The process process starts with Social Security, not your doctor

To begin receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) based on disability, you file a claim directly with the Social Security Administration. You do not go through your employer, your state, or your doctor's office. Social Security is the only body that decides whether you meet their definition of disability—which is stricter than most people expect—and only Social Security can start your benefits.

You can file in three ways: online at ssa.gov, by phone at 1-800-772-1213 (TTY 1-800-325-0778), or in person at your local Social Security office. Online filing is fastest for SSDI if you have a Social Security account already set up. Phone and in-person filing work for both SSDI and SSI, though SSI often requires an in-person appointment because it involves questions about your income, resources, and living situation that are harder to verify over the phone.

Key Takeaways

  • You file your claim with Social Security, either online, by phone, or at a local office, and you will need your Social Security number, medical records, and work history ready.
  • SSDI requires a work history and contributions to Social Security through payroll taxes; SSI is for people with little or no work history and limited income and resources.
  • After you file, Social Security sends your case to your state's Disability information Services office, which takes the medical evidence and decides within 30 to 90 days.
  • Most people are denied on the first decision; if you are denied, you can request reconsideration, then a hearing before an administrative law judge, and then further appeals.
  • While you wait for a decision, you can work and earn money up to certain limits without losing your claim, and some work incentives protect your benefits once you are approved.

What you need to have ready before you file

Gather these documents before you start your process. You will need your Social Security number, birth certificate, and proof of citizenship or legal residency (passport, green card, or state ID). Have your medical records available—doctor's names, hospital names, dates of treatment, and the conditions you were treated for. Social Security will request these directly from your providers, but having them on hand speeds things up.

If you are filing for SSDI, bring your work history: the names and dates of jobs you held in the past 15 years, and the dates you stopped working due to your condition. If you are filing for SSI, bring proof of your income (pay stubs, bank statements), your resources (savings account statements, property deeds), and your living situation (lease, mortgage, or proof you live with someone else). If you receive workers' compensation or other disability payments, bring those statements too—they affect how much you receive.

You do not need a lawyer to file, but you can bring one or a representative to your appointment if you want. If you cannot afford a lawyer, you can find a free or low-cost representative through your state's Protection and Advocacy for Beneficiaries of Social Security (PABSS) program or through a legal aid organization in your area.

SSDI versus SSI: which one you file for

SSDI (Social Security Disability Insurance) is for people who have worked and paid into Social Security through payroll taxes. You do not have to be currently working, but you must have earned enough credits—usually 40 credits, with at least 20 earned in the past 10 years—to be insured. If you meet this work history requirement and Social Security finds you disabled, you receive a monthly benefit based on your own earnings record. Your family members may also receive benefits on your record.

SSI (Supplemental Security Income) is for people with little or no work history, or whose work history does not meet SSDI's requirements. SSI is also for people age 65 and older, and for blind or visually impaired people. To receive SSI, you must have limited income (usually under $1,000 per month) and limited resources (usually under $2,000 in savings). SSI is a needs-based program, meaning your benefit amount depends on your income and living situation, not on your work history.

You can file for both SSDI and SSI at the same time if you think you might meet either program's rules. Social Security will determine which one you may have access to for. Some people receive both: a small SSDI benefit plus SSI to bring their total income up to the SSI payment level.

The medical evidence Social Security needs

Social Security does not decide your case based on your word alone. They need medical evidence from doctors, hospitals, therapists, or other treatment providers who have examined you or treated you. The stronger and more recent your medical records, the faster your case usually moves.

When you file, Social Security will ask you to authorize the release of your medical records. They will then request records from every doctor, hospital, or clinic you list. This process can take weeks. You can speed it up by gathering your own records and submitting them with your process, especially if you have recent treatment notes or test results.

Social Security looks for specific things in your medical records: objective findings (test results, imaging, physical exam notes), your doctor's assessment of your condition, how your condition limits your ability to work, and whether your condition is expected to last at least 12 months or result in death. If your records are thin or outdated, Social Security may schedule you for a consultative examination—a one-time appointment with a doctor they choose and pay for—to gather more information.

What happens after you file: the timeline

After you submit your process, Social Security sends your case to your state's Disability information Services (DDS) office. This is a state agency that works under contract with Social Security. The DDS office reviews your medical evidence and decides whether you meet Social Security's definition of disability. This decision usually takes 30 to 90 days, though it can take longer if your medical records are incomplete or if your case is complex.

You will receive a written decision in the mail. The letter will say you are approved, denied, or approved for a different reason than you expected (for example, approved as blind rather than disabled). If you are approved, your benefits begin the month after you are found disabled, or the month after you file, whichever is later. There is usually a five-month waiting period before your first check arrives.

If you are denied, the letter will explain why. Common reasons include: your condition does not meet Social Security's definition of disability, your medical evidence does not show you cannot work, or you do not have enough work history (for SSDI). The letter will also tell you how to appeal.

The appeal process if you are denied

Most people are denied on their first process. This does not mean you cannot receive benefits—it means you have the right to challenge the decision. There are four levels of appeal, and each one is a separate process with its own timeline.

Reconsideration is the first appeal. You request it within 60 days of your denial letter. A different examiner at your state's DDS office reviews your case from scratch, usually with new or updated medical evidence. This takes 30 to 90 days. You can submit new medical records, doctor's statements, or letters from people who know your condition.

Hearing before an administrative law judge is the second appeal. If reconsideration is denied, you can request a hearing within 60 days. You appear before a judge (by phone, video, or in person) who listens to your case and makes a new decision. This process takes several months because there is a backlog of cases. At a hearing, you can bring a lawyer or representative, present medical evidence, and testify about how your condition affects your ability to work.

Appeals Council review is the third level. If the judge denies you, you can ask the Appeals Council to review the decision within 60 days. The Appeals Council looks at whether the judge followed the law correctly, not whether they made the right call about your disability. Most Appeals Council requests are denied.

Federal court is the final appeal. If the Appeals Council denies you, you can file a lawsuit in federal district court within 60 days. This is rare and usually requires a lawyer.

Working while your claim is pending

You can work and earn money while you wait for a decision on your SSDI or SSI claim. Working does not hurt your claim. In fact, Social Security has work incentives designed to let you test your ability to work without losing your benefits.

If you are approved for SSDI, you can earn up to a certain amount per month (called substantial gainful activity, or SGA) without Social Security counting it as proof you can work. In 2024, SGA is $1,550 per month for non-blind individuals and $2,590 for blind individuals, but these amounts change each year. If you earn more than SGA, Social Security may decide you are not disabled and stop your benefits.

If you are approved for SSI, your benefit is reduced by one dollar for every two dollars you earn above $65 per month. So earning money reduces your SSI check, but you keep some of the benefit. There are also SSI work incentives—like the Plan to Achieve Self-Support (PASS)—that let you set aside income and resources for work or education without losing your SSI.

After you are approved: Medicare and Medicaid

When you are approved for SSDI, you become covered by Medicare automatically after you have received SSDI benefits for 24 months. Medicare is federal health insurance. You pay premiums (deducted from your benefit check) and have copays and deductibles, but it covers hospital stays, doctor visits, and prescription drugs.

When you are approved for SSI, you are usually covered by Medicaid automatically. Medicaid is state health insurance for people with low income. Coverage and benefits vary by state, but Medicaid typically covers doctor visits, hospital stays, prescription drugs, and mental health services with little or no cost to you.

Some people receive both SSDI and SSI and are covered by both Medicare and Medicaid. Others receive only one program and one type of health insurance. Understanding which insurance you have and how it works is important because it affects which doctors you can see and which medications are covered.

Frequently Asked Questions

Can I file for disability benefits online if I do not have a Social Security account?

You can create a Social Security account at ssa.gov before you file, which takes about 10 minutes. If you do not want to create an account, you can file by phone at 1-800-772-1213 or in person at your local Social Security office. Phone filing is usually faster than in-person if you have your documents ready.

What if I do not have all my medical records when I file?

You do not need to have all your records before you file. When you submit your process, you authorize Social Security to request records from your doctors and hospitals. However, submitting records you already have speeds up the process. If your records are incomplete or old, Social Security may schedule a consultative exam to gather more information.

How long does it take to hear back after I file?

Initial decisions usually take 30 to 90 days after you file. If you are denied and appeal, reconsideration takes another 30 to 90 days. A hearing before a judge can take several months because of case backlogs. The entire process from filing to a final decision can take one to three years.

Do I need a lawyer to file for disability benefits?

You do not need a lawyer to file or to appeal. Many people file on their own and are approved. However, a lawyer or representative can help you gather medical evidence, prepare for a hearing, and present your case. If you cannot afford a lawyer, contact your state's Protection and Advocacy for Beneficiaries of Social Security program or a local legal aid organization.

What happens to my benefits if I go back to work?

For SSDI, you can earn up to the substantial gainful activity amount ($1,550 per month in 2024 for non-blind individuals) without Social Security stopping your benefits. If you earn more, they may find you are not disabled. For SSI, your benefit is reduced by $1 for every $2 you earn above $65 per month. Both programs have work incentives that protect your benefits if you are testing your ability to work.