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How to Apply for Social Security Disability Benefits (SSDI) in Pennsylvania

Each year, hundreds of thousands of disabled Pennsylvanians apply for monthly disability benefits through social security programs administered by the Social Security Administration, or SSA.  If you have a health condition which prevents you from working, depending on factors like your employment history and financial resources you may be eligible for SSI (Supplemental Security Income), or SSDI (Social Security Disability Insurance), both of which provide federal financial assistance.  The SSA reports that as of December 2013, nearly 400,000 Pennsylvania residents were approved for benefits.

However, while numerous applicants are successful, many more are rejected.  In Pennsylvania, only about 32% of claims are accepted after the initial application is made. The SSA’s eligibility criteria are notoriously strict, and there are plentiful technical and medical reasons a claim might be denied.  When you’re up against such challenging odds, you need to take every possible step to make your claim as strong and compelling as it can be.  The more you understand the application process, the better equipped you will be to deal with the social security system.

The experienced Pennsylvania disability benefits lawyers of Young, Marr & Associates can help you prepare. To schedule a confidential legal consultation completely free of charge, call our law offices right away at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania.

Pennsylvania Disability Agencies

In Pennsylvania, the Bureau of Disability Determination assists the federal government in processing applications. According to the agency’s website, examiners in Pennsylvania process more than 140,000 applications for disability benefits each year. They employ examiners, physicians, and psychologists to review medical records and conduct independent assessments of applicant medical conditions to make benefits determinations.

Understanding the Disability Requirements

Before you take the time to file a claim, you should understand the SSA’s basic eligibility requirements:

  • You must be disabled.
  • Your disability must be so severe that it prevents you from working, either in your old job or in a new, less exerting job.
  • Your disability must have lasted or be projected to last for no fewer than 12 consecutive months, or to result in death.
  • You must not be earning more than $1,070 per month for SSDI (or $1,800 per month for blind claimants).  For SSI, the income limit is the current Federal Benefit Rate (FBR) of $721 per month, although not all of your income may be counted toward that limit.
  • If you are applying for SSDI, you must have earned a certain amount of work credits depending on your age.
  • If you are applying for SSI, you must have limited income and other financial resources.

Qualifying for SSI in Pennsylvania

The SSA reports that in 2014 in Pennsylvania, the maximum total monthly payments were:

  • $721 for an eligible individual.
  • $1,082 for an eligible couple.

But how do you qualify?  There are several medical and financial SSA criteria you’ll need to pass:

  1. You must have both “limited income” and “limited resources.”  More specifically, the combined value of your possessions must be less than $2,000 (for single people) or less than $3,000 (for married couples).
  2. You must not be earning more than $1,070 per month.  If you do, the SSA will determine that your SGA or “Substantial Gainful Activity” is not sufficiently limited.
  3. Your health issue must be considered severe, meaning it interferes with your ability to perform steady work.  Medical conditions which are mild and easy to control are not considered disabling.
  4. Your condition must either have lasted or be expected to last for at least 12 months, or be expected to end in death. The Compassionate Allowance program allows expedited processing for claimants with very advanced illnesses.

These are only the general requirements.  In addition, the specific disability you are claiming must be able to either match or equal the severity criteria in the SSA’s “Blue Book,” or Listing of Impairments.  Needless to say, these criteria vary widely from one condition to the next: for example, the requirements for diabetes are very different from those for arthritis.

Qualifying for SSDI in Pennsylvania

While SSI is based on financial need, Social Security Disability Insurance is meant for applicants who have already spent a certain number of years earning “work credits” through employment. But how do you earn these credits, and how many do you need in order to be eligible for SSDI?

In 2014, you receive one work credit per $1,200 you earn.  (Note that these numbers change on an annual basis, so be sure to check the SSA requirements in the future.)  You cannot earn more than four credits per year, even after your earnings exceed $4,800.

If you are 62 or older, to qualify for SSDI you need a total of 40 credits, half of which should have been earned within the past 10 years.  However, the precise number of credits you need varies depending on age, and younger applicants need fewer credits.  For example, people who became disabled at:

  • Age 31-42: 20 credits
  • Age 44: 22 credits
  • Age 46: 24 credits

People even younger can also qualify, again with fewer credits.  For example, if you became disabled before the age of 24, you can potentially qualify with just six credits (earned during the three-year period ending with the start of your disability).

Other eligibility requirements for SSDI are similar to those for the SSI program:

  1. You must have a severe, disabling medical condition which prevents you from performing work.
  2. Your disability must have lasted or be expected to last for a minimum of 12 months, or be expected to end in death.
  3. You must not be earning more than $1,070 per month.  For blind claimants, the income limit is slightly higher at $1,800 per month.

How to File for Disability Benefits in Pensylvania

There are three ways you can start the process of filing a monthly benefits claim in Pennsylvania.  You can:

  • Apply in person, by going to your nearest convenient social security field office.  You can find your local office by using the SSA’s Social Security Office Locator, which will prompt you for your zip code.  You should schedule an appointment before you arrive.
  • Apply via phone, by calling (800) 772-1213, Monday through Friday, during the hours of 7 A.M. through 7 P.M.  If you are hearing impaired, call (800) 325-0778.
  • Apply online, by visiting the SSA’s website.

The SSA will confirm that your application has been received.

Because the SSA constantly receives millions of applications from around the country, it works with smaller, state-level organizations to expedite claims processing.  In Pennsylvania, the SSA is assisted by the Bureau of Disability Determination (BDD), which processes approximately 145,000 applications on an annual basis.  That’s nearly 400 claims for every single day of the year, which means processing does tend to take some time.  Generally speaking, unless a case is fast-tracked with the Compassionate Allowances (CAL) program due to advanced or terminal illness, most claims take about three to four months for review.

Once a review of your application is complete, the SSA will mail you notification of its decision.  If your claim is approved, your notification will include a notice of award letter, which will contain information about the payment you will receive, and when payments will start.  If your claim is rejected, your notification will include a denial letter explaining the reasoning behind the rejection.  While some denials are made on a technical basis, such as earning too much income, the majority are rooted in medical reasons, such as a health condition not being severe enough.

How to Prepare a Strong Disability Claim

Clearly stating how your medical condition limits your daily activities is the most important component of your application. If the records and statements included by your doctor in your application don’t make that known, state examiners may ask for additional information. The Bureau of Disability Determination may also ask you to submit to a special examination so examiners can better understand your limitations, including your ability to perform work-related tasks such as writing, lifting objects and sitting.

Submit all tests, including diagnostic images, and their results along with your application. If you have a team of Pennsylvania SSD attorneys working for you, they can compile the materials on your behalf. This eliminates the need for you to hunt down all the medical files on your own. You should also hand over treatment records and documentation of how you’ve responded to them. Incomplete treatment records can lead to a denial of benefits, if you haven’t explored all options to relieve your pain and restore your ability to work.

What to do if Your Disability Claim is Denied

A denial doesn’t have to be final.  You can appeal the SSA’s initial determination and may be able to have your claim approved after a reevaluation. The social security application process can take months or even years from start to finish.

Even if you are denied, that isn’t necessarily the end of the process.  If the SSA rejects your claim, you can appeal.  The first step to the appeals process is called Reconsideration, which may be requested by using an online application, or by downloading and printing out paper forms to send in the mail.  These paper forms include:

  • Form SSA-3441 — Disability Report – Appeal
  • Form SSA-827 — Authorization to Disclose Information to the Social Security Administration
  • Form SSA-561 — Request for Reconsideration

The average Pennsylvania acceptance rate during Reconsideration is only about 21% (which is still better than the national average of about 10%), but don’t get discouraged. The next available appeals stage, known as the ALJ (Administrative Law Judge) Hearing, has a significantly higher average approval rate: approximately 60%, both nationally and in Pennsylvania.  Therefore, if you reach this stage of appeals, your claim is actually more likely to be accepted than rejected. Furthermore, Pennsylvania residents can actually skip the Reconsideration stage and proceed straight to the ALJ Hearing, provided they file a request within 60 days.

You can request an ALJ Hearing by submitting Form HA-501 (Request for Hearing by Administrative Law Judge), in addition to Forms SSA-3441 and SSA-827 as noted above.

Wherever you are in this complex process, the experienced Pennsylvania disability benefits attorneys of Young, Marr & Associates can help. To set up a free and private case evaluation, call our law offices at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania, or contact us online today.

Our Pennsylvania Disability Attorneys Can Help

Filing for benefits can be a daunting task.  The social security system is highly complex, and imposes stringent technical requirements on disability claimants.  When you’re already seriously ill or injured, you shouldn’t have to struggle with navigating the system on your own: you deserve the support of a knowledgeable attorney.

At Young, Marr & Associates, our legal team has over 20 years of experience helping the residents of Pennsylvania obtain the benefits they deserve.  Whether you’re still in the process of filing or ready to appeal a denial, we can help guide you through the process. Call us today to talk about how we can assist you.

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