Social Security Disability Insurance (called SSD or SSDI) is a federal benefit program administered by the SSA that provides monthly income to people who are unable to work due to a serious, long-term medical condition.

Supplemental Security Income (SSI) is a federal needs-based benefit program administered by the Social Security Administration. It provides financial support to people who are disabled, blind, age 65+ with limited income and resources.

Your doctor’s role is critical in a disability claim, but medical treatment alone is not enough. Disability decisions are based on functional limitations, not just diagnoses. Your physician must explain how your ability to work is limited by your condition.

Completing the Disability Application and Activities Questionnaire is one of the most important steps in a disability claim. These forms give decision-makers at the Social Security Administration a detailed picture of how your medical conditions affect your daily life and ability to work.

You can work and continue to receive disability benefits. The Social Security Administration has specific rules that determine whether your work affects your eligibility/payments. The rules can differ depending on benefits you can apply for or receive.

The hearing is your chance to talk directly to a judge after an initial denial. It takes place before an Administrative Law Judge (ALJ) and is often the most important stage of the process. Your medical records and work history are reviewed on how your condition affects your daily life/work ability.

Long-term disability video surveillance is a tactic used quite frequently by private disability insurance companies to observe claimants and look for activity that could be used to challenge an long term disability claim. It is legal in many situations—but the process of video surveillance and how it is used is often misunderstood and frequently misused.

In long-term disability claims, the administrative record is the complete file the insurance company builds while your claim is under review. It includes all evidence submitted before the insurer issues its final decision and it is often the only evidence a court will ever consider.  If it’s not in the administrative record, it usually doesn’t exist legally.

An Independent Medical Exam (IME) is a medical evaluation requested by an insurance company to assess your health condition and your ability to work. It is performed by a doctor chosen/paid for by the insurance company.  It gathers medical opinions about your diagnosis, functional limitations, and if you meet the policy’s definition of disability.

When a long-term disability claim is denied or benefits are terminated, the case enters the administrative review and appeals process. This phase happens inside the insurance company, not in court, and it is often the most important stage of the entire claim. For most employer-provided LTD plans, this process is governed by ERISA rules, which strictly limit what evidence can be used later.

An Social Security Disability (SSDI) offset means your long-term disability insurance company can reduce your monthly LTD benefits by the amount you receive from SSDI. Most employer-provided LTD policies require claimants to apply for SSDI and treat those benefits as “other income”.  If SSDI is approved retroactively, insurers often demand repayment for the months they overpaid LTD benefits.

Whether the Employee Retirement Income Security Act (ERISA) applies to your claim determines your rights, your strategy, and your chances of success. ERISA cases require building a flawless paper record early, while non-ERISA cases allow for a more traditional litigation approach if benefits are denied. Knowing which rules apply is essential before responding to a denial or appeal. It’s critical to know whether ERISA applies to your policy.