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What are the basics of a Social Security Disability case?

For Massachusetts residents who are injured, ill, or are suffering from a condition that renders them unable to work, Social Security Disability (SSD) can be a lifeline. In the aftermath of discovering that work is no longer possible – at least for the foreseeable future – and that SSD might be needed, it is helpful to be aware of the steps involved in making a claim. The process can be confusing, especially for those who are already worried about what they will do to make ends meet and get the medical treatment they need. It is imperative to, from the outset, have a grasp of the basics of an SSD case.

The fundamentals of an SSD claim

People who are seeking SSD benefits must pass both the “recent work” test and the “duration of work” test. Essentially, this means that they must have been working recently before they needed SSD benefits and they must have worked long enough to qualify. The calendar of the year is split into quarters., January 1 through March 31 is the first quarter; April 1 through June 30 is the second quarter; July 1 through September 30 is the third quarter; and October 1 through December 31 is the fourth quarter. The person’s age will dictate how long they need to have worked to get SSD benefits.

The situation will determine how long the person must have worked through a certain age to get benefits. A construction worker whose birthday is in December, just turned 24 and was injured during or prior to the fourth quarter of the year must have 1.5 years of work in the prior three years to get benefits. Those seeking SSD benefits must have at least six quarters of coverage before the injury to have a chance at approval.

The Social Security Administration (SSA) will assess the application to see if the basic requirements have been met. It will also look at the years the person worked and if the person is working currently. Once these hurdles are passed, the case goes to the state’s Disability Determination Services (DDS). The applicant’s doctors will give information to the DDS for assessment. This will include the applicant’s medical condition, prognosis, tests, treatment, and more. The applicant’s ability to perform basic activities will also be discussed. If further information is needed, then a special examination might be requested.

There are five steps during which the application is evaluated. The DDS will want to know if the person is working and what they are earning; it will look at the medical condition to see if it is of sufficient severity to warrant benefits; the Listing of Impairments will be referenced to see if the applicant’s impairment matches or equals one on the Listing; the DDS will want to know if the person can do the same work he or she did before; and it will analyze if the illness, condition or injury precludes the person from doing other kinds of meaningful work. If the claim is denied, the person has four levels of appeal including asking for reconsideration, seeking a hearing before an Administrative Law Judge, going before the Appeals Council, and filing in federal court.

Having assistance may be crucial to an SSD claim

Although these rules seem straightforward, people frequently make mistakes when filing for SSD benefits on their own. It is possible to seek benefits alone and still achieve a positive outcome, it is beneficial to have professional guidance when filing a claim, addressing any issue that might arise and appealing if the initial application is denied. To ensure that a case is handled correctly and any challenge is met head-on, experienced guidance is key. Discussing the case with an advocate who is well-versed in handling SSD claims can be vital when seeking benefits.