Requirements for Obtaining Disability Benefits (SSDI) in Pennsylvania
Statistics estimate that about 13.4% of Pennsylvanians have a disability. For some, their health conditions are easy to manage — but others have impairments that are so severe that employment becomes completely impossible. If that is the case for you, you may qualify for disability benefits.
When a medical condition negatively impacts your ability to earn income, the financial consequences can be devastating. Fortunately, you may be able to qualify for social security disability benefits through the Social Security Administration (SSA). Unfortunately, it can often be extremely difficult to qualify without the assistance of an experienced disability benefits attorney. Statistically speaking, well over half of all Pennsylvania claimants are denied after making their initial application, and the denial rate skyrockets to about 90% during the Reconsideration stage of appeals. While it may be difficult to get a claim approved, it isn’t impossible — but you do need a basic understanding of the eligibility criteria and application process.
To learn more about the requirements for getting SSDI in Pennsylvania and for a free case evaluation with our SSDI lawyers in Philadelphia, call today at (215) 515-2954. Young, Marr, Mallis & Deane are ready to help.
What Are SSDI Benefits in Pennsylvania?
Social Security Disability Insurance (SSDI) benefits are a form of assistance provided by the Social Security Administration. SSDI is funded from Social Security taxes that you will have paid into by working. People who have never had to pay taxes for Social Security, or people who have never had an income for whatever reason, may not be eligible for this kind of program and could instead apply for a different form of need-based disability benefits.
Your disability benefits are calculated based on your total income during the years you were able to work. You must have actually spent a certain number of years gainfully employed to be eligible in the first place. Many people may have never held a job and may not receive SSDI benefits. People who may not have worked because they stayed home while their partner worked, or people who were too young to work when their disability began may need to find a different form of assistance.
If you were previously able to work, have a history of working for at least several years, and suffered a disability that now prevents you from working, you might be eligible to receive SSDI. If this does not sound like you, please get in touch with our Pennsylvania SSDI lawyers about finding a program that works better for you.
Do You Qualify for Disability Benefits?
Disability benefits are contingent upon disability. This may sound too obvious to be worth mentioning, but actually, the SSA uses very strict guidelines to define disability, and the majority of denials are attributed to medical rather than technical reasons. While you may feel positive that you are impaired, the SSA may come to a different conclusion based on its own set of stringent standards. Therefore, you can prepare a much stronger claim if you understand SSA evaluation.
In order to be approved, your impairment will need to meet the following criteria:
- If your condition is easy to suppress or workaround, you will not be found disabled by the SSA. Your condition must be severe to the extent that it prohibits you from working.
- Ideally, your condition would (1) be found in the SSA’s “Blue Book,” or Listing of Impairments, and (2) match the severity standards listed for your condition. However, even if your condition doesn’t exactly match the severity standards — or if it isn’t included in the Listing at all — you can still qualify through other channels (e.g. Compassionate Allowances, medical-vocational allowances).
- Your condition is so severe that, not only can you not do what you used to, you also cannot find an alternative position.
Proving Your Disability in Pennsylvania
Proving you are indeed disabled requires more than just filling out some paperwork. You will need to provide evidence and documentation of your disability in order to be approved for SSDI benefits. For some, this may be easy if their disability is included in the SSA’s Listing of Impairments. For others, we may have to go the extra mile when demonstrating your disability.
First, we absolutely need hospital and doctor’s records regarding your disability and any treatments you received. These records should be thorough enough to indicate when your disability started and how it has impaired your life. Your primary care doctor should submit a report about your disability, their experience treating you, and their opinion on the level of impairment you suffer. If you have seen any other doctors, like specialists or surgeons, we should get records from them as well.
The evidence should not only indicate that you have a disability, but that your disability prevents you from working or at least prevents you from earning a significant income. The point of applying for SSDI benefits is that you are unable to earn enough income to support yourself due to your disability. If the SSA and BDD find that you are capable of gainful employment, your application may be denied.
Your Ability to Work and SSDI Benefits in Pennsylvania
Not all disabled individuals are completely unable to work. Some disabled people can perform more limited kinds of work, but their income would be insufficient to support them fully. You do not have to be completely incapacitated in order to be approved for SSDI benefits in Pennsylvania. Perhaps you can work a part-time job with more limited job duties.
SSDI is calculated based on the average income of your working years. For people who had a lower income, their SSDI benefits may not be enough. In such cases, speak to an attorney before trying to supplement your SSDI benefits with a small income from working. If you are able to work, your benefits may be reduced.
Your Work History and SSDI Benefits in Pennsylvania
Getting approved for SSDI requires more than just being disabled. SSDI is based on Social Security and will only be available to people who have a history of employment during which they paid Social Security taxes. A person who has never worked or never paid into Social Security taxes may be ineligible for SSDI, unless they can use their spouse or parent’s record to get SSDI. If you have no eligible spouse or parents, there are other forms of public assistance for which you may qualify. Contact our Philadelphia SSDI lawyers to discuss your situation.
Generally, the age at which you became disabled will dictate how many years of work you must have in order to be approved for SSDI. The younger you are, the fewer years of work experience you need. However, if your disability did not manifest until a later age, you will need a longer work history in order to be approved.
Your work history is also important because it is used to determine the number of your benefit payments if you are approved. Benefits will be based on your average lifetime income. The more you earned when you were able to work, the greater your benefits will be. This can put people who earned low incomes who had shorter work histories at a disadvantage. Contact our Bucks County SSDI lawyers or our SSDI lawyers in Philadelphia, discuss your best options.
Eligibility for Children and Spouses of a Disabled Person in Pennsylvania
SSDI benefits are mainly intended for people who are unable to work due to a disability or medical condition. However, under limited circumstances, family members of disabled individuals may be eligible to receive SSDI benefits.
For the most part, family members who can receive SSDI benefits from your working history are limited to spouses and children. Eligible children include adopted children and can sometimes include stepchildren and grandchildren, depending on your situation. If you are the spouse or child of an injured worker, you may be able to use your spouse or parent’s working record to obtain benefits for your support in addition to theirs.
Elderly spouses over the age of 62 may be eligible, but spouses of any age could also be eligible if they are taking care of your child and dependent on your income. The eligibility of children is primarily based on their age, marital status, and disability status.
If you have family members who you believe are eligible to receive SSDI benefits through your disability status, speak with our Allentown SSDI attorneys about beginning the application process.
How to Apply for Disability in Pennsylvania
The SSA is a federal organization. However, in order to more rapidly process the sheer volume of applications, the SSA works with smaller organizations in each state. In Pennsylvania, the SSA works with the Bureau of Disability Determination (BDD), which is part of the Pennsylvania Department of Labor and Industry.
The BDD reports evaluating about 145,000 claims every year, or approximately 400 claims every day. These claims, which are sent to the BDD after receiving a basic review by the SSA, represent both Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). While these two programs have different eligibility standards, with SSI based on financial need whereas SSDI is based on earning work credits, both grant assistance to Pennsylvanians who cannot work because they are impaired.
There are five BDD offices spread throughout the state to serve different counties. For residents of Eastern Pennsylvania, there are two offices that might be appropriate:
If you are a resident of Bucks County, Chester County, Dauphin County, Montgomery County, or Philadelphia County, call or visit the BDD office at:
1171 S. Cameron Street
Harrisburg, PA 17104-2594
If you are a resident of Berks County, Lehigh County, or Northampton County, call or visit the BDD office at:
264 Highland Park Blvd.
Wilkes-Barre, PA 18703
In general, there are three ways you can apply for benefits in Pennsylvania:
- You can apply online through the SSA’s website.
- You can visit a field office to apply in person. There are dozens of field offices scattered throughout the state, so you should use the SSA’s field office locator to find the closest and most convenient office.
- You can apply over the phone by calling the SSA at (215) 701-6519.
How Long Does it Take to Get SSDI Benefits in Pennsylvania?
Once you apply for SSDI benefits in Pennsylvania, it may be some time before you start receiving benefits. Pennsylvania applicants should expect to wait several months before they get their first check from the Social Security Administration, if not longer.
Generally, it takes a few months for the SSA to review and approve SSDI applications. If your claim is approved, you will automatically enter into a five-month waiting period before you start receiving benefits, depending on your medical condition. For example, Pennsylvania applicants with ALS don’t have to wait and can receive benefits immediately after their claim is approved. To clarify whether or not you’re eligible for immediate benefits or must face the five-month waiting period, ask your Pennsylvania disability lawyer.
The five-month waiting period after SSDI claim acceptance is so that the SSA can be sure you are eligible for benefits. If your condition improves or changes during that time, inform the SSA right away.
Once the five-month waiting period is over, you’ll start receiving your monthly SSDI checks. The amount you receive each month will be exclusively based on your work history. Ask a Pennsylvania disability lawyer for insight to get a better idea of what your monthly payments may look like.
The exact day you get your monthly SSDI benefit will depend on the day you were born. The following is the current payment schedule for Pennsylvania SSDI recipients:
- Those born between the 1st through the 10th receive payments on the second Wednesday of each month
- Those born between the 11th through the 20th receive payments on the third Wednesday of each month
- Those born between the 21st through the 31st receive payments on the fourth Wednesday of each month
If you get SSDI benefits through a parent’s earning record, you will receive your monthly checks according to your parent’s birthday.
What Are the Requirements for Maintaining Access to Disability Benefits in Pennsylvania?
Once you’re approved for SSDI payments, there is no guarantee that you will receive them forever. While SSDI benefits are designed to support Pennsylvania residents with permanent disabilities for the rest of their lives, certain things can threaten a recipient’s access to benefits. Understanding the requirements for maintaining access to disability benefits is crucial so that you don’t unknowingly put yourself and your family at risk.
Substantial Gainful Activity
In order to remain eligible for SSDI benefits, Pennsylvania residents can’t earn over a certain amount in additional income each month. After all, being unable to engage in substantial gainful activity (SGA) is a prerequisite for getting SSDI benefits. In 2022, the SGA threshold is $1,350 monthly for non-blind recipients and $2,260 for blind recipients. If you earn over the SGA limit in a month, you may become ineligible for SSDI benefits.
Unfortunately, many SSDI recipients are unaware of this restriction or the fact that they have to report additional earnings to the SSA. Your Pennsylvania disability lawyer can help you keep track of your income so that you don’t unknowingly earn over the SGA limit and lose your access to SSDI payments.
Trial Work Periods
Sometimes, SSDI recipients think they might be able to return to work but are unsure. In order to accommodate these recipients, the SSA allows for trial work periods (TWPs). Pennsylvania recipients can attempt to reenter the workforce during a TWP while still getting benefits. Unfortunately, these trial work periods are automatically triggered when SSDI recipients earn over $970 monthly over nine months. That means you can enter into a TWP without knowing it, ultimately risking your access to benefits.
The good news is your checks won’t go away immediately. Once aware of a TWP, your Pennsylvania disability lawyer can contact the SSA, explain the situation, and get them to reconsider repealing your benefits. Quickly addressing an unintentional trial work period is important, so you don’t lose access to the monthly SSDI payments you and your family rely on.
SSDI benefits are reserved for individuals with severe medical conditions and disabilities that prevent them from earning a sufficient income. In order to remain eligible for SSDI benefits in Pennsylvania, your condition cannot improve significantly. If it does, and you can again engage in substantial gainful activity, the SSA may revoke your monthly benefit.
SSDI recipients must inform the SSA of any changes or improvements to their medical condition. Depending on your initial prognosis, the SSA may subject you to regular evaluations over the years to ensure you are still eligible for SSDI benefits based on your disability.
Why Should I Talk to a Pennsylvania SSDI Attorney?
If you plan on applying for SSDI benefits in Pennsylvania, hiring an attorney is important. The application process can be complicated, and just one mistake might result in a rejection. An experienced Pennsylvania disability lawyer can help you gather the necessary information to succeed in your initial application for SSDI benefits.
Applying for SSDI benefits can be a complex process. Pennsylvania applicants must compile proof of their work history and disability or medical condition, which can be laborious. In addition to proving your eligibility, you may also have to answer questions regarding your family, dependents, and other personal details.
If you are denied SSDI benefits, an attorney can help you file an appeal. Unfortunately, the SSDI claim appeals process can take months or even years. By that time, you may face serious financial difficulties if you still cannot work because of your disability. An experienced Pennsylvania disability lawyer can help you properly apply for SSDI benefits and answer any questions you may have about the process so that you can start receiving monthly payments as soon as possible.
Get in Touch with Our Pennsylvania SSDI Attorneys for Help
If you’re interested in getting benefits for yourself or your family, our experienced Easton disability lawyers can help. For a free and private consultation, call the law offices of Young, Marr, Mallis & Deane right away at (609) 557-3081 in New Jersey or (215) 515-2954 in Pennsylvania, or contact us online today.