How do I qualify for Social Security disability or SSI? Note: The following is for informational purposes only. It is not intended to apply to any specific situations. No one should rely upon it in making decisions about his or her situation.

How do I apply for Social Security Disability benefits? Applications for disability benefits can be filed online at www.socialsecurity.gov  and by calling toll-free at 1-800-772-1213. You can also apply in person at your local Social Security office.

What is the difference between Social Security Disability and SSI? Social Security Disability benefits are payable to insured claimants and their dependents who meet Social Security's definition of disability. Supplemental Security Income (SSI) benefits are payable to persons who meet the same definition of disability, or who are aged or blind, who meet a means test.

What does it mean to be insured for the purpose of Social Security Disability? Whether you have insured status depends on whether you had enough income subject to social security taxes for a long enough period of time. The rules are complex, depending on a number of factors, but insured status is measured by the number of calender quarters in which a minimum amount of income. The basic number of required calender quarters is forty, subject to various qualifications and exceptions. The minimum amount of income upon which social security tax is paid required to qualify as a quarter of coverage is a relatively small amount which is adjusted on an annual basis by Social Security.

If I qualify for Social Security Disability, what will be my monthly benefit amount? The monthly benefit amount of Social Security Disability paid to a recipient depends on the recipient's record of earnings subject to social security tax.

If I am insured and qualify for Social Security Disability benefits, can my family members also qualify for benefits? Your minor or disabled children, and in some cases your grandchildren, are potentially eligible for benefits. Your spouse if he or she is more than 62, caring for your children under the age of 16 or disabled, or who is also disabled and over the age of 50, may be also be eligible for benefits. If your earnings level is low, family members may not be eligible for benefits on account of your disability.

What sort of means test do I have to pass in order get SSI, besides being aged, blind, or disabled? The means test takes into account your income and resources, if any. Subject to various exceptions, all of your income from any source is deducted from the SSI payment amount. If there is anything left after all the deductions, you get what is left. Again subject to certain exceptions, you can't have property worth over a certain amount. If you want to check your eligibility, you can use Social Security's Benefit Eligibility Screening tool at its web site at www.socialsecurity.gov .

What is the SSI benefit amount? The basic benefit amount is $552 for an individual, $829 for an eligible couple.

How disabled do I have to be in order to qualify for Social Security Disability or SSI? Social Security's test for disability requires an inability to do any substantial gainful activity as the result of a medically determined physical or mental problem for at least 12 months, or that these conditions would result in death.

What are the steps in the process that are supposed to be followed by Social Security in determining if I am disabled? Social Security's regulations require a five-step process for determining disability. The first step considers whether you have any earnings or had any earnings in the period of time since you said you became disabled. If your earnings, subject to a number of exceptions and adjustments are over a monthly amount set in the regulations, presently $780, it is assumed that this means that you are able to work and, therefore, not disabled. If so, your application will be denied without looking at your medical condition. The second and third steps just consider the medical evidence in your case. If the medical evidence fails to show that you have a physical or mental condition or combination of conditions which significantly limit your ability to do basis work activities, your application is denied at this step. On the other hand, at the third step if the medical evidence shows that your met one of specific criteria which attempt to cover all physical or mental conditions or the equivalent of one, you will be found disabled without having to go to the final two steps. For instance, if you have a severe breathing problem and the test results of your breathing tests are below a value for a person of your height according to a chart, you met this step and are assumed to be disabled. The fourth and fifth steps look more at you as a total person, taking into account your age, education, and work experience in determining whether you can go back to any of the kind or work you have done in the past, or similar work.

After I apply, what happens next? In the case of an application for Social Security Disability, your earnings records will be looked up on Social Security's computer system to see if you are insured. In the case of a SSI application, your income and resources will be reviewed to see if you qualify. If your application or applications pass either or both of these examinations, your application will go to an agency known as the Disability Determination Service (DDS) which will collect your medical records and review the forms that you have completed. Doctors or other medical professionals will review your records and fill out forms expressing opinions about your case. You may be sent to a doctor or other professional for an examination but that is not required. You will not meet with anyone at the DDS.

If my application is turned down, is there anything that I can do to appeal it? If your application is turned down, you can request reconsideration by completing the required forms. If your claim was denied for medical reasons, any new medical records will be collected and different people at the DDS will review your case. If your case is denied after being reconsidered, you can then request a hearing before an Administrative Law Judge (ALJ). The ALJ is from a separate branch of Social Security. He or she will look at your case without giving any weight to the earlier decisions on your case. You will have the opportunity to appear before the ALJ to actually tell your story to the person who will decide your case. If the ALJ rules against you, you can request review by a body within Social Security called the Appeals Council. The Appeals Council sits in Virginia and its review will be on paper only, to determine if the ALJ's decision is supported by the evidence presented in your case. If you lose your review by the Appeals Council, you can file a case in U.S. District Court, and that Court will review your case, again to determine if the evidence supports the ALJ's decision.

Will I be wasting my time if I appeal a denial of my application? The short answer is that it is not a waste of time to appeal for many applicants. Statistics from Social Security over the years show that overall, somewhere between one-quarter and one-half of the applications are allowed at the initial application step; a much smaller percentage of those who request reconsideration are allowed; and somewhere in the 60-70% range of all claimants who request a hearing before an ALJ win. A much smaller percentage who pursue their claims to the Appeals Council and U. S. District Court are eventually allowed benefits. In our view, the high win rate at the hearing level shows that there is something wrong with the system. Until the system is fixed, many disabled persons will have to pursue their claims until at least that level in order to obtain the benefits to which they are entitled.

Does it help my case if I have an attorney or other representative help me with my appeal? Social Security's statistics show that more claimants with representation get favorable decisions from ALJs following hearings that claimants who go in on their own. A representative can ensure that all necessary evidence, including and very importantly letters from doctors addressing issues in your case, prepare your testimony and the testimony of other witnesses or present their statements for the hearing, and argue your case on your behalf.

How can I pay for an attorney or other representative in my Social Security Disability case? Attorneys and other representatives, including our firm, generally represent claimants in Social Security case on a contingent fee basis. This means that if you win your case, the representative will get a share of your back benefits (usually 25% up to a cap which is presently at $5,300) If you lose your case, no fee will be paid. However, you will generally be responsible for out-of-pocket expenses whether you win or lose. In a contingent fee situation, the attorney will only take your case if it appears you have a winnable case.

If I am found disabled, how far back will my benefits be payable? The rules for Social Security Disability and SSI are different. Social Security Disability benefits don't start accruing until five months has passed since the month in which you were disabled. For instance, if you were to be found disabled as of June 15, 2001, your benefits will start with the following December, 2001. Also, you can get benefits for as much as a year before the month in which you applied. Using the same example, if you applied in February 2003, your benefits will only go back to February 2002. In the case of SSI, your benefits will only go back to the date your application was filed, which could be when you first contacted Social Security and indicated you wanted to apply, regardless if when you were first disabled.