How to Apply for Social Security Disability (and Appeal a Denial)

Social Security pays monthly benefits to people who can't work because of a serious medical condition expected to last at least a year or result in death. Getting approved takes patience, good medical evidence and attention to deadlines.

Two programs

• SSDI (Social Security Disability Insurance) is for people who've worked and paid Social Security taxes long enough, and recently enough, to be insured. Benefits depend on your earnings history. Medicare eligibility generally follows after a waiting period.
• SSI (Supplemental Security Income) is need-based, for people with very limited income and assets, regardless of work history. It usually comes with Medicaid.

Some people qualify for both.

How Social Security decides

It uses a five-step evaluation:

1. Are you working above the "substantial gainful activity" earnings level? If so, you're generally not disabled.
2. Is your condition severe enough to significantly limit basic work activities?
3. Does it meet or equal a condition in Social Security's listing of impairments?
4. Can you do your past work?
5. Can you do any other work, considering your age, education and skills? Age matters a lot here; rules are more favorable for people over 50.

Applying

Apply online, by phone or at a local office. You'll need your medical providers, treatment dates, medications, test results and work history for the past several years. The strongest applications have consistent medical treatment and doctors' records that describe specific functional limits, such as how long you can sit, stand or lift.

If you're denied, appeal

Many first applications are denied. Don't start over; appeal. You generally have 60 days (plus mailing time) at each stage:

1. Reconsideration, a fresh review.
2. Hearing before an administrative law judge, where many claimants have their best chance. You can testify and present new evidence.
3. Appeals Council review.
4. Federal court.

Filing a new application instead of appealing can cost you months of back pay.

Lawyer fees

Disability lawyers and representatives work on contingency, and their fee is set by federal law: generally 25% of your past-due benefits, up to a dollar cap that Social Security adjusts periodically, and approved by Social Security. If you don't win, you typically owe no fee, though you may owe for costs like medical records.

Find a Social Security disability lawyer near you.

This guide is general information, not legal advice. Check ssa.gov for current rules and amounts.