To Qualify For Medicare You Need To Get Disability Benefits From:
- Social Security
- Railroad Retirement Board
If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
If you live in Puerto Rico or outside the U.S.
Appealing Denied Social Security Disability Application
Its common for applicants to be denied. In fact, only about 1 in 3 applicants are initially approved for SSDI benefits. The two main reasons for denial are usually a lack of work credits, or that applicants do not meet the criteria for disability.
If you have been turned down, you do have the right to go through a Social Security Disability appeal process. Either you or your designated representative can file a Request for Reconsideration. Your initial appeal will then be turned over to Disability Determination Services, who will thoroughly review your file.
If you are denied again, you can proceed to the next level of appeal which is to appear in front of an Administrative Law Judge. An Administrative Law Judge will conduct a hearing in which all of your medical records and testimony will be heard before the judge renders a decision in the form of a written notice.
If you are still denied benefits, then you have a final appeal step you can take: filing a lawsuit in U.S. district court. You will need an attorney for this step if you havent already retained one. This can be an expensive and time consuming option, and as a result, less than 1% of disability claimants take their cases to this level.
Additional Information That May Impact Your Benefits Eligibility
The SSA outlines some of the requirements to apply for benefits under SSDI and SSI. They include:
- Having a condition that has prevented you from working for at least one year
- Being at least 18 years of age
Beyond these basic requirements, the SSA will request several types of information as part of your application. Your answers to these questions and your ability to provide various forms of documentation may directly impact your eligibility for benefits. Some questions on the Checklist for Online Adult Disability Application may ask about:
- The age you were at the time that you became disabled
- How many years you participated in the workforce before becoming disabled
- The nature and severity of the medical condition that causes you to be disabled
- Your marital status
- Whether you have any dependents
- Whether you can complete any type of work to earn an income
- Your education and work history
Your ability to provide thorough documentation about the nature of your medical condition and the date of the conditions onset is essential in determining your eligibility for benefits through SSDI and SSI.
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How To Apply For Social Security Disability Insurance
There are three ways to apply for SSDI:
Benefits For People With Disabilities
The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.
Social Security Disability Insurance pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes.
pays benefits based on financial need.
When you apply for either program, we will collect medical and other information from you and make a decision about whether or not you meet Social Security’s definition of disability. Periodically, we will need updated information about your condition. You may receive a Disability Update Report . This form can now be completed online.
Use the Benefits Eligibility Screening Tool to find out which programs may be able to pay you benefits.
If your application has recently been denied, the Internet Appeal is a starting point to request a review of our decision about your eligibility for disability benefits.
If your application is denied for:
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What Is The Difference Between Ssi And Ssdi
SSI eligibility is determined based on age, disability and available resources, while SSDI is based on a persons disability and work credits.
For most people, medical requirements that will allow you to receive disability payments are the same for both, and disability is determined using the same process. Both SSI and SSDI are managed by the Social Security Administration as well.
Location and monthly income
Record of earnings
The most notable difference between SSI and SSDI is that SSDI is only available to people who have accumulated enough work credits, while SSI is available to low-income individuals who have not accumulated enough work credits or who have never worked. In addition, SSDI is based on your work history, but SSI is strictly based on a financial situation of considerable need.
Additionally, SSI benefits begin on the first of the month that a social security disability application is submitted and approved, but for SSDI there is a five-month waiting period. People who qualify for SSI can also receive Medicaid benefits. After receiving SSDI benefits for two years, a disabled person will be eligible for Medicare benefits. The amount of SSI benefits depend on where a person lives and what their monthly income is, while SSDI benefit amounts are dependent on a persons earnings record.
Applying For Medicare Part A And Part B By Phone
Just like applying online, applying for Medicare by phone is easy. You can contact a Medicare representative at your local Social Security office by calling 1-800-772-1213. This number will automatically connect you to a Medicare representative who can help you in the process of applying for Original Medicare.
Depending on call volume, there might be a wait time. If the wait time is above average, you can schedule an appointment to have a representative call you.
The only downfall with applying for Medicare by phone is that it can take longer than online. If youre ahead of the game and start well before your birthday, applying by phone shouldnt cause any issues.
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What Do I Need To Know About Advance Designation
You should be aware of another type of representation called .
Advance Designation allows capable adult and emancipated minors who are applying for or receiving Social Security benefits, Supplemental Security Income, or Special Veterans Benefits the option to choose up to three people in advance who could serve as their representative payee, if the need arises.
In the event that you can no longer manage your benefits, you and your family will have peace of mind knowing that someone you trust may be appointed to manage your benefits for you. If you need a representative payee to assist with the management of your benefits, we will first consider your advance designees. We must still fully evaluate them and determine their suitability at that time.
You can submit and update your advance designation request when you apply for benefits or after you are already receiving benefits. You may do so through your personal account, contacting us by telephone at 1-800-772-1213 , or at .
My Condition Is Not Listed In The Blue Book Can I Still Receive Ssdi Benefits
While the Blue Book is a fairly comprehensive guide, by no means does it contain every ailment or disability that could keep a person from working. If you have a condition not listed in the Blue Book , you can still apply for SSDI. The main thing to remember is that you will need to provide substantial proof that your condition has rendered you unable to work.
What Documents Do I Need To Apply For Social Security Disability Benefits
While there are a few different ways to apply for Social Security disability benefits, each one requires you to provide specific documentation about your case.
The Social Security Administration needs both personal and medical evidence to evaluate your claim effectively, and your decision may be delayed if you don’t provide complete information.
What Happens After I Submit My Application
Once submitted, your application will be processed and reviewed. The time this takes will vary, depending on the type of disability you have and other factors. For example, the review process moves faster for those suffering from amyotrophic lateral sclerosis , pancreatic cancer, or leukemia.
Reviewers may contact you with questions or to request additional documentation. The SSA will let you know of their decision to approve or deny your application via US mail, usually within three to six months.
As you await the SSAs decision, you can check the status of your application online using your my Social Security account, or by calling during hours of operation.
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Apply Online For Disability Benefits
Social Security offers an online disability application you can complete at your convenience. Apply from the comfort of your home or any location at a time most convenient for you. You do not need to drive to your local Social Security office or wait for an appointment with a Social Security representative.
You can use the online application to apply for disability benefits if you:
- Are age 18 or older
- Are not currently receiving benefits on your own Social Security record
- Are unable to work because of a medical condition that is expected to last at least 12 months or result in death: and
- Have not been denied disability benefits in the last 60 days. If your application was recently denied for medical reasons, the Internet Appeal is a starting point to request a review of the medical determination we made.
- Print and review the Adult Disability Checklist.
It will help you gather the information you need to complete the application.
We suggest that you have the following information at hand. It will make completing the application much easier.
Information About You
Information About Your Medical Condition
Information About Your Work
We may ask you to provide documents to show that you are eligible, such as:
We accept photocopies of W-2 forms, self-employment tax returns or medical documents, but we must see the original of most other documents, such as your birth certificate.
Mailing Your Documents
After we receive your online application, we will:
What Is The Social Security Administrations Definition Of Disability
The Social Security Administration has a very specific definition of disability. To be considered disabled by the SSA, you must:
- Be unable to do your job: Your disability must be so severe that it prevents you from doing the same job you held before your disability began.
- Be unable to adjust to other forms of work because of your medical condition: If you cannot adapt to other types of work because of your disability, the SSA will find you disabled.
- The SSA will also consider your age, education, past work experience, and any transferable skills you may have when determining if you can adjust to other work. If you cannot adjust to other work, you will qualify as disabled.
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Benefits For Widows Or Widowers With Disabilities
If something happens to a worker, benefits may be payable to their widow, widower, or surviving divorced spouse with a disability if the following conditions are met:
- The widow, widower, or surviving divorced spouse is between ages 50 and 60.
- The widow, widower, or surviving divorced spouse has a medical condition that meets our definition of disability for adults and the disability started before or within seven years of the worker’s death.
Widows, widowers, and surviving divorced spouses cannot apply online for survivors benefits. If they want to apply for these benefits, they should contact Social Security immediately at 1-800-772-1213 to request an appointment
To speed up the application process, complete an Adult Disability Report and have it available at the time of your appointment.
We use the same definition of disability for widows and widowers as we do for workers.
Q: What Would Disqualify Me For Ssdi
A: There are a few different things that could disqualify you for social security disability benefits:
- You are still engaging in substantial gainful activity and earning a solid income.
- Your disability is not expected to last for at least 12 months.
- Your condition does not meet the SSAs definition of a disability.
If any of these apply, you will likely be denied benefits. Anyone who feels like the SSAs decision is unfair or inaccurate should feel encouraged to submit an appeal with new information that combats the SSAs conclusions.
Appealing A Social Security Decision
When you get a denial, the initial reaction is to resubmit and reapply. However, this could take longer and wouldnt be a better course of action. When you get denied in the first round, you can appeal your case and have a second examiner evaluate it. If you get rejected again, you can take it to court and request an administrative hearing.
At every stage, you are given a deadline to make your appeal. As soon as you receive a denial letter, lodge your appeal so the timeline starts. Doing things early will save you the hassles of missed deadlines and last-minute appeals.
Also, when you opt for an appeal, the SSA already has a record of your application. This can increase the chances that youll be approved, although it wont be a guarantee.
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Information About Family Members
- Social Security numbers and proof of age for each family member who may qualify for benefits and
- Proof of marriage, if your spouse is applying for benefits, as well as dates of prior marriages, if applicable.
If you don’t have all the documents you need, don’t delay filing for benefits. We will help you get the information you need.
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Disability Application Checklist Item #: Your Us Military Service Papers
Obviously, this disability application checklist item wont apply to everyone. But if you served in the military before 1968, the SSA requires you to submit your service papers along with your application. In fact, your service history may actually qualify you for extra earnings! This document can be a DD-214 Certificate of Release or Discharge from Active Duty form.
How Much Work Do You Need
In addition to meeting our definition of disability, you must have worked long enough and recently enough under Social Security to qualify for disability benefits.
Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year.
The amount needed for a work credit changes from year to year. In 2022, for example, you earn one credit for each $1,510 in wages or self-employment income. When you’ve earned $6,040 you’ve earned your four credits for the year.
The number of work credits you need to qualify for disability benefits depends on your age when your disability begins. Generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year your disability begins. However, younger workers may qualify with fewer credits.
For more information on whether you qualify, refer to How You Earn Credits.
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Family Eligibility And Children With Disabilities
Certain family members may be eligible to receive disability benefits on your record including a spouse, a divorced spouse, children, a disabled child and/or an adult child who was disabled before the age of 22. Each beneficiarys rate depends on the number of family members receiving benefits on your record as well as the amount you receive.
The maximum amount each family member is eligible to receive is 50 percent of the disability rate. The total payment to an entire family, however, is capped and is not based on other personal financial situation factors.
Disability Application Checklist Item #: Contact Information For Your Healthcare Provider
On your application, include the names, addresses and phone numbers of all doctors that treat you, as well as hospitals and clinics. The Disability Determination Services office is responsible for deciding whether or not you qualify for benefits. They need this information to pull your complete medical records for review.
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Adding Funds To Your Card Account:
You may add funds to your Card Account at any time. Some reload locations may have limits on the minimum amount you may load to your Card. Absent special approval, the maximum aggregate value of funds in your Card Account may not exceed $50,000 at any time. You agree to present the Card and meet identification requirements to complete value load transactions as may be required from time to time. Load locations may have their own load limits that may be less than our allowable amount. Load locations may also assess a fee to load funds to your Card Account. You cannot load your Card Account by check or money order. You may also direct deposit funds to your Card Account by providing our bank routing number and your assigned Account Number to your employer or other direct deposit payer .