When you are disabled and cannot work in California, you and your family have earned the right to seek Social Security disability insurance (SSDI) benefits. The Social Security Administration, however, has a complicated, highly-technical process that requires you prove your disability according to arcane standards. At Walker Disability Law, our Social Security benefits attorney based in Sacramento, California personally handles every client's case. Our experience, skills, and dedication to winning your Social Security case help relieve our clients' fears by maximizing your ability to get the benefits you earned and need. Contact us today at 916-476-5044 to schedule a Case Evaluation.
Social Security Disability Process in California
Social Security Disability Insurance (SSDI) is a benefit available to certain people that become disabled and are unable to work. However, the process to obtain the benefits available under SSDI can be arduous, lengthy, and time-consuming. In fact, the majority of applicants are denied the first time they apply. The following is a synopsis of the major steps of the SSI process in most states.
Filing the Initial Application
The first step to filing the initial application for SSDI benefits is to gather the necessary information that you will need to provide to the Social Security Administration (SSA). The more information you provide, the more likely they will not ask for additional information, which can delay your claim.
- Basic Information. The SSA will want your basic information, including your:
- Place of birth
- Name of current and former spouses (if they died or the marriage was longer than 10 years)
- Names and date of birth of your children
- Phone number
Employment Information. You must provide the SSA your employment information, including:
- Where you have worked for the last 15 years your rate of pay, your job titles, type of duties you had, and the date your disability began to affect your ability to work
- Education and Training Information. You must provide your level of education and any special training you have received
- Medical Information. You must provide a list of your medical conditions; dates of examinations, treatments, and tests; names of all medications
- Additional Documentation. Additional documentation will also be needed, including your birth certificate and a W-2 if you have worked in the last 12 months
Once you have gathered the necessary information, it is time to complete the application. This is a three-part process.
- You can complete the initial application in person at the SSA office, over the telephone, by mail, or online. Online is the preferred method.
- The SSA will delegate review of your application to the state level agency.
- Typically, three to five months later, the SSA issues its decision. The decision can take much longer depending on the circumstances.
Most initial applications are denied. In fact, only around twenty percent of SSA applications for disability benefits are granted initial awards. The SSA will send you a form letter informing that your application has been denied. You can then appeal the initial denial.
Request a Reconsideration of Denial
The next step is to file a request for reconsideration. Your claim will then be reviewed, from start to finish, by a different state agency examiner and a decision will be made. Some districts will even consider new information at the reconsideration level. This process generally takes three to four months.
Very few applications are approved at this stage of the process.
Request an Administrative Law Judge Hearing
If you still receive an unfavorable decision at the reconsideration level, you have 60 days to request a hearing before an Administrative Law Judge (ALJ). It can take from 6 to 18 months for the hearing to occur, and the ALJ will not have been involved at the initial application or the reconsideration level.
The Administrative Law Judge hearing is your chance to present your case and prove you are disabled under the Social Security Act.
Request a Review by SSA's Appeals Council
The next step after the ALJ hearing is an appeal before the SSA's Appeals Council. It is not guaranteed that your request for review will be granted. Even if it is granted, the SSA may decide the case on its own or remand it to the ALJ for further action.
Very few ALJ denials are reversed at the Appeals Council stage of the process.
Request a Review by Federal Courts
If the Appeals Council denies your request for review, your only option is to file a civil action in a federal district court. It is the only step in the process where you must have an attorney represent you.
It is advised, however, that you have an attorney before this step and throughout the entire process. In 2017, the U.S. Government Accountability Office released a Report to the Chairman, Subcommittee on Social Security, Committee on Ways and Means, House of Representatives, that indicated applicants represented by a lawyer throughout the SSDI benefits process were 2.9 times more likely to be awarded benefits than those applicants filing on their own.
Common Challenges to SSDI Benefits in California
There are many reasons why applications for SSDI become derailed. The following are some of the most common.
- Income. You are permitted to earn a small amount of income while receiving SSDI benefits. Earning more than the mandated amount will result in the denial of a benefits claim.
- Failure to cooperate with the SSA. You must take certain steps to comply with the SSA requests while the SSA is reviewing your application for benefits. Failure to do so can result in denial of a benefits claim.
- Failure to cooperate with your physician or medical professional. It is very likely that your physician will require you to attend certain therapies and return for follow-up visits. Unless you have a valid, verifiable excuse for not doing so, you must comply to collect your benefits.
- Failure to prove a qualifying medical condition. Not all medical conditions will qualify you for SSDI benefits. If you cannot prove that yours is a qualifying condition, then the application will be denied. In fact, 20-30% of applications are denied because their medical condition does not qualify.
- Failure to prove inability to work. It can be difficult to prove that you cannot work, but it is necessary for SSDI. Technical reasons, meaning nonmedical reasons, are the main reason applications are denied. Thirty-five to forty percent of applications result in technical denials.
Pros and Cons of a Disability Lawyer in California
As noted above, having a disability attorney represent your SSDI benefits case is to your advantage. There are minimal or zilch reasons not to hire one. Here, however, is what you should consider before making your decision.
Advantages of a Disability Lawyer
- Attorney fees are statutorily fixed at 25% of past-due benefits and are capped at $6,000.
- Attorneys have no rights to future benefits.
- Your chances of approval are nearly three times more than if you apply for SSDI benefits on your own.
- Your attorney takes on your case for you so you can manage other things in your life.
- Given that most denials are based on technical issues, an attorney can make sure all the paperwork is complete, well-documented, and well-supported.
- You do not have to communicate with the SSA, but your attorney will––including updating the SSA with updates to your medical treatment and following up with the SSA to make sure they obtain all evidence and documentation they need to review and approve your application.
- If your case moves along to the hearing stage, your attorney will represent you before the ALJ and advise you on what to expect and what to do
- At the disability hearing, our attorney at Walker Disability Law will cross-examine any experts and make sure your case is best presented in a way most favorable to you.
Disadvantages of a Disability Lawyer
The disadvantages are limited. Mostly, it is this: attorney fees. The fees generally run somewhere between $1,000 and $4,000 – the more experienced and more services your attorney provides, the higher the fees. That's a price you may be able to live with if it means your SSDI benefits are approved.
Contact a Social Security Lawyer in Sacramento, California Today
Applying for SSDI benefits may seem straightforward, but it is not. More likely than not, an applicant's claim is denied. In fact, only about 30% percent of applicants are awarded SSDI benefits. That is a pretty low percentage for people who cannot work and need to care for their families and pay bills. On the other hand, your chances of an award dramatically increase with the assistance of competent legal representation.
At Walker Disability Law, our disability attorney in California will help you secure the disability benefits you deserve. Contact us by either filling out the online form or calling us at 916-476-5044 to schedule a Case Evaluation. This is the single best way for you to improve your chances of winning disability benefits in California.