Do I qualify for Social Security/SSI disability benefits?
Adults may be eligible for Social Security and/or SSI disability benefits if they are unable to perform past work or any other work due to their medical condition. In other words, you must be 100% disabled. To get Social Security Disability benefits, you must also have sufficient earnings to be covered under that program. To get SSI disability benefits, you must have limited income and resources. Some people are eligible for both if they are found disabled.
Children may also receive Social Security and/or SSI disability benefits if they have a severe impairment that very seriously limits his or her activities. In general, it is harder for a child to qualify as a disabled person under Social Security's rules and regulations than it is for an adult.
How do I apply for disability benefits?
You may call Social Security at 1-800-722-1213 (TTY: 1-800-325-0778) or visit your local Social Security office where a claims representative will assist you. You may also visit Social Security online at www.ssa.gov. The website allows you to file some application forms online and download others. We recommend that you visit your local office for best results.
Fresno Area Social Security Offices:
Fresno Main |map|
5090 North West Avenue
Fresno, California 93711
(559) 487-5061
Fresno Southeast |map|
5060 East Clinton Way
Fresno, California 93727
(559) 487-5548
Fresno West |map|
1052 'C' Street
Fresno, California 93706
(559) 487-5391
Kings County Social Security Office
Hanford |map|
400 East Sixth Street
Hanford, California 93230
(559) 582-3767
Merced County Social Security
Merced |map|
3191 'M' Street
Merced, California 95348
(209) 723-2072
Tulare County Social Security
Visalia |map|
505 North Court Street
Visalia, California 93291
(559) 732-7892
Click here for more Social Security offices in California
What information should I give Social Security when I apply?
You will be asked to provide information and documentation including your birth certificate, your Social Security card, your living arrangements, your finances, you medical condition and treatment among other things. Download the following worksheets for detailed information:
Adult Disability - in pdf format: |English| |Espanol|
Child Disability - in pdf format: |English| |Espanol|
What happens after I file my disability claim?
Most Social Security/SSI disability claims are initially processed through a network of local Social Security Administration (SSA) field offices and State agencies (usually called Disability Determination Services or DDSs).
Social Security and DDS gather information from you, people you know, your doctors, and other sources. The information is analyzed by DDS doctors and other qualified personnel to determine if you are disabled under Social Security's rules and regulations. DDS may arrange one or more "consultive medical exams" for you at Social Security's expense if it can not make a decision based on the information you provide and it gathers.
It takes about 3-6 months for Social Security to make and send you its initial decision. You may submit additional evidence about your disability during this period. This may be especially helpful if there is a change in your condition, or if you obtain new evidence that proves that your impairments prevent you from working. If possible, submit your evidence to the DDS office handling your claim. Always keep a copy of any document you submit for your records.
What happens when my disability benefits are approved?
Your local Social Security office will ask you to come in to update the information in your file and to sign any necessary documents. You will begin receiving your monthly benefit check and any back benefits after that. Since each case is different, Social Security is your best source for information about when you will receive your benefits and the amounts that you will receive.
What should I do if Social Security denies my disability claim?
The administrative steps in the disability decision-making process are: initial claim, reconsideration, hearing, and Appeals Council. In general, you have 60 days to appeal any unfavorable decision made on your claim (plus 5 days for mailing). You may file your appeal yourself, or you may ask an attorney or qualified representative to do it for you.
Be sure to file the correct documents with Social Security when you appeal. Claim processing may be delayed if you don't. You may obtain the forms you need online from Social Security, from your local Social Security office, or by calling Social Security's toll free number: 1-800-722-1213 (TTY: 1-800-325-0778). You may also download the forms here...
- Request for Reconsideration
- Request for Hearing
- Appeals Council Review
Why is it taking so long to get a decision?
Each step in the administrative appeals process can take 3-6 months or more. In general, it takes 12-18 months to go from the initial application to the hearing level.
We advise clients to follow-up on their claims every 3-4 months if they do not hear from Social Security. You should also inform Social Security if you move or change your telephone number. If you do not, you may miss a deadline to provide information or appeal. You will need a "good cause" reason if you miss a deadline. If you do not have a good cause reason, you may have start all over again.
It is also very important that you keep copies of any document you file. If you file in person, insist that the Social Security claims representative gives you a date-stamped copy of your documents. If you file by mail, send the documents by "certified mail - return receipt requested."
It is important to keep copies because Social Security sometimes loses documents and even whole files. It will be much easier to fix your case if you have copies of all the documents you filed.
I missed my deadline to appeal. Now what?
If you do not appeal on time, you need a good cause reason for missing the deadline. "Good cause" for missing a deadline is defined in Social Security's regulations at 20 CFR §416.1411. You should prepare a written statement explaining why you missed the deadline and give it to Social Security along with your appeal. Good cause is granted in most, but not all cases. You should consult with an attorney or qualified representative if your request is denied.
Can you help?
Central California Legal Services accepts Social Security/SSI disability claims on an advice-only, brief service, and full representation basis. Our services are free and we do not collect a fee from your back benefits if you win your case. However, you are responsible for paying out-of-pocket expenses (e.g. medical records copy fees). The level of service you receive will depend on your circumstance and the merit of your claim. It is always better to contact us early in the appeals process. We may be able to offer you advice-only if you contact us shortly before your hearing.
This fact sheet is for informational purposes only. It is not a substitute for competent legal advice. You should contact us, a private attorney, a qualified representative, or Social Security if you need help with you appeal.
CONTACT US FOR MORE INFORMATION
