Social Security Disability Benefits

Social Security Disability Facts and Information
Applying for Benefits
How DDS Determines Disability
If your Claim is Approved
How to Appeal a Determination

 

Applying for Disability Benefits under Social Security

You apply for Social Security disability benefits either:

  1. Online at www.socialsecurity.gov/applyfordisability.
  2. Through your local Social Security Office. To locate the office nearest you, call 1-800-772-1213 toll free or go to the Social Security Office Locator, and enter your five-digit zip code.

Before you apply, you should read one of the Disability Starter Kits developed by Social Security. They include the following helpful information: the definition of disability, a checklist of information and documents you'll need to gather, a worksheet that helps you prepare for your disability interview, and answers to frequently-asked questions about applying for benefits.

Adult Disability Starter Kit |  SSI Child Disability Starter Kit (under 18)

Once you've applied, Social Security staff will review your application with you to make sure it is complete. This can be done by phone or face-to-face.

If Social Security determines that you meet the work and/or income-related requirements, they will forward your application to DDS so we can determine whether you meet the medical requirements. 

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How DDS Determines Disability

  1. A trained disability examiner reviews your forms and writes to your medical sources to obtain evidence. Your medical sources are asked about the following:
  • What illnesses, injuries or conditions limit your ability to work?
  • How do the illnesses, injuries or conditions limit your activities?
  • When did you become unable to work? 
  • What have medical examinations and tests shown?
  • What treatment has been provided?

Your medical sources will not be asked whether you are disabled. That determination is made by a state agency team, which includes a disability examiner and a medical consultant.

  1. Usually, the team gets enough evidence from your medical sources to make a decision. However, if more evidence is needed, a special exam will be arranged and paid for by DDS. Transportation to and from the exam may also be paid for by DDS.

If you do not have transportation to the special exam, dial 2-1-1 (from anywhere in Vermont) and request a list of the medical transportation available in your community.

You can also search the Vermont 2-1-1 website. Click on "about the 2-1-1 database” on the left hand side, then "start your 2-1-1 database search". Enter your zip code and then click on “search for services by word or phrase. Enter the words “medical transportation”. Be sure to click on "all words" to the right before you click on go. This should give you a list of available transportation in your community. 

  1. After all the needed evidence is obtained, the examiner and medical consultant will:
  1. Consider all the facts in your case, including the severity of your condition; when it began; how long it has lasted; how it affects your ability to work; and your age, education, and work experience; and
  2. Follow a step-by-step procedure that includes the following five questions:
  • Are you working? If you are and your earnings average more than $1070 a month, you generally cannot be considered disabled.
  • Is your condition "severe"? Your impairments must interfere with basic work-related activities for your claim to be considered.
  •  Is your condition found in the list of disabling impairments? SSA maintains a list of impairments for each of the major body systems that are so severe they automatically mean you are disabled. If your condition is not on the list, we have to decide if it is of equal severity to an impairment on the list. If it is, your claim is approved. If it is not, we go to the next step
  • Can you do the work you did previously? We must determine whether your impairment interferes with your ability to do the work you did in the last 15 years. If it does not, your claim will be denied. If it does, your claim will be considered further.
  • Can you do any other type of work? If you cannot do the work you did in the last 15 years, we then look to see if you can do any other type of work. We consider your age, education, past work experience, and transferable skills, and we review the job demands of occupations as determined by the Department of Labor. If you cannot do any other kind of work, your claim will be approved. If you can, your claim will be denied.
  1. It usually takes several months for DDS to make a decision; however, this time frame varies depending on how quickly your medical sources respond to requests for records and the need for special exams.
  2. Once DDS has made a determination, Social Security will send you a letter informing you of the decision.

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If your Claim is Approved

If your claim is approved, you will receive a notice showing the amount of your benefit and when payments will begin.

If the claim is denied, the notice will provide an explanation of the denial.

 

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How to Appeal a Determination

If you disagree with the determination, you must request that your case be reconsidered—within 60 days from the day you receive the letter informing you of the decision. You will be asked to fill out some more forms—about any changes in your condition and any new medical treatment.

Some of the reasons to request reconsideration are: a) the condition is more severe than determined; b) the condition has lasted longer than expected; c) the condition has worsened since the decision; d) the condition became disabling earlier than determined; and e) another condition developed that complicates the first condition.  

Here's how to request an appeal:

  1. If your application was recently denied for medical reasons, you may request an appeal on the Social Security Administration's Internet Appeal website. There are two parts to the Internet Appeal process: a) an Appeal Request Internet form, and b) an Appeal Disability Report that provides more information about your condition. 
  2. If you do not want to request an appeal via the Internet or if your application was recently denied for non-medical reasons, you may:
  • Contact your local Social Security Office and tell the representative that you want to appeal the decision made on your case.
  • Call SSA toll-free at 1-800-772-1213. Explain that you don't want to use the online appeal process but do want to appeal the decision made in your case. Representatives are available Monday through Friday from 7 AM to 7 PM.
  • Call the toll-free TTY number if you are deaf or hard of hearing:1-800-325-0778.

The reconsideration case is returned to Disability Determination Services where it is handled by a different examiner and medical consultant. Evidence from the original decision and any new evidence is considered. Once again medical evidence is obtained, and an independent decision is made.

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