How to Apply for Disability in North Carolina: A Simplified Guide

December 10, 2023 3:29 pm

How to Apply for Disability in North Carolina: A Simplified Guide

How to Apply for Disability in North Carolina: A Simplified Guide

Applying for disability benefits in North Carolina can be a frightening task, especially for individuals who are already coping with a disabling condition. The process involves understanding the eligibility criteria, navigating the application process, and securing the necessary assistance and resources to support independence while living with a disability. With the right information and resources, applicants can successfully access support and benefits to help address their financial, medical, and personal needs.

North Carolina offers assistance programs and services designed to help disabled individuals maintain their independence and quality of life. The state works in conjunction with federal agencies, such as the Social Security Administration, to ensure that eligible residents receive the financial support they need. Additionally, there are various legal and advocacy resources available to help individuals navigate the approval process and address any issues they may encounter, such as a denied application.

Key Takeaways

  • Applying for disability in North Carolina involves understanding eligibility criteria and following the application process
  • Various assistance programs and resources are available to support disabled individuals in maintaining their independence and quality of life
  • Navigating the approval process and addressing potential issues, such as a denied application, can be aided by legal and advocacy resources

Understanding Disability in North Carolina

In North Carolina, disability benefits are available to eligible individuals through two primary programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). These programs are designed to provide financial assistance to those who are unable to work due to a qualifying disability.

SSDI is a federal insurance program that offers monthly benefits to individuals who have worked and paid Social Security taxes for a sufficient amount of time.  These are called Title II benefits. Generally, you need to have worked at least 5 out of the last 10 years to qualify for SSDI benefits. In addition to the work requirement, you must also demonstrate that you have a qualifying disability that prevents you from engaging in substantial gainful activity.

On the other hand, SSI is a means-tested program that offers financial aid to individuals with limited earnings and resources who are aged, blind, or disabled. These are called Title XVI benefits.  To be entitled for SSI in North Carolina, you must meet the Social Security Administration’s (SSA) classification of disability, which includes having a physical or mental damage that is estimated to last at least 12 months or result in death. Additionally, you must meet certain income and resource limits.

According to OSHR ,In North Carolina, over 1.3 million residents, or about 13% of the state’s population, live with a disability. Among these individuals, over 720,000 are of working age. However, only 35% of these working-age individuals with disabilities are employed, in contrast to 76% employment among North Carolinians without disabilities.

Difference Between Short-term Disability vs. Long-Term Disability

Short-term and long-term disability benefits cater to different kinds of needs based on the duration and nature of a person’s disability.  STD and LTD benefits are private insurance benefits, and if you don’t have an STD or LTD policy through work or purchased privately, these will not be available to you.

Short-term Disability:

This type of benefit is designed for temporary conditions and typically has a predetermined end date, usually lasting less than a year. It’s intended for situations like injuries expected to heal or recovery periods following surgery. Short-term disability benefits provide financial support during a period when you’re unable to work due to these temporary conditions. The aim is to bridge the gap until you can return to work following treatment or recovery.

Long-term Disability:

 In contrast, long-term disability benefits are meant for more permanent or enduring conditions that are not expected to improve significantly over time. These benefits are designed to support individuals whose disabilities significantly limit their ability to work for extended periods, often lasting several years or even until retirement age. Long-term disability addresses situations where a full recovery or return to the previous level of work activity is not anticipated.

SSDI and SSI Eligibility Criteria

Age and Disability Requirements

For SSDI and SSI, to be eligible for disability benefits, an individual must meet several requirements: they should be 18 years old or older, but not yet retirement age. One must be unable to work due to a medical condition. Additionally, they must not have had a disability benefit application denied in the last 60 days

Work History and Medical Conditions

Work history plays a crucial role in SSDI eligibility, as one needs to have contributed to the Social Security disability program for a certain number of years. The amount of required work credits depends on the applicant’s age at the time of disability. On the other hand, medical conditions must be assessed as serious enough to prevent the applicant from engaging in substantial gainful activity (SGA) for at least one year. For a detailed list of qualifying medical conditions, refer to the Social Security Administration’s Blue Book.

Financial Eligibility for SSI and SSDI

Both SSI and SSDI are federal programs with specific financial requirements. The Supplemental Security Income (SSI) program is designed for those with limited income and resources, regardless of work history. The financial eligibility criteria for SSI include:

  • Income: The applicant’s countable income must be below the federal benefit rate (FBR).
  • Resources: The total value of the applicant’s resources must not exceed the SSI resource limit.

The Social Security Disability Insurance (SSDI) program, on the contrary, is based on the applicant’s work history. Payments are calculated according to the individual’s past earnings and contributions to Social Security. SSDI financial eligibility requirements are:

Work Credits: The applicant must have accumulated a sufficient number of work credits to be eligible for SSDI.

Insured Status: The applicant must have worked recently enough to retain insured status under Social Security.

For more information on eligibility and application procedures, you may visit the North Carolina DHHS Disability Determination Services website.

The Application Process

Initial Application Submission

To apply for disability benefits in North Carolina, individuals can choose from three submission methods: in-person at a local SSA field office, by telephone, or by filing online. It is important to select the method that is most convenient and comfortable for the applicant.

Filling Out an Online Application:

 You can apply for SSD benefits directly through the Social Security Administration’s (SSA) website. This process involves creating an account with a username and password. Once your account is set up, you’ll need to provide detailed information about your disability and other personal details. This online method offers convenience and the ability to complete the application at your own pace.

Calling the SSA:

If online application is not feasible for you, another option is to apply by phone. Here are some key points to keep in mind:

  • The SSA’s phone lines are open on weekdays from 8 am to 7 pm.
  • Be prepared for potential wait times, especially during peak hours. The SSA notes that waiting times are typically shorter on Wednesdays, Fridays, and later in the day.
  • For those who are hard of hearing, the SSA provides a dedicated line at 1-800-325-0778, offering personalized assistance.

Visiting Your Local SSA Office:

 You can also apply in person by visiting a local SSA office in North Carolina. However, it’s advisable to call ahead and schedule an appointment. This ensures that a representative will be available to assist you and will inform you about the necessary documents and information you should bring to your appointment.

Each of these methods is designed to accommodate unique needs and preferences, ensuring that applying for SSD benefits is as accessible as possible.Top of Form

Required Documentation

When applying for disability benefits, the applicant must provide necessary documentation to support their claim. The required documents include:

  • Proof of U.S. citizenship, such as a birth certificate or passport
  • Social Security card or record of the Social Security number
  • Employment history, including dates and locations of jobs held in the past 10 years
  • A list of medications currently being taken and the prescribing doctors’ contact information
  • Medical records from doctors, hospitals, and clinics detailing the applicant’s disability

Medical Evidence Submission

Submitting comprehensive medical evidence plays a crucial role in the application process for disability benefits. The applicant should gather all pertinent medical records and documents to support their claim. This includes:

  • Physician’s reports detailing the applicant’s medical condition and functional limitations
  • Test results, such as X-rays, MRIs, and laboratory work supporting the diagnosis
  • Treatment records and prescribed medications, if applicable

It is essential for the applicant to have their medical evidence prepared and organized before submitting their disability application. Providing thorough and accurate information during the initial application phase increases the chances of being granted disability benefits in North Carolina.

Next Steps Following Application for SSD/SSI Benefits in North Carolina

Next Steps Following Application for SSD/SSI Benefits in North Carolina

After you apply for Social Security Disability (SSDI) and Supplement Security Income (SSI) benefits in North Carolina, several steps follow:

Application Review: Initially, your application will be reviewed by the Social Security Administration (SSA) to ensure that you meet some basic requirements for disability benefits, such as checking your work history and verifying that you haven’t been working above the Substantial Gainful Activity (SGA) level.

Medical Disability Determination: Once the basic criteria are met, your application is forwarded to Disability Determination Services (DDS) in North Carolina. DDS is responsible for making the initial determination on whether you are medically disabled according to SSA standards.

Medical Evidence Collection: DDS will collect medical evidence from the healthcare providers you listed in your application. They might also contact you for additional information or clarification. In some cases, DDS may require you to undergo a consultative examination (CE) to get up-to-date information about your medical condition.

Decision Making: After gathering all necessary information and evidence, DDS makes a decision on your claim based on all the information available. They assess your medical condition, your capacity to work, and how your condition affects your daily activities.

Notification of Decision: Once DDS makes a decision, the SSA will send you a letter to inform you of the outcome. If your claim is approved, the letter will detail the amount of your benefits and when they will begin. If your claim is denied, the letter will explain why and provide information on how to appeal against the decision.

Appeal Process (if necessary): If you disagree with the decision, you have the right to appeal. The first level of appeal is typically a Request for Reconsideration, where your case is reviewed by someone who was not involved in the original decision.

The entire process from application to decision can take several months, depending on factors like the complexity of your case, the need for additional medical evidence, and the current workload of the DDS.

What Happens if the SSA Denies Your Application? 

If your disability benefits application is denied by the Social Security Administration (SSA), they will send you a letter detailing the reasons for the denial. If you disagree with their decision, you have the option to appeal. The appeals process can involve several steps:

Requesting Reconsideration: This is the first step if you believe the SSA might not have fully understood the severity of your condition. You can provide additional information or evidence to support your case, asking the SSA to re-evaluate your application.

Requesting a Hearing with an Administrative Law Judge (ALJ): If your application is still not approved after reconsideration, you can request a hearing before an ALJ. This hearing will be scheduled within 75 miles of your residence, offering a chance to present your case in more detail.  Many of these hearings present take place over the telephone or by video.

Requesting a Review by the Appeals Council: If the decision is still not in your favor after the ALJ hearing, you can ask the Appeals Council to review your case. The Council can either approve your case or send it back to an ALJ for further review.

Requesting a Federal Court Review: While many applications are approved before this stage, if yours is not, you have the right to file a lawsuit in a Federal Court. This allows you to argue your case in a higher legal setting.

It’s often beneficial to work with a Social Security Disability lawyer throughout this process. A lawyer experienced in this field can manage the appeals process on your behalf, review your application, and advise on what additional information might increase the likelihood of approval. Their expertise can be invaluable in navigating the complexities of the appeals process.

What is the Payment Amount for Disability in North Carolina?

The amount of disability benefits you can receive in North Carolina varies and depends on several factors. The calculation takes into account your previous work history and income prior to becoming disabled. This is because disability benefits aim to partially replace the income lost due to your inability to work.

If you are getting workers’ compensation, this will also influence the amount of disability benefits you’re eligible for, as there are rules regarding the combined total of these benefits. Your matrimonial status can play a role too, affecting the benefits calculation, particularly in cases where household income is considered.

Furthermore, if you are still working despite your disability and earning an income, this will be factored into the calculation of your benefits. The objective here is to supplement, rather than fully replace, income for those who are still able to work to some extent.

Importantly, if you are receiving other social security benefits, the total amount, including your disability assistance, will not exceed 80% of your pre-disability income. This cap is in place to ensure a fair and balanced distribution of benefits.

For a more personalized estimate of the disability benefits you may receive, the SSA provides a free benefits calculator. This tool can give you a clearer idea of the supplemental security income you might be eligible for, based on your unique circumstances.

Tip: In case you lack the required number of work credits, consider applying for Disability benefits via Supplemental Security Income (SSI). The primary criterion (after your disabling condition) for SSI eligibility is financial necessity.

Is It Possible to Work While Receiving Disability Benefits?

It is possible to work while receiving disability benefits, but there are important considerations and rules to follow:

Income Deductions:

 If you choose to work while on disability, the income you earn may affect your monthly disability benefits. Specifically, the amount you earn from working could be subtracted from your disability payments. This is part of the Social Security Administration’s (SSA) efforts to encourage beneficiaries to return to work if they’re able, while still providing financial support.

Mandatory Reporting:

It’s crucial to report your total monthly income to the SSA. This transparency ensures that your benefit payments are accurately calculated based on your current income. Failure to report your income can lead to overpayments, and subsequently, you may be required to repay the excess benefits received.

Consequences of Non-Compliance:

 Not reporting your income can have serious consequences. If the SSA discovers unreported income, you could be accused of fraud. In the worst-case scenario, this could lead to criminal prosecution.

Income Cap:

There’s generally an income threshold or cap that determines how much you can earn while still receiving disability benefits. For the year 2023, this cap is set at $1,470 per month for non-blind individuals and $2,460 per month for those who are blind. Earning more than these amounts could lead to the cessation of your disability benefits.  You should consult with an attorney before going to work.  You should not accept an offer from the SSA for a “Ticket to Work,” because everyone I have known that has participated in that program has lost their benefits.

It’s important to understand these guidelines to balance work and disability benefits effectively, ensuring compliance with SSA regulations while maximizing your financial and personal wellbeing.

Empower Your Disability Claim with Expert Legal Support at the Morrison Law Firm

Are you lost in the Social Security Disability maze? You’re not the only one. For many, the journey to secure disability benefits is fraught with uncertainty and stress. Each day without help is a risk – a risk of denied claims and lost support. Morrison Law Firm is here to change that.

We’ve spent a decade mastering the complexities of disability claims. Our approach is more than just legal expertise; it’s a commitment to safeguard your rights and secure the benefits you deserve. The wrong move can mean more than just a denied claim; it can mean a threat to your livelihood and stability.

We know the stakes are high. That’s why we don’t just file your claim; we fight for it, ensuring every detail is perfect. Beyond Social Security Disability, we’re your allies in Worker’s Compensation and Personal Injury cases too. Contact Morrison Law Firm now. Together, let’s secure the benefits that support your tomorrow

Frequently Asked Questions

Frequently Asked Questions

What is the Average Monthly Payment for Social Security Disability in North Carolina?

As of 2023, the amount received for Supplemental Security Income (SSI) in North Carolina is $914 per month for an eligible individual and $1,371 per month for an eligible couple. However, the exact amount you receive through SSI can vary depending on your specific financial situation.

What’s the Distinction Between SSDI and SSI?

 SSDI benefits are provided to individuals who have worked and contributed to Social Security, while Supplemental Security Income (SSI) is available to individuals based on financial need, irrespective of their work history.

What is Social Security Disability Insurance (SSDI)?

 SSDI is a federal insurance program managed by the Social Security Administration that provides benefits to people who are unable to work due to a qualifying disability.

Who qualifies for SSDI?

To qualify for SSDI, you must have a medical condition that meets the SSA’s definition of disability and have earned enough work credits based on your work history.

How is SSDI different from SSI?

 SSDI is based on your work history and the credits you’ve earned, whereas Supplemental Security Income (SSI) is a program for people with limited income and resources, regardless of their work history.

How do I apply for SSDI?

You can apply for SSDI online, by phone, or in person at a Social Security office. You’ll need to provide detailed information about your medical condition, work history, and other personal details.

How long does it take to get a decision on my SSDI application?

The time frame varies, but it generally takes several months to receive a decision. Complex cases may take longer.

What happens if my SSDI application is denied?

 If your application is denied, you have the right to appeal the decision. There are several levels of appeal, including reconsideration, a hearing before an administrative law judge, review by the Appeals Council, and filing a lawsuit in federal court.

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