The SSA offers two types of benefits for its disabled members: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). If you got injured for whatever reason (work-related or not), then you might just qualify for these benefits.
In theory, this all sounds easy. In reality, however, the disability application process in Florida can be complicated and arduous.
In 2021 alone, the SSA received over 1.8 million applications for disability benefits. Unfortunately, only 31.8% of them were granted that same year. This means that over 1.23 million applications were either rejected or subjected to further review. Most of the time, disability applications get rejected because:
- the claimant’s medical conditions did not meet the SSA’s definition of disability, or
- they didn’t pay enough social security taxes
But before we talk about how to apply for disability in Florida, you first need to make sure that you’re eligible for disability benefits.
Will You Qualify for Disability Benefits?
Your eligibility for benefits will depend on whether you’re applying for SSI or SSDI.
SSDI Eligibility Requirements
If you’re applying for SSDI, the SSA looks at two crucial factors to evaluate your claim: your medical condition and social security credits.
To be eligible for SSDI benefits, your medical condition must meet SSA’s definition of disability. As a rule of thumb, the SSA can only consider your medical condition a disability if:
- it prevents you from doing “substantial gainful activity”
- it’s expected to last for more than a year
- it’s expected to result in death
Substantial Gainful Activity (SGA) is any type of work with an income that exceeds the amount set by the SSA. The SGA income ceiling changes each year and for 2021, it’s at $2,260 for blind individuals and $1,350 for the non-blind. If the work you’re doing earns you more than that amount, you may not qualify for disability.
The SSA also maintains a list of disabling conditions (both physical and mental). It includes various diseases that the SSA considers severe enough to warrant a disability benefit. If your condition is included in this list, you are more likely to get approved for disability
Social Security Credits
If you haven’t paid social security taxes, you can’t expect to receive social security disability benefits. Thus before you can claim for disability, you need to have earned a certain amount of social security credits.
To earn these credits, you must have worked in jobs covered by social security. Your credits will depend on your total yearly wages. For 2022, an income of at least $1,510 is required to earn one credit. You can only earn up to 4 credits a year. In general, you need to have at least 40 work credits to qualify for disability. Twenty of which must have been earned in the last 10 years. But younger workers may still qualify even if they have fewer credits.
Qualifying for SSI
Unlike SSDI, SSI doesn’t have complicated eligibility requirements. You can qualify for SSI if you meet any of the following:
- you’re at least 65 years old
- you are totally or partially blind
- you have a medical condition that prevents you from working, is expected to last a year, or result in death
Note that if you’re qualified for both SSI and SSDI, its also possible to receive both at the same time.
How to Apply For Disability in Florida
After confirming your eligibility, here’s a step-by-step guide on how to apply for social security disability in Florida.
1. Prepare the required documents and information.
According to the SSA website, these are some of the information and documents you need when applying for disability in Florida:
- your social security number
- proof of your age
- name, address, and contact information of the doctors, caseworkers, hospitals, and clinics that treated you including the dates of your visit
- medical records and reports from your doctors, therapists, caseworkers as well as the hospital and clinics where you got treatment from
- names and dosages of the medications you’re taking
- laboratory and test results
- your employment history
- your most recent W-2 form or, if you were self-employed, a copy of your federal tax return.
2. Fill up SSA’s disability application form.
If you’re applying for SSDI, you need to fill up Form SSA-16. You can download it from the SSA’s website or get a copy from the SSA office nearest you. For SSI applications, you need to submit Form SSA-8000-BK (01-2012).
3. Submit your application.
There are three ways to submit your social security disability application in Florida: online, by phone, or in person.
- Online. To apply online, just sign-up for an SSA account. If you already have one, you only need to complete the disability benefit application and the medical release forms.
- By Phone. If technology isn’t your strongest suit, you can also apply by phone. Just contact the SSA at 1-800-772-1213 or at 1-800-325-0778 if you are hard of hearing. This hotline is available from Monday through Friday from 7 a.m. to 7 p.m. SSA offices in Florida also have their own phone numbers you can contact.
- In Person. For in-person applications, you can visit your local social security office. Just enter your zip code to locate the ones nearest you.
4. Wait for the SSA’s decision
It usually takes about 3 to 5 months before a disability claim is decided. Though the actual processing time will vary depending on the documents you submitted and the circumstances of your disability. If there are suspicions of fraud on your claim, the SSA may also conduct their own investigation before they’ll release a decision.
The Claims Evaluation Process
After submitting your claim for disability, the SSA will then forward it to the state’s Division of Disability Determinations (DDD) in Tallahassee, FL. Their main task is to evaluate the medical eligibility of Florida citizens who have filed SSA disability claims. The agency is also responsible for determining the eligibility of claims made under the state’s medically needy program.
The actual processing of your claim, however, is handled by the Bureau of Medical Disability Program Operations. It’s in charge of adjudicating disability appeals too. After the initial disability evaluation, your claim is sent back to the SSA for final determination. This is where the SSA will look at whether you qualify for their technical requirements. If you meet all the medical and technical requirements, then your claim will be approved.
How Much Disability Benefits You’ll Get in Florida?
In Florida, disabled individuals can get benefits from both the SSA and the state. Though they vary in amount and eligibility requirements.
As mentioned, there are two kinds of disability benefits you can get from the SSA: SSDI and SSI.
If you’re applying for SSDI, the SSA calculates your social security disability benefits based on your covered earnings before you got disabled. Covered earnings refer to your average income from which you’ve paid social security taxes. It includes most types of wages and other self-employment income except for earnings from railroads and certain state and local governments.
As a general rule of thumb, if you work at jobs that withheld social security taxes, then your income from that job is covered earnings. The SSA applies a complicated formula to your average covered earnings to come up with your monthly disability payment. For a more detailed calculation, please refer to the SSA’s online calculator.
Since covered earnings vary for everyone, the benefit amount can also differ for each person. According to the SSA, the average disability benefit for 2022 is $1,358 per person. Though most beneficiaries receive less than that. Benefit payments may also fluctuate each month as the SSA considers other income you’ve earned during the month.
SSI, on the other hand, is a needs-based benefit. It provides cash benefits to disabled individuals who don’t qualify for SSDI. The SSI maximum benefit amount for 2022 is $841 for individuals and $1,261 for married couples. But your actual monthly payment could be much lower.
State Welfare Programs
Aside from SSA’s disability benefits, Florida also offers state welfare programs for its disabled individuals such as:
- Temporary Cash Assistance Program. Families with children aged below 18 may qualify for temporary cash assistance. Provided that they meet the eligibility and income requirements.
- Optional State Supplementation (OSS) Program. Florida’s OSS program offers monthly supplemental payments to disabled individuals staying in assisted living facilities. Those admitted in mental health facilities may also avail of this program.
- Medicaid. If you qualify for SSI, chances are you’ll also qualify for Florida’s Medicaid program. It provides health care assistance for people who are disabled, pregnant, or blind. Applications for this program can be made at the Florida Department of Children and Families.
When to Apply For Disability
In general, the SSA advises that you should apply for disability benefits as soon as possible. Disability benefit applications can take months to get approved. And there’s a very big chance that it can get denied. While waiting for the SSA’s decision, you need to pay for your medicine, food, and rent. With no work and no income, making ends meet might not be possible. Thus, it’s best to apply for disability benefits at once to avoid missing out on benefits.
Can You Apply For Disability in Florida After Age 62?
Yes, you can as long as you haven’t reached your full retirement age. Between the ages of 62 to 66, Americans can opt between early retirement or filing for disability. At full retirement age, your disability benefits will automatically convert to retirement benefits.
The chances of your disability claim getting approved also increase as you age. That’s because it’s usually harder for older people to find gainful employment – making disability easier to prove.
Should You Hire a Lawyer?
Yes, you should. Dealing with a debilitating medical condition and unemployment can be too much to handle already. The last thing you need is to get stressed out with your disability claim application. An experienced workers’ compensation lawyer like Victor Malca can help ensure the approval of your disability claim. With almost three decades of experience, he can help you more easily navigate the complicated disability claims process. He will guide you throughout the entire process up until your case is won and you get the benefits you rightfully deserve. Contact us now for a free consultation.
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.