The SSDI Podcast - EP8

Speaker 1 0:00
All right, buckle up, everybody, because today we are diving deep into the sometimes murky waters of Social Security, disability insurance.

Unknown Speaker 0:08
Yeah, those waters can get pretty choppy. We’ve

Speaker 1 0:10
got some great excerpts here from the Laporte law firms article. It’s called, how does the SSA determine if you are eligible for SSDI? And let me tell you, it can be a real headache trying to figure this stuff out on your own.

Speaker 2 0:25
Definitely, it’s a lot to process, a lot of rules and regulations, but that’s why we’re here, right? That’s right, yeah,

Unknown Speaker 0:30
break it all down. Exactly

Speaker 2 0:31
no more head scratching. We’re gonna make it clear as day. So. You know, lots of people think SSDI is just about having a medical condition, but there’s way more to it than that. Oh, absolutely.

Speaker 1 0:41
It’s not just, oh, I’m sick. You know, it’s really about how that condition impacts your ability to work, to hold down a job,

Speaker 2 0:49
exactly. You could have a diagnosis, but if you could still work. SSDI isn’t really the right program,

Speaker 1 0:54
right? It’s meant to be a safety net for those who can’t work because of a disability, and it can be a real lifesaver for those folks, especially when you consider that the average SSDI payment as of January 2024 is around $5,537.03

Speaker 2 1:10
per month. Oh, it’s, uh, yeah, definitely a significant amount of money, especially when you’re dealing with medical bills and you’ve lost your regular income. Okay,

Speaker 1 1:17
so let’s get down to brass tax, the Social Security Administration, the SSA has this five step evaluation process to decide who gets approved for SSDI benefits. Five steps, five hurdles to clear. You might say, I like that hurdle number one is simple, right? Are you working? Well,

Speaker 2 1:34
it sounds simple, but there’s a catch. Oh, there’s

Unknown Speaker 1:37
always a catch, isn’t there? The SSA,

Speaker 2 1:39
they look at your income. If you’re making more than $5,550 a month in 2024 that’s considered what they call substantial gainful activity, or SGA, for short. SGA got it, and if you’re above that limit, you won’t

Speaker 1 1:52
qualify. Wow. So even if you’re working part time, just barely scraping by, but you’re over that SGA limit, you’re out

Speaker 2 1:57
of luck. It’s tough, but yeah, that’s how it works. The SSA is focused on whether you can sustain full time employment. Okay,

Speaker 1 2:04
on to hurdle number two, then, is your impairment severe? But what does severe actually mean in this context? It’s

Speaker 2 2:13
not just a matter of having a doctor’s note saying, you know you’re under the weather, your condition has to seriously limit your ability to perform basic work tasks, makes sense. And here’s the kicker, it has to have lasted, or be expected to last for at least 12 months. That’s key. 12

Speaker 1 2:30
months, that’s a long time, especially when you’re already struggling. I guess that really shows how SSDI is designed for long term disabilities, right? Not

Speaker 2 2:38
just, you know, a temporary setback or short term illness.

Speaker 1 2:41
Okay, I thought that trips some people up. You know, filing too soon before that 12 month mark. Oh,

Speaker 2 2:46
absolutely. Timing can be everything with SSDI, and it’s easy to understand why folks would want to file right away,

Unknown Speaker 2:51
totally, especially when they’re in a tough spot. Can you give us an example of how that timing thing plays out?

Speaker 2 2:56
Sure. Let’s say we have two people, Carly and Steven. They both had the same surgery of spinal fusion, let’s say in February 2024 the surgery meant they both had to stop working back in January. Now, Carly, she was eager to get the ball rolling, so she filed for SSDI immediately makes sense. Steven, on the other hand, he decided to wait a bit and filed in July. Okay, so what happened? Well, because of the way processing times work. Carly got her decision first, and it was a denial. Oh no, yeah. See, she hadn’t quite hit that 12 month mark of being unable to work yet, I see, but when Steven’s application was reviewed, it was clear that his recovery was taking longer than expected. He had been disabled for well over 12 months at that

Speaker 1 3:39
point. So he was approved Exactly. Wow. That’s a great illustration of how important that 12 month rule is. Timing

Speaker 2 3:45
can be everything sometimes Patience is key with SSDI.

Speaker 1 3:49
All right. Well, let’s move on to hurdle number three. This one’s all about whether your impairment meets or equals a listing. What in the world does that mean?

Speaker 2 3:58
Well, you see the SSA has this big, comprehensive list of impairments they consider severe enough to automatically qualify you for SSDI,

Unknown Speaker 4:06
oh, so like a master list of conditions? Yeah,

Speaker 2 4:09
it covers all sorts of physical and mental conditions, and they call it the listing of impairments. So

Speaker 1 4:15
if your conditions on that list, you’re golden, right? Automatic approval,

Speaker 2 4:19
not quite it’s not that simple. Meeting a listing is actually pretty tricky. Oh, how so well you need very specific medical evidence, evidence that checks all the boxes for that particular listing.

Speaker 1 4:33
So more than just, hey, I have this diagnosis, right? You got to prove the severity

Speaker 2 4:36
of your condition, how it impacts your ability to work, you know all the details. So they

Speaker 1 4:41
really scrutinize those medical records. Even if your condition is on the list,

Speaker 2 4:45
absolutely, they want to be sure your condition truly prevents you from working. They’re looking for strong evidence.

Speaker 1 4:51
So even if your condition doesn’t match a listing perfectly, there’s still hope, right?

Unknown Speaker 4:56
You bet that’s where hurdle number four comes in. Yeah, can you do your past work? Work. All right, that one

Speaker 1 5:00
seems a little more straightforward. You know, if your disability prevents you from doing your old job, you need SSDI, logically,

Speaker 2 5:08
yes, but remember, the SSA has its own rules, its own way of doing things, and in this case, they’re only looking at your work history for the past five years. Five years, I thought it used to be 15. You’re right. They changed the rules recently. Anything beyond that five year window? Well, it’s not really relevant to their evaluation. Wow,

Speaker 1 5:28
that’s a big change that could really affect some people,

Speaker 2 5:31
definitely, yeah, especially for folks whose disability would make it impossible for them to go back to a job they had years ago.

Speaker 1 5:37
So how do you accurately describe your past work to the SSA, any tips?

Speaker 2 5:42
Well, first off, don’t inflate your job title, so be honest Exactly. Focus on the actual tasks you performed day to day. You know, if you were a cashier, but your title was customer service representative, tell them about the actual work you did.

Speaker 1 5:56
Don’t try to make it sound fancier than it was, right? Don’t exaggerate. I get it, because they might make assumptions about a certain job title that just aren’t accurate

Speaker 2 6:04
Absolutely. And another thing be specific about the physical demands of your past jobs. Oh,

Speaker 3 6:09
right, like lifting, standing, that sort of thing, exactly if you were

Speaker 2 6:13
a construction worker and only had to lift heavy stuff occasionally, you got to be upfront about that paid a complete and accurate picture. Yeah, no sugar coating. No sugar coating. Got it right. The more accurate and detailed your description, the better the SSA can assess whether you could actually go back to that kind

Speaker 1 6:31
of work. Okay? So no fibbing honesty is the best policy, exactly.

Speaker 2 6:35
And if the SSA agrees that you can’t do your old job, then it’s time for the final hurdle. Bring

Speaker 1 6:41
on hurdle number five, the last challenge before those sweet, sweet SSDI benefits, right?

Speaker 2 6:48
That’s right. And this was all about whether you could do any other kind of work. Okay, see if the SSA decides you can’t do your past work, they then have to prove there are other jobs out there that you could do considering your limitations.

Speaker 1 6:59
Oh, so it’s not just about proving you can’t do your old job. You gotta show that

Speaker 2 7:03
your disability keeps you from working any job that sounds really tough you can be, and your age well, plays a big role in this. Really?

Unknown Speaker 7:12
How so? Well,

Speaker 2 7:13
if you’re under 50, the SSA, they’re less likely to believe that you can’t work at all. Oh, interesting. The thinking is that younger people can, you know, adapt more easily, learn new skills. So

Speaker 1 7:24
if you’re younger, it’s harder to qualify. Doesn’t seem very fair. I know

Speaker 2 7:27
it can feel that way. So how do they make that decision? Well, they have these guidelines. They call them the grid rules. And these rules, they take into account your age, education, work experience, and the severity of your disability,

Speaker 1 7:41
all of it, wow, that’s a lot of factors. It’s like a giant equation,

Speaker 2 7:45
right? A complex calculation. And that’s often where having a disability lawyer can be so helpful, they can really help you navigate those complicated rules, make

Speaker 1 7:52
sure your application is as strong as it can be, exactly.

Speaker 2 7:55
Okay? So we’ve cleared all five hurdles, right? We’ve covered SGA limits, that 12 month rule, how to approach the SSA, listing of impairments, accurately describing past work and how your age can impact your case. Phew,

Speaker 1 8:10
that was a lot. My head’s spinning. And that’s just the basics. It is

Speaker 2 8:14
just the beginning. Remember the SSDI process. It’s notoriously complicated,

Speaker 1 8:19
and you said the denial rate is really high. Something like two thirds of applicants are initially denied, right? Yeah,

Speaker 2 8:24
it’s tough, but a denial doesn’t always mean the end of the road. Yeah, you have the right to appeal.

Speaker 1 8:30
Oh, that’s good to know, but that probably adds even more complexity, right? It does, unfortunately. And the wait time for a decision, even without an appeal, is how long seven months.

Unknown Speaker 8:40
That’s the average. Yeah, seven long months. Wow.

Speaker 1 8:43
So it’s really important to understand the process, to have the right support absolutely

Speaker 2 8:48
well. I think this is a good place to pause for a moment. We’ve covered a lot of ground,

Speaker 1 8:53
definitely, and there’s still more to discuss, but we’ll be back soon for part two of our deep dive. Stick around. We’ll be exploring even more strategies for making your SSDI application bulletproof. You know, thinking

Speaker 2 9:06
about this whole process, it’s amazing how much emphasis is put on your medical records, right? Like that’s the real proof, yeah, it’s not just about what you say, it’s what your doctor says.

Speaker 1 9:15
So more than a doctor’s note that says, yeah, they’re sick.

Speaker 2 9:19
Oh, way more those records, they have to paint a complete picture for the SSA, everything like your doctor’s notes, the test results, the treatment plan, they want to see it all, every detail. And it’s not just physical limitations either. What else they look at, things like your cognitive abilities, your mental health, even how you’re handling pain. Wow.

Speaker 1 9:39
So it’s not just Can you lift a box, it’s can you think clearly? Can you cope with the stress of a job? Exactly.

Speaker 2 9:47
It’s a holistic view how your disability affects your life every day, and especially how it affects your ability to work.

Speaker 1 9:52
Okay, so the SSA wants the full picture. No hiding anything. Nope. Any

Speaker 2 9:57
inconsistencies between what you say and what you’re. Show that could be a red flag.

Speaker 1 10:01
So no downplaying the good days or exaggerating the bad days. Nope.

Unknown Speaker 10:05
Gotta be honest and consistent. All right, so

Speaker 1 10:07
medical evidence is key. But what about that other thing you mentioned earlier? What’s that a Social Security Disability lawyer? Can you talk more about how they can help? Oh, for

Speaker 2 10:14
sure, having a lawyer on your side that can make all the difference. It’s like having a guide, you know an advocate who knows the ins and outs of the SSDI

Speaker 3 10:22
system, so they’re not just filling out forms for you. No, no, no. They understand

Speaker 2 10:26
the whole process. They know what kind of evidence the SSA is looking for, and they know how to present your case the right way.

Speaker 1 10:34
So it’s like having a translator, someone who speaks SSA. You

Speaker 2 10:37
got it. They can help with everything, gathering the right documents, preparing for interviews or hearings, they’ll make sure your application is as strong as it can be. Okay.

Speaker 1 10:46
So it’s worth it to have that expert guidance, definitely, and there’s

Speaker 2 10:50
actual research to back that up. A study by the Government Accountability Office found that people with a lawyer, they were almost three times more likely to be approved for SSDI, wow,

Speaker 1 11:00
three times. That’s a huge difference, and I bet it takes a lot of the stress off your shoulders, knowing you’ve got a pro in your corner absolutely

Speaker 2 11:07
lets you focus on what’s important, your health and recovery, while someone else handles the paperwork and the red tape.

Speaker 1 11:13
So what happens if your application is denied? You mentioned appeals earlier, but that probably adds another few months to the wait time, right? Yeah,

Speaker 2 11:21
appeals can take a while, but the good news is you have the right to appeal if you’re denied,

Unknown Speaker 11:25
so it’s not over till it’s over, right? It’s

Speaker 2 11:28
like hitting a roadblock, yeah, you just need to find a detour. No? And having a lawyer by your side during the appeals process, well, that can be crucial.

Speaker 1 11:36
I bet they know how to navigate those twists and turns. They do. They can help

Speaker 2 11:39
you gather new evidence, make sure everything’s in order, and they can really fight for your rights. Okay,

Speaker 1 11:43
so those pro tips about accurately describing your past work, that seems really important for building a strong case. It’s

Speaker 2 11:50
all about painting a clear picture for the SSA, showing them how your disability affects your ability to work. And those tips, they’re not just for people who are applying for SSDI, right now. Oh, so even if you’re just thinking about applying exactly, start keeping track of your condition now how it affects your daily life. Keep good records, because you never know when

Speaker 3 12:10
you might need them. That’s good advice. Be prepared. Yep,

Unknown Speaker 12:13
the more information you have, the better.

Speaker 1 12:15
So you’ve got medical evidence, lawyers, the appeals process. What else should we know about this whole SSDI world? Well, there’s

Speaker 2 12:22
one more thing we should talk about. It’s a different program called SSI, Supplemental Security Income.

Unknown Speaker 12:27
Okay, I’ve

Speaker 2 12:28
heard of that. What’s the difference? Both programs, they offer financial help to people with disabilities, but they have different rules for who qualifies. So like, what

Unknown Speaker 12:38
are the main differences SSDI,

Speaker 2 12:40
it’s based on your work history, like it’s something you’ve earned by paying into the system, right? But SSI, it’s needs based. They look at your income, your assets, to see if you qualify.

Speaker 1 12:51
So SSDI is for folks who’ve worked enough to be eligible, and SSI is more of a safety net for people who maybe haven’t worked enough or have very limited resources, exactly.

Speaker 2 13:00
And here’s where it gets interesting. You can actually qualify for both. Wait,

Speaker 1 13:04
really, you can get both SSDI and SSI. You can, but it’s a

Speaker 2 13:09
little more complicated because the programs have different rules and regulations, so it can be tricky to figure out if you qualify for both.

Speaker 1 13:15
And I’m sensing a theme here, another situation where a disability lawyer can be really helpful.

Speaker 2 13:21
You got it. They can help you navigate both programs and make sure you’re getting all the benefits you’re entitled to.

Unknown Speaker 13:26
Okay, so

Speaker 1 13:27
we’ve covered a lot of ground today, the five step evaluation process, the importance of medical evidence, the role of a disability lawyer, the appeals process, and now SSDI versus SSI. It’s a lot to take in.

Speaker 2 13:41
It is, but we’ve given our listeners a good overview of what to expect

Speaker 1 13:45
and remember, knowledge is power. The more you know about the system, the better you can navigate it. Absolutely, we’ll be right back with the final part of our deep dive. So stick around. We’ve got more insights to share, and we’re back for the final stretch of our deep dive into SSDI. We’ve

Unknown Speaker 14:02
covered a lot of ground, haven’t we? It’s been quite a

Speaker 1 14:04
journey, but I feel like we’re finally starting to see the light at the end of the tunnel. I

Speaker 2 14:07
think so too. We’ve definitely shed some light on the whole SSDI eligibility process, yeah. And

Speaker 1 14:12
I think it’s safe to say it’s not as scary as it seems at first, definitely not.

Speaker 2 14:16
It’s all about understanding the rules and presenting your case the right

Unknown Speaker 14:19
way and remembering that a denial isn’t the end of the world

Speaker 2 14:22
exactly. You’ve got options like the appeals process, right?

Unknown Speaker 14:26
So it’s more like a detour than a dead end. That’s a good

Speaker 2 14:28
way to put it, and that’s another area where having a lawyer can be a huge help.

Speaker 1 14:33
Yeah, they can really guide you through those appeals and fight for your rights. They’re

Unknown Speaker 14:37
like your Sherpa on this SSDI mountain.

Speaker 1 14:39
I like that analogy, speaking of which, remember that whole thing about potentially qualifying for both SSDI and SSI? Oh, yeah,

Unknown Speaker 14:47
that’s a real game changer. For some people, it’s

Unknown Speaker 14:49
like having a double safety net.

Speaker 2 14:51
Exactly if you qualify for both, you can get even more support.

Speaker 4 14:55
But I’m guessing it’s not easy to figure out if you’re eligible for both. Nope. It can be pretty

Speaker 2 15:00
complicated, but that’s where a disability lawyer can really come in handy. They can help you navigate both programs and make sure you’re getting everything you’re entitled

Speaker 1 15:08
to. So it’s all about having the right information and the right support.

Speaker 2 15:12
Absolutely. And remember that story about Carly and Steven, oh

Speaker 1 15:16
yeah, the ones who had the same surgery but filed for SSDI at different times. It

Speaker 2 15:20
really shows how important timing can be. Great sometimes it pays to wait a little bit before you file. It’s like waiting for the perfect wave to come along. You don’t want to jump in too early and wipe out exactly, and a lawyer can help you figure out the best time to file for your situation. So it’s all about being proactive and strategic, absolutely. And don’t forget, you don’t have to do this alone. There are tons of resources

Speaker 1 15:42
out there to help you, like disability lawyers and support groups exactly

Speaker 2 15:46
they can offer guidance, support and even just a sense of community. So

Speaker 1 15:50
remember, knowledge is power. The more you know about SSDI, the better prepared you’ll be.

Speaker 3 15:56
Couldn’t said it better myself. Well, that wraps up

Speaker 1 15:59
our deep dive into the world of SSDI. I hope you all learned something new today. Me too.

Unknown Speaker 16:05
It’s been a pleasure chatting with you. Likewise. And remember, if

Speaker 1 16:08
you’re thinking about applying for SSDI, don’t be afraid to seek out help. There are people who can guide you through every step of the way. So take charge of your future and don’t give up you.