First a quick look at what Social Security Disability (SSD) is not. SSD is not State Disability Insurance (SDI) which is an injured worker’s insurance program administered by the Employment Development Department (EDD) of the State of California. And SSD is of course not a private disability insurance plan of the type which was once a widely available fringe benefit for employees, but is becoming increasingly rare. On this website, we will discuss these disability plans in the future.

So what is Social Security Disability? Generally, it is a system funded and administered by the federal Social Security Administration to provide disability benefits to two classes or categories of disabled people. To qualify, a person must fall into one class or the other. Unfortunately, not every disabled person meets the qualification to be in either class. Therefore, there are many disabled people who do not qualify for Social Security Disability benefits. Many do, however, and they are either disabled persons who have worked in the past and paid into Social Security from their earnings for a sufficient period of time, or they are disabled persons who are without substantial assets.

Those in the first category receive benefits under Title II of the federal Social Security Act. They are referred to as "Title II" beneficiaries, or "SSDI" (Social Security Disability Insurance) beneficiaries. Title II and SSDI refer to the same beneficiaries.

The second category receives benefits under Title 16 of the Act. These beneficiaries are generally referred to as "SSI" (Supplemental Security Income) beneficiaries.

The same criteria for establishing whether a person is disabled applies to both SSDI and SSI claimants. Beyond that there are many differences, such as:

(1) What it takes to meet the criteria to be in one class or the other, or in some cases, both classes at the same time;

(2) What monthly disability payments will apply;

(3) What past due benefits will apply;

(4) When Medicare benefits will go into effect. Remember an important part of a disabled person’s benefits is medical care insurance through the federal Medicare program, regardless of how old the disabled person is.

It is important to have a legal representative help with your Social Security Disability claim. Your security disability attorney will help to establish that you belong in a class that qualifies, and more importantly, that you meet Social Security’s complicated criteria for establishing your disability. Here, having an attorney can make a big difference. A much higher percentage of applicants who have a legal representative assisting them recover benefits, than those without a representative.

You should know that what an attorney can charge you is controlled by the law, and that there will be no fee charged unless you recover your benefits. Fees are not charged "up front." They are always paid from past due benefits, if any, owed to you when the award of benefits is made.

The Disability Determination Process

After the Application has been filed, the Social Security Administration (SSA) investigates the claim. As part of the application paperwork you will need to identify your doctors. They will be contacted by letter and asked to provide copies of your medical records. Not all doctors cooperate. Those records that are provided are then reviewed, and based on that review, the claim for disability benefits is accepted or denied. A very high percentage of the applications are denied at this point, so this first denial, while disappointing, should not discourage you from continuing with your claim.

The first denial is appealed by filing a Request for Reconsideration. Instructions for making this request are provided with the denial. The same medical documents are then reviewed by another person and in nearly all cases, the claim is denied a second time. Again, while disappointing to the applicant, you should proceed with the claim. Instructions for appealing from the second denial are provided with the denial letter. This second appeal will be in the form of requesting a hearing of the case before an Administrative Law Judge (ALJ).

A Word About Time

While the time it takes from the date of the application to the point of the second denial varies, the typical case will take from two to four months. The second appeal, the request for hearing before an ALJ, starts another clock running, and the file is transferred to another branch of the determination processors.

If the SSA has not already had you examined by a medical specialist, you may have a medical examination scheduled now. More medical records may be requested for review, and your case is then placed in line for calendaring an ALJ hearing. This second round of processing takes many months and it will probably total about eight months from the time you request an ALJ hearing to the hearing date itself.

More About Having Representation

Your experienced social security disability attorney can be particularly helpful throughout the claim process after your first denial. Your doctors may have to be prodded to provide records, additional doctors, therapists, and counselors may need to be contacted. Your attorney will write, and talk to them in person as necessary. Your attorney may ask them to prepare statements about your physical or psychological limitations that consider the specific points that the ALJ will be looking for in deciding your claim. Your attorney will then prepare you and any witnesses he/she feels are necessary for their testimony at the ALJ hearing, and your attorney will accompany you and represent you at the hearing itself.

After the hearing, your attorney remains active in the case by:

• Gathering and submitting any additional documentation that the ALJ requests;

• Explaining the ALJ’s decision to you, whether favorable or otherwise;

• And in the event of an unfavorable ruling by the ALJ, appealing your case to the Appeals Counsel if the facts and law warrant.

Be sure you hire an experienced social security disability attorney to help you overcome the hurdles imposed by the social security administration.