Start with Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI)
Pennsylvania does not run its own disability program. Instead, you file for federal benefits through Social Security — either Social Security Disability Insurance (SSDI) if you have a work history, or Supplemental Security Income (SSI) if you have limited income and resources. Both are administered by the Social Security Administration (SSA), and both require the same medical evidence of disability. The difference is what qualifies you: SSDI is based on your own or a family member's Social Security work record; SSI is based on financial need.
Pennsylvania also has a state program called Pennsylvania Medicaid for Workers with Disabilities (MAWD), but that covers health insurance only — it does not provide cash benefits. You must first be approved for SSDI or SSI to use MAWD. This guide focuses on the federal process, which is the first step for most people in Pennsylvania.
Key Takeaways
- You file for SSDI or SSI through the Social Security Administration, not through Pennsylvania state offices, by phone, online, or in person at a local Social Security office.
- You must provide medical records, work history, and a list of doctors and hospitals that have treated you — Social Security will request these directly from providers.
- The SSA typically makes a decision within three to five months, but many first applications are denied and require an appeal.
- If you are denied, you can request reconsideration within 60 days, and if that is denied, you can request a hearing before an administrative law judge.
- Pennsylvania has a free Work Incentives Planning and information (WIPA) program that helps you understand how work affects your benefits if you are approved.
Gather Your Medical Records and Work History Before You File
Social Security will not make a decision without medical evidence. Before you contact the SSA, collect the names, addresses, and phone numbers of every doctor, hospital, mental health provider, and specialist who has treated you for your condition. Include dates of treatment if you have them. You do not need to collect the actual records yourself — Social Security will request them from providers — but you do need to tell the SSA where to look.
You will also need your work history for the past 15 years: the names of employers, dates you worked there, and the type of work you did. If you are filing for SSI (not SSDI), you will need to list your current income and resources — bank accounts, property, vehicles, and anything else of value. Bring your Social Security card and birth certificate or passport to your appointment.
If you do not have recent medical treatment, Social Security may schedule you for a consultative examination (CE) — a free medical exam paid for by the SSA. This does not mean you will be approved; it means the SSA needs current medical evidence. The exam is usually brief and focuses on your ability to work, not on curing your condition.
File Your process by Phone, Online, or In Person
You have three ways to file in Pennsylvania. The fastest is online at ssa.gov — you can start an SSDI or SSI process and submit it without leaving home. The form takes 15 to 20 minutes. You will create a my Social Security account, answer questions about your medical condition and work history, and upload documents if you have them.
You can also call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778). A representative will take your process over the phone. Wait times are usually shorter early in the morning or on Tuesday through Thursday.
If you prefer to file in person, find your local Social Security office on ssa.gov/locator. In Pennsylvania, there are offices in most cities and towns. You do not need an appointment, but you can schedule one online or by phone to avoid waiting. Bring your Social Security card, birth certificate or passport, and the list of doctors and employers you prepared.
When you file, you will receive a receipt notice with an process number. Keep this number — you will use it to check the status of your case online or by phone.
What Happens After You File: The SSA Review Process
After you submit your process, the SSA sends requests to all the doctors and providers you listed. This usually takes two to four weeks. Once the SSA has your medical records, a disability examiner in Pennsylvania reviews your case. The examiner looks at whether your condition meets or equals one of the SSA's Blue Book listings — a detailed guide of conditions that automatically may have access to as disabling. If your condition does not match a listing, the examiner decides whether you can do any work, even part-time or sedentary work.
The entire review typically takes three to five months. You can check the status of your process online at ssa.gov using your process number, or by calling 1-800-772-1213. The SSA will mail you a decision letter when the review is complete.
If the SSA approves your process, the letter will tell you your monthly benefit amount and when payments begin. SSDI payments usually start the month after you are approved. SSI payments may start sooner if you meet the financial requirements.
Understand What Happens If You Are Denied
Most first applications for disability are denied. This does not mean you are ineligible — it means the SSA did not find enough medical evidence that you cannot work. You have the right to appeal, and many people are approved on appeal.
You have 60 days from the date on your denial letter to request reconsideration. You do this by contacting your local Social Security office or by calling 1-800-772-1213. Ask for a "Request for Reconsideration" form (SSA-561). You can submit new medical records, new statements from your doctors, or new information about your condition. A different examiner will review your case.
If reconsideration is also denied, you can request a hearing before an administrative law judge (ALJ) within 60 days of that denial. At a hearing, you can present evidence, answer questions, and have a representative speak on your behalf. Many people are approved at the hearing stage. You do not have to pay for a representative upfront — they are paid from your back pay if you win.
Find a Free Representative to Help With Your process or Appeal
You can file on your own, but having help increases your chances of approval. Pennsylvania has several free resources. The Work Incentives Planning and information (WIPA) program is free and helps you understand how work affects your benefits. Find your local WIPA office at vcu-ntdc.org or call 1-866-927-4872.
For help with your process or appeal, contact a Protection and Advocacy for Beneficiaries of Social Security (PABSS) office. These are free legal services for people filing for or receiving disability benefits. In Pennsylvania, PABSS is run by Disability Rights Pennsylvania. Call 1-800-692-7443 or visit drpa.org.
You can also hire a disability representative or attorney, but you are not required to. If you hire one, they can charge you only if you win your case, and only up to 25 percent of your back pay (capped at $7,200 as of 2024). Ask any representative for their fee agreement in writing before you sign.
Know the Timeline and What to Expect at Each Stage
The path from filing to a decision follows a predictable sequence, though the exact timing varies based on how quickly your doctors respond and how complex your medical history is. Understanding each stage helps you know what to expect and when to follow up if you do not hear from the SSA.
| Stage | Timeline | What Happens |
|---|---|---|
| File process | Day 1 | You submit your process online, by phone, or in person. You receive an process number. |
| SSA requests medical records | Weeks 1–4 | The SSA sends requests to your doctors and hospitals. Providers have 10 days to respond. |
| Disability examiner reviews case | Weeks 4–12 | An examiner in Pennsylvania reviews your medical records and work history. |
| SSA mails decision | Weeks 12–20 | You receive a letter approving or denying your process. |
| Request reconsideration (if denied) | Within 60 days of denial | A different examiner reviews your case, usually with new medical evidence. |
| Request hearing (if reconsideration denied) | Within 60 days of reconsideration denial | An administrative law judge holds a hearing and makes a decision. |
If you do not hear from the SSA within the expected timeframe, call 1-800-772-1213 with your process number. Delays often happen when medical providers are slow to respond, and the SSA can sometimes send a follow-up request to speed things up.
Frequently Asked Questions
Can I work while my process is being reviewed?
Yes. Working does not disqualify you from SSDI or SSI. However, if you earn more than $1,550 per month (as of 2024), the SSA may use your work as evidence that you can work and deny your process. Keep records of your earnings and any limitations you face at work — this information helps your case.
What if I do not have recent medical records?
Tell the SSA when you file. The SSA can schedule a free consultative examination (CE) with a doctor or mental health provider. The CE is not a treatment appointment — it is a brief evaluation to gather current medical evidence. You are not required to have ongoing treatment to be approved.
How much will I receive if I am approved?
SSDI payments are based on your work history and Social Security earnings record. SSI payments are based on financial need and vary by state. Pennsylvania's SSI rate is set by federal law. You can estimate your SSDI benefit at ssa.gov/benefits/retirement/estimator.html, but the exact amount depends on your record.
Do I have to use a lawyer to appeal my denial?
No. You can appeal on your own. However, having a representative increases your chances of approval at the hearing stage. Free representatives are available through PABSS (Disability Rights Pennsylvania) and other advocacy organizations in Pennsylvania.
What is the difference between SSDI and SSI?
SSDI is based on your own or a family member's work record. SSI is based on financial need — you must have limited income and resources. You can receive both at the same time if you meet the requirements for each. Most people in Pennsylvania who work file for SSDI first.