When you realize that your medical conditions are severe enough that you may not be able to continue to work and support yourself, you've reached a difficult point in your life. But how do you know when it’s time to apply for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI)? If you wait too long, you may lose out on benefits. But applying too early is counterproductive, because you may not have the evidence to meet the definition of disability. In order to qualify for Social Security disability benefits, you need to have a medical condition that is expected to last twelve months or longer and that results in an inability to work eight hours a day, five days a week.
Let's look at a few types of situations and discuss when it makes sense to apply for Social Security disability benefits.
Sometimes it’s very clear when you need to apply for disability benefits. A car accident or other catastrophic event can change your life in an instant. If this happens to you and it’s immediately clear that you are not going to be in any condition to go back to work for at least a year, go ahead and apply for benefits. If you are diagnosed with a condition that will require treatment that will incapacitate you, such as advanced cancer treated with chemotherapy and radiation, it may also be a good idea to apply for benefits sooner rather than later.
Most people thinking of applying for disability are in the situation where they have a painful or disabling medical condition that has been going on for some time but they continue to work with the condition as long as possible. Over time, it becomes harder to go to work every day. Absences pile up and your employer starts losing patience. You know that you can’t keep going much longer and that you need to plan for a future where you cannot work. However, you should not apply for SSI or SSDI while you’re still working full time. Social Security will deny your application without even looking at your medical condition.
While Social Security allows you to work part time -- still be found disabled -- as long as you are not making above a certain amount ($1,040 in 2013), it’s more difficult to be approved for benefits if you’re working in any capacity.
One problem that comes up often is that you cannot continue doing your current job, but could possibly do some other job. If you’re over 55 years old, this is probably not an issue because of the way Social Security's medical-vocational grids are used to decide disability. But if you’re younger, you generally cannot receive disability benefits if there is some sort of full-time work you can do, physically and mentally. In this case, it is usually better to see if you can retrain for a new job rather than apply for disability benefits.
You cannot receive disability benefits without some sort of medical record documenting your condition. It is best to have a concrete diagnosis before you apply for disability. A general “I just don’t feel well” or "my lower back hurts all the time" will not get you very far. If you really are feeling so sick that you cannot keep working, you should be seeking medical treatment anyway, because there may be a treatment that would allow you to keep working.
Some conditions are much harder to diagnose than others. Multiple sclerosis and lupus are two perfect examples. You could have doctors arguing about whether or not you have MS for years. In those cases, it can be difficult to get disability benefits, but at least you still have medical records that document your symptoms and show any testing and treatments that you've tried. Once you realize that you are not improving and cannot see going back to work in the next several months, it is a good idea to apply for disability benefits even without a diagnosis.
When in doubt, ask your doctor. You will need your doctor’s support during the application process for disability. If there is harmful information in your medical records, such as allegations of your exaggerating medical complaints, it’s best to know before you apply. If your doctor says that he doesn’t believe you should be applying for disability, reconsider whether or not you really could perform some type of employment. If you genuinely feel that you cannot work, you should try to find another doctor, one more supportive of you and your difficulties. Regardless of whether or not you are ever approved for disability, it is always best to have a doctor that you can talk to about your symptoms freely.
If you wait too long before you apply for SSI or SSDI, you may lose out on benefits. SSI benefits are paid from the date you apply. SSDI benefits start either a year before the date you filed or five months after the date you stopped working, whichever is later. And if you haven't worked in several years, you can actually lose your insured status for SSDI.
If you believe you will not be returning to work for at least a year, go ahead and apply for disability sooner rather than later.