Applying for Disability Benefits

If you're injured and can't work, applying for disability benefits can help you receive an income until you can work again. Disability is a major and often underestimated risk that workers face, and medical bills can quickly add up.

According to the Social Security Administration, a fourth of workers will become disabled before reaching the age of 67. Disability coverage can protect you and your dependents from loss and suffering if you're suddenly disabled due to a car accident or other personal injury.

This article discusses the various types of disability benefits and how to apply for them.

Types of Disability Coverage

How you apply for disability benefits will vary depending on the type of coverage you have. About 30% of workers have long-term disability benefits through their employer. This disability insurance is heavily regulated by federal law.

If you're completely unable to work for at least a year due to a serious injury, you may also qualify for Social Security disability benefits.

How Do I File a Disability Claim Through Work?

You may have disability insurance through your employer as part of your employee benefits package. These offerings are regulated under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA 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 your plan provides
• 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

Typically, only non-work-related injuries qualify for coverage. Work-related injuries, in contrast, might render you eligible for workers' compensation benefits.

Step Three: Sending in Your Claim

Your summary plan description (SPD) will describe the steps to follow when filing a claim for benefits. The SPD must include information on:

• Where to file
• What documents to file
• Who 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 the insurance company to do all the work. Consider asking 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 critical parts of your claim.

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

Step Four: Getting a Decision on Your Claim

Disability claims must be decided within 45 days after being 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 provide the additional information, the insurer must then make a decision within 30 days (with another possible 30-day extension). Any additional delays will require your consent.

Filing for Disability Benefits for Social Security

Suppose you become disabled as a worker before retirement age. In that case, you may qualify for benefits through the Social Security Disability Insurance (SSDI) program. Eligibility for Social Security disability benefits requires a determination that:

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

Step One: Gathering Needed Information

If you apply for SSDI benefits, your application will require detailed information. The Social Security Administration (SSA) 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. This is the date you became unable to work. Perhaps your disability arose from a medical condition that worsened over time. In that case, you'll want to look back to the date when 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'll be asked to describe the details of your disability. Gather a list of all conditions that limit your ability to work. This can include mental conditions such as post-traumatic stress disorder (PTSD). Be detailed and thorough in describing how your limitations prevent you from working. You'll want to provide more than just your diagnosis.

Step Two: Apply Online or in Person

You can apply online for SSDI benefits. You can also apply in person by making an appointment at your local Social Security office. Once you've applied for insurance benefits, your state's Disability Determination Services Office makes the decision about your medical condition. A decision is reached by looking at your medical records and evidence from your doctors.

Need Help? Have an Attorney Review Your Disability Claim

Suppose you're considering filing a disability claim due to back injuries, spinal cord injuries, an amputation, or a traumatic brain injury resulting from an auto accident. Whether you seek benefits through your employer's disability insurance or Social Security for your car accident injuries and impairments, your situation may require legal expertise from a disability lawyer.

Have an attorney experienced in disability benefits review your claim and provide legal advice to you as an accident victim. An attorney can also help you determine whether you have a related personal injury claim.