SSDI Resources of Interest

nyanko_the_sane

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I created this thread to share information I found useful in my quest for SSDI benefits. Please feel free to post additional resources or ask related questions.

Almost Everything in a nutshell:
As the title implies, this article outlines what you need to know about SSDI, Social Security Disability: Everything You Need to Know

The SSDI Process:

Here is an SSA presentation on The Sequential Evaluation Process. This is the process that is used by the SSA to determine if you are disabled.

The SSA Blue Book is a listing of medical conditions and criteria used to determine disability. If your medical conditions are found in the blue book, there is a good chance you can be found disabled.

The SSA Grid is used to determine the kind of work you can do, if any, based on your RFC. Your age, education, and past work is used to determine if you are disabled. As you will find, the younger you are the more difficult it is to prove disability using the SSA grid.

Often times at a hearing before an ALJ, a vocational expert is present. SSA will tell you if a vocational expert will be at your hearing. If you want to learn more about their role in the process, here is the Vocational Expert Handbook.

Even an ALJ makes mistakes, if you can catch any mistakes in an unfavorable decision, it can make it possible to successfully appeal. Top Ten Mistakes Social Security Makes on Your Disability Case That Get Your Case Remanded

Qualifying for Medicare:

When you receive SSDI you also qualify for Medicare after two years of disability. This article outlines some of the details you need to know: Does someone on Social Security disability get free Medicare? Want even more details, read the following SSA publication: How You Earn Credits

Working While Receiving SSDI Benefits:

If you find your condition has improved enough for you to work, here is a useful page on SSA's Trial Work Period.
Here is an informative FAQ on How Self-Employment Affects Social Security Disability Benefits.
 
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nyanko_the_sane

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Tips for the Win

A solid disability case needs as much objective evidence as possible to support the medical opinions of your doctors. Your physical as well as your mental health will be considered. The SSA's blue book can help you identify conditions that will help you secure a favorable decision. ME/CFS is not in the blue book, but many of the underlying conditions are. It is important to indicate in your evidence whether treatments you tried had debilitating side-effects.

Just because your doctor states you are disabled, means nothing to the SSA. Only the SSA can decide if you are disabled. What is important is that the evidence be consistent in how it describes your disabilities and limitations. This means your healthcare professionals and even your friends/family should all be on the same page, if they are providing evidence. An ALJ will not hesitate to use an inconsistency against you. To prevent unfortunate surprises make sure you look at your doctors detailed notes, this is of utmost importance.

An ALJ can decide you are not disabled by stating that jobs exist that are within your residual functional capacity (RFC), they are required to identify at least three jobs. It does not matter to the SSA, if you can't find these jobs, are not hirable, or are too disabled to do the work. This is why it is important to have a good advocate that knows the law because they can cross-examine the vocational expert. A finding of no work is the desired outcome.
 
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Second star to the right ...
This is a lovely service to this community, and it clearly was a time, energy, and mental energy-consuming undertaking.

I know there are many members here who have tried and failed, and tried again and failed, and tried again to get approved for disability. They had no guide, and in at least 2 cases that I remember reading about here, their legal advocate was sub-par and not particularly engaged or interested in their case or its outcome.

This guide that you have created will be invaluable to them, and to who knows how many others in the future, and it's a huuuuuuge contribution to the wellbeing of innumerable members here, past, present, and future.

Am tagging in @PatJ , who might want to include this in his newcomer's welcome, if he feels that's appropriate. @Howard might also be interested .....

Thank you @nyanko_the_sane for going so far above and beyond in doing this for our community :hug::hug::hug:!!!
 
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nyanko_the_sane

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Tips for the Self-Employed

If you are self-employed don't cheat yourself out of benefits, pay your self-employment tax! If you are anything like me, you are always looking to find ways to save. Unfortunately this can lead to problems in the future especially if you need to file for disability. Having too many $0 tax years is very bad, as it not only reduces the amount of your benefits, it can also mean having to pay for your Medicare part A coverage.

If you suffer from brain fog, you may not be well enough to prepare your own business tax returns every year. In order for you to receive your Social Security and Medicare credits, you need to file and pay within three years, three months, and 15 days after the close of the preceding calendar year. After this date those credits are gone forever, so get some help and file those late returns!
 
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nyanko_the_sane

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When to Apply for SSDI Benefits

The earliest you can apply for SSDI benefits is when your impairments have lasted or are expected to last for no less than 12 consecutive months. When applying for benefits there are three specific dates to consider. Firstly is your Date First Insured (DFI) this is the first day you are deemed insured and eligible for SSDI benefits. Secondly is the date you became disabled, this the Alleged Onset Date (AOD) which can not be before your DFI. As of your AOD, you must no longer have Substantial Gainful Activity (SGA). Thirdly is your Date Last Insured (DLI) this is the date your coverage lapses, you must apply for benefits on or before this date. To determine your DFI and DLI, contact the SSA. But remember, don't wait too long to file for your disability benefits.
 
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nyanko_the_sane

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SSI Benefits

The Supplemental Security Income (SSI) program is for those that may not qualify for SSDI benefits because of a limited work history or lapsed SSDI coverage. SSI recipients receive fixed monthly payments that are federally funded. Additional SSI supplement payments are made by most states. It is possible that some may qualify for both SSI and SSDI benefits. Eligibility for the SSI program is fairly complex. Those that qualify for SSI benefits may also qualify for many low income programs, such as Housing Choice Voucher, Medicaid, Supplemental Nutrition Assistance, energy discounts, free cellphones, reduced cost Internet, 50% off Amazon Prime, among others.
 

nyanko_the_sane

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SSDI and Taxes

There are two things to consider when planning for your tax return after you start receiving SSDI benefits.

The first is to figure out if all your income makes your initial lumpsum large enough to be taxable. If it is and you were paid for a few years of backpay, there are methods to divide your lumpsum income over those past years. Learn more: How Is Social Security Disability Backpay Taxed?

The last is whether your state will tax your SSDI benefits. SSDI benefits are tax exempt in most states.
Learn more: Does My State Tax Social Security Disability Benefits?

Information about tax rates on SSDI income: Are Social Security Disability Benefits Taxable?

Need to break the IRA piggy bank early:
The Disability Exception to the Early Distribution Penalty Tax for Retirement Accounts

Many municipalities offer property tax exemptions to the disabled. Check with your local property tax collector's office to see what tax breaks are available for you.

Bonus fact:
Owe money to creditors? Don't worry, they can't touch your SSDI or SSI benefits.
 

Pyrrhus

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And here is some SSDI advice from another thread:

Please read the sleepy girl website for details on applying for SSDI. Lots and lots of good information.
https://howtogeton.wordpress.com/social-security-disability/

It is really important that you have one or more doctors supporting you. The more out of range tests you have that support your diagnosis the better. Multiple diagnosis even better. e.g. Mast cell? SIBO? Small fiber neuropathy? Cognitive testing? etc.

Pull your medical record and create a summary of the main points in your record that will support your case. For this you normally have to make a written application to your medical group to get all the notes, not just the ones your doctor lets you see in their health system.

For the first stage you can do the application yourself. 90+% are denied straight away unless it is really really really obvious you cannot work. Most people normally go through one or more appeals process, that's when a lawyer can be helpful I think.

Here is the SSDI document for ME/CFS.
https://www.ssa.gov/disability/professionals/documents/64-063.pdf

These are good articles written last year by an ME patient.

https://themighty.com/2020/11/covid-19-long-haulers-disability-benefits/

https://chronicallycaroline.com/2020/11/29/10-tips-for-long-haulers-seeking-disability-benefits/

https://chronicallycaroline.com/202...ter-helped-me-to-win-my-ssdi-case-for-me-cfs/
Some good resources on the Massachusetts ME/CFS & FM Association Disability page.
https://www.massmecfs.org/disability
on YT there is a lawyer that talks about this. Her name is Nancy Cavey. I'm not sure where she handles cases but it sounds like she does actually take ME/CFS SSDI cases.

There is another attorney, Jonathan Ginsburg, that talks about Fibromyalgia cases. He's very honest about what it takes to get onto SSDI with such a diagnosis. You could look for others there too but I did not see too many--not for SSDI anyway. When I was trying for it, I watched a lot of his videos. He explains things very well.
 

nyanko_the_sane

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gbells

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Good article.

An ALJ will not hesitate to use an inconsistency against you.
I went through this for four years (2008-2012) and won at appeal after the ALJ hearing. Social Security's goal is to deny, make you homeless and kill you off and they look for any way to do this that is allowed. Some ways they use are technical disqualifications, too much earned income, insufficient months worked, declaring your physicians not credible, highlighting contradictions in your testimony to destroy your crediblity, assuming non-complaince with medications, etc. That judge's job is to find a way to deny you and they are rated on how many cases they approve (see this disability judge rating website for each judge's history of approvals).

Typically Administrative Law Judges dismiss 20% of cases on technicalities, deny half of the remaining cases (40%) and approve 40%. If your individual judge consistently approves more than 40% they are considered lenient. My judge had a fairly good record and only denied around 20% but he still denied me initially after the ALJ hearing (before I had neuropsychological testing). That is how hard it is to get SSD for ME.

They also use the long, drawn out process to stretch your finances to the breaking point in case you don't have good budgeting sense and haven't planned for a long fight.

I have met numerous homeless people who were denied disability by them and the average homeless person only lasts 10 years on the street then dies so improper denial of disability is a eugenic death sentence. I was only approved as a mental patient (not ME) for undifferentiated somatoform disorder due to neuropsychology testing for the ME symptom of poor memory (forgetfullness and difficulty word finding) and my attorney said that they are biased against young males (I was 38 at the time with a big student loan balance that they didn't want eliminated) because they hate paying extended claims and I was lucky to get it. The judge grilled me for 10 minutes about my student loans because he thought I might be faking to get out of them despite having been terminated from two $72k/yr CNIM technologist jobs for impaired work performance related to ME (difficulty concentrating, impulsiveness, impaired dexterity from lost of coordiation and slowness from fatigue) and on track to make $100k/yr as a DABNM neuromonitoring expert. Because the examiner was a PhD psychology instructor at a state medical university they couldn't contest her opinion. Every other physician, including their own medical examiners, were eventually deemed not credible in the final verdict.

My mother's physician remarked that SSA typically grills any type of claim except mental disabilities. At the time I was ardent about being truthful and confident that I could win with my ME diagnosis. I was insulted when I was diagnosed with a mental condition that didn't make sense based on the timing of my stress because it came after the ME diagnosis. I was wrong. The only reason I won was because of the neuropsychology exam and I am now happy to have gotten it because it allowed me to survive. My savings had been drained from $30k to $7k over all the medical and dental expenses (I lost six teeth due to impaired immunity) even living in public housing for the minimum $50 per month rent. For all I cared they could diagnose me with broccoli disorder and say I was a vegetable if it won the claim. I was fighting to survive against a corrupt system.

I think they like to approve mental claims if they can't get a denial because it allows the insurance industry to get out of paying long term disability claims after two years on the mental disorder disallowance limitations clause. It shows how much control the insurance lobby has over the US government.

Only 15,000 ME patients get SSA disability out of 2.5 million in the USA. I think the only way most ME patients get it is if they have a decent case file, induce pity in the judge and they have affinity for them and/or see a ME specialist who meticulously tests and documents their case. Those cost a lot and don't take insurance so I didn't hire one. Their treatment results aren't much better than general MDs so I couldn't justify the expense. If you have significant cognitive dysfunction from ME (most people do) get the neuropsychology testing. Mine was fully paid for using charity care at the state medical university hospital. If it shows any diagnosis on the List of Impairments and you don't have a technical disqualifier it is an automatic win. However, the downside is that if you have a long term disability policy they won't keep paying after two years.

Also for those with student loans, they are easy to get forgiven through a diasability discharge, though they probably will make you apply twice through the US Dept of Ed failing to submit your paperwork to the Nelnet servicer (intentional rejection delay). However, if you lose the SSA disability claim they reinstate the loans. As I said, forcing you to keep the debt and preventing insurance companies from paying long term claims are the primary motivators of Social Security.

My mother had $15k in student loans from a shady nursing program. We discussed it and I advised her not to file for disability since it could jeopardize her student loan discharge. Had she lost they would have deducted it from her SSA retirement benefits until she died. She ended up getting early retirement and living on HUD project based voucher and food stamp assistance.
 
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nyanko_the_sane

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They also use the long, drawn out process to stretch your finances to the breaking point in case you don't have good budgeting sense and haven't planned for a long fight.
I seriously thought I was going to have to dip heavily into my retirement savings. From start to finish my SSDI case took exactly 22 months to win in 2020. The average wait time was estimated to be 27 months in 2019.
 
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I read that if you've never had a job, you can't apply for SSDI. Is it true that you can only get SSI if you've never worked, and you can't get on Medicare? That doesn't seem right, but few people who get on disability after the age of 18 have no employment history, so there may be a strange exception.
 

Wayne

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Sounds like a good change is in the works at Social Security, which may bode well for those attempting to get disability benefits. I still thank my lucky stars I was able to get SSDI without major roadblocks back in 1997 (I'm now getting retirement benefits). It took a couple of years to finally get it, but it made a huge difference for me that I was able to get that (fairly minimal) monthly income.

Biden fires top official at Social Security Administration after he refuses to resign

(CNN)President Joe Biden on Friday fired Social Security Commissioner Andrew Saul after he refused to submit his resignation as the President had requested, a White House official told CNN.​
Biden had asked for the top two officials at the Social Security Administration to submit their resignations, the White House official told CNN, but only Saul refused. Deputy Commissioner David Black agreed to submit his resignation, the official said, and it was accepted.​
"Since taking office, Commissioner Saul has undermined and politicized Social Security disability benefits, terminated the agency's telework policy that was utilized by up to 25 percent of the agency's workforce, not repaired SSA's relationships with relevant Federal employee unions including in the context of COVID-19 workplace safety planning, reduced due process protections for benefits appeals hearings, and taken other actions that run contrary to the mission of the agency and the President's policy agenda," the White House official said...​
 

rel8ted

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I read that if you've never had a job, you can't apply for SSDI. Is it true that you can only get SSI if you've never worked, and you can't get on Medicare? That doesn't seem right, but few people who get on disability after the age of 18 have no employment history, so there may be a strange exception.
You have to pay into social security to get SSDI. Otherwise, you are only eligible for SSI, that is correct. It’s not a strange exception because you haven’t paid into the plan.
 

Pyrrhus

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And this is a reminder that the non-profit Workwell Foundation in California offers diagnostic CPET testing specifically for Social Security Disability Insurance (SSDI) applications:
https://workwellfoundation.org/testing-for-disability/#brochure

Workwell Foundation said:
Considered by many of the major medical organizations to be the gold standard for determining disability, cardiopulmonary exercise testing (CPET) uses objective measures to accurately assess an individual’s capacity for work. It is applicable to any condition where fatigue and reduced functioning are present. CPET can also assist in diagnosing a variety of medical conditions. The 2 day testing protocol is particularly helpful in documenting post-exertional malaise (PEM) and symptom exacerbation following physical activity. Testing is performed on a stationary bicycle with resistance added incrementally to keep tests approximately 8-12 minutes. It is very rare for a patient not to complete the test. Because CPET results are virtually impossible to fake, they can be a valuable adjunct to any medical and/or legal argument.