In North Carolina, workers with disabilities may receive Social Security Disability Insurance benefits to help meet their living expenses. But it is important to comply with all of the requirements and procedures for SSDI or you may lose important rights and this financial support.
Eligibility
SSDI provides payments to workers who worked at least five in the last 10 years before they became disabled. Benefits are based upon the claimant’s work record.
Supplemental Security Income is the other Social Security disability program. SSI benefits are paid to individuals, up to 64-years-old, who have little or no income or assets.
For SSDI or SSI eligibility, a person must be incapable of doing any substantial work because of their mental or physical disabilities. These conditions must be so serious that a worker cannot earn over $1,000 per month or $1,640 for a blind individual.
Additionally, the disability must have lasted or is expected to last at least one year or result in the person’s death.
Application
Claimants must submit a complete and accurate application and meet all requirements, or they jeopardize their eligibility for benefits. The Social Security Administration receives applications made by telephone, mail, the internet, or in-person.
With their application, claimants must submit medical information for each disability keeping them from work. This includes places where treatment was provided, the dates of the first and most recent treatments, the number of treatment visits made, and the addresses of the health care facilities providing treatment. Medical bills, discharge documents and medical records often contain this information.
The SSA then sends the application to the North Carolina disability determination services. DDS employees will order and review the applicant’s medical records. If sufficient information was submitted, DDS will decide whether the worker is disabled under Social Security rules.
DDS may seek more information, however, such as descriptions of daily activities. DDS can also request that the applicant go to a special examination performed by a physician or psychiatrist. Social Security will pay for this examination.
After DDS decides the request for benefits, the SSA will mail notification to a claimant that their benefit claim was approved or denied. If approved, the claimant will receive letter identifying the amount of monthly benefits that were granted and when payment will start.
Reconsideration request and hearing
When benefits are denied, claimants will receive mailed notification that they can appeal the denial within 60 days. This process is called reconsideration request.
SSA will review this reconsideration request and any additional information provided by the claimant concerning their disability. It will then issue another decision.
Claimants may appeal this second decision within 60 days after benefits are denied. They can also request a hearing before an administrative law judge. It typically takes 16 to 24 months before this hearing is held.
Appeals must be timely filed. Otherwise, claimants will have to begin the application process all over.
Claimants who receive Medicaid because of a disability must also appeal the denial of SSDI benefits. Otherwise, they will lose Medicaid benefits.
An attorney can help identify information and complete and file the required forms with SSA. Lawyers can also represent claimants in reconsideration requests and through the hearing stage.
