Social Security Disability Insurance in the State of Wisconsin
Wisconsin ranks 24th on America’s State Health Rankings. About one-third of Wisconsinites have a problem with obesity and excessive drinking is a primary health concern. Both these health concerns can lead to mental and physical impairments leading to different types of disabilities. About 39% of those on the Social Security Disability Insurance (SSDI) beneficiary list are those who have a mental disorder resulting in a severe disability that prevents them from working for at least one year. The other top diagnostics on the SSDI beneficiary list include disabilities that stem from musculoskeletal diseases (27%) and those that stem from nervous disorders (11%).
In order to qualify for SSDI benefits, your disability can stem from any kind of medical condition. However, there are certain medical and non-medical eligibility criteria you must meet such as:
- Your disability has lasted or is likely to last for at least one year.
- You disability prevents you from engaging in substantial gainful activity.
- Your disability must meet a medical condition listed in the Social Security Administration’s (SSA’s) Blue Book.
- You have paid into the Social Security system and have earned enough work credits.
Those who apply for SSDI benefits in Wisconsin have more than a 35% chance of being approved for benefits at the initial application level.
Filing a Social Security Disability Insurance Claim in Wisconsin
About 12.2% of residents in Wisconsin suffer from a disability but as stated earlier, in order to qualify for SSDI benefits your disability must meet the SSA definition of a disability. Those whose disabilities are an exact match to a Blue Book listing will find the approval process easy and quick. The SSA also recognizes those with an extremely severe disability and automatically moves them to an expedited approval process.
It’s tough to meet an exact impairment listed in the Blue Book, but the SSA does provide benefits for those whose disabilities are comparable or equivalent to a Blue Book listing. Such people can qualify for a medical vocational allowance. The majority of claimants fall into this category and in order for the SSA to evaluate your condition for a determination it is very important to provide a full history of your disability including the onset date, medical treatment history and work history. The SSA will want to know whether your work skills can be transferrable to any other type of work that will allow you to earn a substantial income. They will consider your age, educational qualifications, work skills and evaluate your Residual Functional Capacity (RFC) which is an assessment of your mental and physical limitations. Only those whose disability prevents them from engaging in any type of gainful employment will be given benefits through a medical vocational allowance.
The entire process can take several months. One of the major reasons for the delay is because the claimant has failed to file complete information. It might be prudent to get an advocate or a professional specialized in the SSDI claims process to help you file the correct paperwork that is necessary to prove your claim. The goal is to get an approval on your claims at the earliest possible stage. It is extremely helpful for claimants to understand the SSDI claims process.
Click here to know more about the SSDI application process or watch the informative video below.
Since the SSDI is a federal program, the application process is the same in every state. You can apply online, by phone, or in person at a Social Security office near you. In the state of Wisconsin there are 27 Social Security offices. The SSA will transfer your case to a state agency and a Social Security Disability examiner will be assigned to your case. The disability examiner will request for your medical records from the treatment centers you have listed. The examiner will call you for an interview which may be via video or telephone if you are not able to come in person. Determinations generally take anywhere between 3 to 5 months. This may take longer if there are a number of backlogs in the system.
Since only 36% of SSDI claims are awarded benefits at the initial application level in Wisconsin, those who receive a denial notice will need to go through the appeals system in order to get the benefits they are entitled to. The process of appeals consists of 4 stages.
- Reconsideration: The first stage of appeal is similar to the initial application process. Another disability examiner reviews your case. The rate of approval at this stage is 17.6%. You have the opportunity to provide recent medical records for the examiner to review that would more solidify your case. Those denied can move to the next level of appeals which gives claimants a higher rate of success.
- The Court Hearing: This is the best opportunity you have to present your case. Your case will be reviewed by an Administrative Law Judge (ALJ) who acts independently of a disability examiner. He may allow you to bring in medical and vocational experts to testify on your behalf. The testimony of a treatment physician is usually given much weightage. In Wisconsin, the approval rate at the disability hearing level is 46.5%.
- The Appeals Council: The Council will determine whether the decision made by the ALJ was fairly determined by looking at all the evidence once again. The Council can reverse the decision of the ALJ or send your case to another ALJ.
- Federal Review: The last and final stage of appeal is the federal court. Not many choose to go to this last stage because it is expensive and slow and the verdict is less likely to be in favor of the claimant.
An appeal at any stage must be filed within 60 days of the date of the denial notice. If you haven’t got an advocate at the initial application level, it is advisable to get one for a hearing. An advocate can increase your chance of success by 50% to 60%. That’s because they specialize in SSDI claims, can understand exactly why you were denied benefits in the first place and can help you prepare a case that clearly demonstrates you meet the approval requirements. Legal representation can save you time, money and stress.
Want to know whether your disability qualifies for SSDI benefits for free? Fill out our disability evaluation form today and be partnered with the best SSDI advocacy group to help you win your claim!
Many make the mistake of waiting to file for the SSDI benefits. Since the claims process can take several months, your best course of action would be not to wait any longer. If you know right now that your disability could last a year or more fill the form on the right and let us help you get the benefits you deserve.
Helpful Resources for those with Disabilities in Wisconsin
If you’re not qualified for Social Security Disability Insurance or would like additional support, the Wisconsin State Administration offers several other programs to help people with different disabilities. Follow the links below to know more about these helpful programs:
- Wisconsin Disabilities and Impairments: This website provides a wide range of resources for people with developmental disabilities, the blind and visually impaired, deaf and hard of hearing as well as those with physical disabilities.
- The LIHEAP assistance program: This is a federally funded energy bill assistance program. You may be able to receive financial help in the form of a grant or credit on an account. Low-income homes that have a disabled family member, an elderly person or a young child are given priority.
- FoodShare Benefits: This program may help seniors, low-income workers, those who are disabled, and others put nutritious food on the table. Benefits are given every month through an electronic benefits card which can be used at authorized local food stores.