Eligibility and Early Stages of the SSDI Claim Process

Ian C. Langtree - Writer/Editor for Disabled World (DW)
Published: 2010/05/25 - Updated: 2024/08/31
Publication Type: Informative
Topic: Disability Insurance - Publications List

Page Content: Synopsis - Introduction - Main

Synopsis: Examining the early stages of the SSDI application process including eligibility determinations. One of the most common questions we are asked is who determines whether or not I am eligible for SSDI benefits?

Introduction

Most social security disability claimants have neither the knowledge nor the understanding of how the SSDI claims process works, hence the need for the assistance of an experienced disability attorney in order to help you with the early stages of the SSDI claims process. There are numerous questions that claimants need answered when they are at this stage of the process, one of which is who actually determines whether your medical condition has disabled you to the extent that you can no longer work and perform everyday tasks.

Main Item

Ironically, whether or not you are eligible and qualify for SSDI benefits is not determined by the SSA or one of their adjudicators. This responsibility normally falls into the hands of a 3rd party or outside agency in your state, and they will determine if you do qualify for benefits at this stage in the application and claims process. This portion of the process follows your claim for a disability classification.

How does the eligibility determination process work?

One of the most common questions we are asked is "who determines whether or not I am eligible for SSDI benefits".

The agency in your state that normally makes this determination is known as the Disability Determination Service. They are responsible for making the initial decision where your disability benefits are concerned once you have been diagnosed with a disabling medical or mental condition. Interestingly enough, the Federal Government's laws and regulations which govern eligibility are the same as those of your home state.

Once the decision has been made by the state authority reviewing your claim it is then forwarded to the Social Security Administration who will eventually contact you regarding the decision on your claim. It is up to the state authority to initially determine and confirm whether or not you have been rendered disabled and unable to work based on the medical and/or mental condition you are suffering with.

The next question we are normally asked is who is responsible for rendering the final decision on my claim?

A DE or Disability Examiner is the person that this responsibility falls on the shoulders of. The DE normally works hand in hand with a Medical Consultant when reviewing your case. Initially, these are the people involved in the determination of eligibility process where you SSDI claim is concerned. Just remember that up to 75% of the initial applications get denied, so don't let this discourage you.

Related Information

• Compassionate Allowances List for Social Security: Social Security Compassionate allowance benefits are fast-tracked for diseases and medical conditions that invariably qualify under the listing of impairments.
• How to Get and Not Lose SSDI: This article outlines how to get SSDI benefits and what can deprive you of the right to receive this money.
• SSDI Claims: Consultative Examinations: Consultative examinations are sometimes requested in an effort to obtain the opinions of outside medical professionals in order to evaluate disability claims.
• Factors For Winning SSDI Claims: Age, Employment, Education: SSDI Judges will consider information into their decision-making process, including your age, your work history background, and your level of education.
• Working After SSDI Approval - Disability Employment: This article reviews the basic social security rules concerning earnings after a finding of disability.
• SSI and SSDI Benefits for Children with Disability: Children who are diagnosed as disabled may be eligible for SSI or SSDI benefits.
• Social Security Video Hearings for Disability Cases: Video hearings may help with the backlog of SSA disability cases caused by increased demand inadequate funding and under-staffing.
• Importance of Medical Records in SSDI Claims: A critical factor involved in evaluating SSDI benefits is medical evidence presented on your behalf.

Author Credentials: Ian was born and grew up in Australia. Since then, he has traveled and lived in numerous locations and currently resides in Montreal, Canada. Ian is the founder, a writer, and editor in chief for Disabled World. Ian believes in the Social Model of Disability, a belief developed by disabled people in the 1970s. The social model changes the focus away from people's impairments and towards removing barriers that disabled people face daily. To learn more about Ian's background, expertise, and achievements, check out his bio.