSD benefits in the Portland area, you’ll be considered capable for SGA and therefore not disabled. The idea is that your health conditions have not risen to the level of “disability” if you can earn at least the designated monthly amount.

Part-time jobs, short-term jobs, and work that earns you less than the monthly adjusted amount are less likely to affect your claim. Be cautious about extensive volunteering or any work-like activity which could (if paid) earn you more than that amount.

Statistically, the vast majority of people who apply for SSI and SSD benefits in Portland and across the United States are denied at the initial claim and reconsideration levels. This means that most claims will need to go to a hearing in front of an Administrative Law Judge (ALJ) before a claimant can hope to receive disability benefits.

It is at the level of an ALJ hearing that having a disability attorney can really help win a claim. While we cannot guarantee that a claimant will be awarded Social Security Disability or SSI benefits, our lawyers can ensure that a case will be properly “developed” prior to a hearing date. We can also help prepare you for the hearing, which might otherwise be an intimidating experience.

Nearly all disability lawyers work on contingency: They do not charge up-front fees or require a retainer to work on a Social Security disability case, and they will be paid a fee only if they win the case.

Additionally, the SSA regulates the fees we may collect for our services. Typically, they are limited to 25 percent of the past-due benefits you are awarded, up to a maximum of $6,000, plus any out-of-pocket expenses. What out-of-pocket expenses will be charged to you, and how much they typically are, should be discussed with your attorney during your initial consultation meeting.

For experienced disability attorneys who can help you successfully apply for SSI and SSD benefits in the Portland area, call or contact us online.