Thank you to everyone who attended our SSDI webinar on Dec. 14! Led by T.J. Geist, Principal Advocate at Allsup, the webinar addressed everything you need to know about applying for Social Security Disability Benefits. Moderated by U.S. Pain Foundation CEO, Nicole Hemmenway, the webinar gave attendees insightful information on the SSDI application process, how to determine eligibility, the information to provide, the steps involved and the resources available to help navigate this often complicated and long process. A full recording of the webinar is available here.
36 million people miss work each year because of a pain-related condition with 20% taking disability from work because of pain. Almost 2 million people apply for SSDI benefits each year with 30% denied for technical reasons. The process for applying for benefits is often lengthy, with some claims taking up to three years to reach a final determination. COVID-19 has impacted that review process, due to long-term COVID symptoms which can include persistent fatigue, shortness of breath and migraine.
“The process of applying for SSDI benefits is complicated and can be frustrating for anyone trying to navigate through it,” stated Hemmenway. “We know that COVID has delayed an already lengthy application review process, but for those suffering from long haul COVID, it has added a level of eligibility that did not exist before the pandemic, resulting in more people applying for such benefits.”
Geist pointed out that one of the most important steps an applicant should take is to document. Document all symptoms document each doctor’s visit, pain management, and anything else that can support a claim for benefits. He recognized that for many patients, telehealth visits have become more common than in-person given the pandemic. With telehealth comes challenges, such as limited observation by a physician, or treatments a patient might receive in the office.
“Continue to see your doctor regularly via telehealth; it is very important to explain everything – all limitations, all symptoms- so that your doctor can document them,” explained Geist.
The webinar followed an in-depth article series developed by the U.S. Pain Foundation and Allsup aimed at helping prospective applicants understand the In’s and Outs of SSDI, how COVID-19 has impacted eligibility for some suffering from long-haul COVID and Ticket To Work, a program designed at helping beneficiaries regain financial freedom. Each article is available below.
Succeeding With Your Social Security Disability Claim: Q&A from U.S. Pain Foundation Webinar
U.S. Pain Foundation hosted a Dec. 14 webinar on “The Ins and Outs of Getting Approved for SSDI Benefits with Pain-Related Conditions,” and the following are responses to attendees’ questions by Allsup Principal Advocate T.J. Geist. Learn more by viewing the webinar online.
1) In your experience, how valuable is doing a CPET test to making a successful SSA disability case?
A successful disability case is dependent upon objective evidence. More specifically, the Social Security Administration (SSA) needs medical records documenting medical signs and laboratory findings from an acceptable medical source to establish a severe medically determinable impairment. If a CPET test is relevant to your disabling impairment and shows it to be severe, it could improve your chances of a successful outcome. This means it could be valuable, depending on the specific disability you are claiming.
2) If someone is successful in obtaining SSA disability, what should one do to ensure that follow-up reviews are also successful?
SSA is required to periodically perform a medical continuing disability review (CDR) on everyone receiving Social Security disability benefits. These reviews can occur anywhere from 6 months to 7 years after the date of the disability determination. The disability award notice by the SSA will specify when this review will occur, and the frequency depends on the expected improvement of your impairment. In order to ensure these reviews are successful, you should continue to see your doctors on a regular basis so there is continued documentation of your severe impairment. When SSA contacts you about the review, respond promptly to requests to complete information and reach out to your doctors to let them know they will be receiving requests for records.
The Ticket to Work program is available for disability beneficiaries who would like to attempt to return to work. The Ticket to Work program allows you to attempt to gradually reenter the workforce while protecting your disability benefits. If you assign your Ticket to an Employment Network (EN), you are exempt from CDRs as long as you are making progress toward returning to full-time work.
3) For SSDI, how much impact does it have when filing a claim if I am also receiving income via an insurance provider long-term disability policy? Is that something seriously weighed when filing for SSDI? Is that something I’d want to inform with my paperwork?
Private long-term disability income does not have an impact on SSDI. However, most long-term disability policies do require that you file for SSDI because these private plans are designed to coordinate with SSDI benefits, and they usually have offset provisions should you be approved for SSDI benefits, so you will want to consult with your insurance provider.
On the disability application, SSA asks if anyone else has medical information about your condition and specifically mentions insurance companies who have paid you disability benefits as an example. SSA will request medical evidence from your long-term disability provider, along with evidence from your other treating sources. Note: Long-term disability policies and SSA do not define disability the same way. SSA will make their own evaluation of the evidence to determine whether you meet the definition of disability under their rules.
4) Can you receive SSDI if you are already on Social Security and become disabled?
If you are receiving Social Security retirement benefits, you can apply for SSDI if you become disabled prior to reaching full retirement age. Since taking Social Security retirement early results in a reduction in monthly benefits, a subsequent SSDI approval might result in an increase in your monthly benefits. It’s a good idea to talk with an expert on the SSDI program to evaluate your options.
5) Is there a difference in the amount you get when you change from SSDI to SSI when you get to retirement age?
Generally, there is not a change in your benefit amount when you reach retirement age.
6) Is the SSA freeze also retroactive up to 12 months?
The SSA freeze applies for the entire period of disability, starting with the date SSA establishes the disability began.
7) Are you eligible for SSDI if you can work, but not at a job in your field that offers enough to support you, or only part-time work in your field due to illness? I’ve lost several jobs because I can’t work in my field full-time.
Whether or not you can find work in your field is not relevant in an SSDI claim. If SSA finds that you can physically or mentally sustain work, you will not be found eligible for SSDI. Depending on your age, SSA may also find that you have transferable skills to perform other work, even if you have never performed that type of work. Additionally, if you are engaging in Substantial Gainful Activity (SGA), even if it is only on a part-time basis, SSA will consider you working and you will not be eligible for SSDI. SGA for 2021 is $1,310 and $1,350 for 2022. However, SSA does consider whether or not you are able to sustain work on a “regular and continuing basis”, which is defined as 8 hours a day, 5 days a weeks, or an equivalent work.
8) What happens if I get approved for SSDI in one state and then move to another state?
SSDI is a federal program, so moving to another state has no impact on benefits.
9) What if you can’t find a doctor in your area that’s knowledgeable enough about your condition to provide adequate documentation for SSDI review/approval?
It is important to have a doctor’s agreement regarding your medical condition and medical records that validate your claim for disability benefits based on that condition. If you cannot find a physician to verify treatment, you may have difficulty with your claim. In addition, if SSA does not have adequate documentation to make a determination, they may schedule you for a Consultant Exam (CE) with one of their doctors.
10) Do you have strategies for how to approach new doctors if you have to relocate in order to keep SSDI benefits?
Establish care with your new doctors as soon as possible to limit gaps in your medical records and continue to see them on a regular basis. Current and up-to-date records are important for documenting the continued severity of your ongoing medical issue. When SSA performs a CDR, they will ask for updated medical records to ensure that your impairment has remained at the same level of severity.