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Applying for Disability Benefits

If you've been injured and can't work, applying for disability benefits can help you receive an income until you can work again. Disability is a major, but often underestimated, risk workers face during their lives. According to the Social Security Administration, one quarter of workers will become disabled before reaching the age of 67. Disability coverage can protect you and those who depend on you from loss and suffering should disability occur.

Types of Disability Coverage

How you apply for disability benefits will vary depending on the type of coverage you have. About 30 percent of workers have long-term disability benefits through their employer. This disability insurance is heavily regulated by federal law. Those who are completely unable to work for at least a year due to disability may also qualify for Social Security disability benefits.

Filing a Claim for Disability Benefits under an Employer's Disability Insurance

Many workers have disability insurance provided by their employer, as part of their employee benefits package. These are regulated under the Employee Retirement Income Security Act of 1974 (ERISA), which establishes strict requirements for processing and responding to claims.

Step One: Reviewing your Disability Benefits Plan

Before applying for benefits, review the summary plan description (SPD) for your benefits plan. This document provides a detailed overview of how your disability benefit plan works, what benefits it provides, and how to file a claim.

Step Two: Make Sure You Meet Your Plan's Requirements

Before filing a claim, examine the details of your plan carefully. Make sure you meet all the requirements for coverage under your plan. Pay particular attention to:

  • Time limits and deadlines
  • The definition of disability
  • Exclusions

Step Three: Sending in Your Claim

Your SPD will describe the steps needed to file a claim for benefits. The SPD must include information on where to file, what documents to file, and whom to contact with questions about your plan.

Support your claim with as much medical evidence as possible. While your insurer will investigate your records, don't trust them to do all the work. You might want to ask your doctor to write a detailed report discussing your medical history and current medical issues. Your medical records and the determinations of your doctor are the most important parts of your claim.

Consider sending your claim via certified mail. This way you can be sure that your claim has been received.

Step Four: Getting a Decision on your Claim

Disability claims must be decided within 45 days after your claim has been received. Your plan may delay making a decision by another 30 days. Your insurer must notify you in writing of all delays.

If more information is requested, you'll have 45 days to supply it. Once you've provided the additional information, the insurer must then decided within 30 days, with another possible 30-day extension. Any additional delays after this will require your consent.

Filing for Disability Benefits for Social Security

Workers who become disabled before retirement age may qualify for benefits through the Social Security Disability Insurance (SSDI) program. Disability under Social Security requires a determination that:

  • You cannot do the work you previously did.
  • You cannot adjust to other work because of medical conditions.
  • Your disability has or is expected to last at least a year or result in death.

Step One: Gathering Needed Information

If you apply for SSDI benefits, the application you fill out will require detailed information. The Social Security Administration provides a checklist for online adult disability applications. Much of the information is routine, but some will require more thought.

You'll be asked to enter your "onset date of disability," the date you became unable to work. If your disability arose from a medical condition that worsened over time, you'll want to look back to the date where your illness began to impair your ability to work. If you have medical records of your illness, reviewing them may help you determine your onset date.

Similarly, you will be asked to describe the details of your disability. Gather a list of all conditions that limit your ability to work, including mental conditions. Be detailed and thorough in describing how they prevent you from work. Don't just list your diagnosis.

Step Two: Apply Online or In Person

You may apply online for SSDI benefits. You can also apply in person by making an appointment at your local Social Security office. Once you have applied, your state's Disability Determination Services office will make the decision about your medical condition by looking at your medical records and evidence from your doctors.

Need Help? Have an Attorney Review your Disability Claim 

If you're considering filing a disability claim, either through your employer's disability insurance or Social Security, you'll want to act fast -- but not hastily. No two claims are exactly alike and your situation may require more legal expertise. Have an attorney experienced in disability benefits review your claim and provide professional advice.

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