Disability in Pennsylvania: How to Qualify, Apply, and Get Approved
March 16, 2023 · 9 min read
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More than 432,000 Pennsylvania residents receive disability benefits from the Social Security Administration (SSA). They’re proof that you’re not alone, no matter how isolating the application process may feel.
To help you apply for and win disability benefits in Pennsylvania, this guide will explain what you need to know about qualifying, how the application process works, and how to determine the size of your potential benefits checks.
What Pennsylvania disability program should I apply for?
Pennsylvania doesn’t have its own disability program, but residents can apply for disability plans through the federal government or private insurance companies. If you live in Pennsylvania, you may be able to qualify for any of these four programs:
Social Security Disability Insurance (SSDI): The federal government offers SSDI for Americans who have worked for years but must stop because of a medical condition. Your income and the amount of tax you’ve paid both factor into how much you get from SSDI. Generally speaking SSDI offers the largest disability benefit amounts. It also comes with Medicare.
Supplemental Security Income (SSI): SSI covers people with limited income, savings, and other assets. If you haven’t worked recently enough to qualify for SSDI or if you have a brief work history, you may qualify. SSI also offers Medicaid coverage.
Veterans disability benefits: The Department of Veterans Affairs (VA) maintains its own benefits program to cover active and retired veterans who are injured during their military service and can’t work as a result. You can receive VA disability benefits at the same time as SSDI and SSI. Learn more about how Atticus can help you apply for VA benefits.
Long-term or short-term private disability insurance: These policies are often available through your employer, but you can also buy them directly from a private insurer. You can only receive benefits if you had the plan before your health condition forced you to stop working. If you file a claim with your insurance company and get approved, you may receive payments worth up to 60% of your former paychecks for months or years. In most cases, long-term disability insurance plans require you to apply for SSDI.
For the rest of this guide, we’ll focus on SSDI and SSI because those are the best options for most Pennsylvania residents with disabilities.
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How to qualify for disability in Pennsylvania
To qualify for disability in Pennsylvania or any other state, you have to meet specific medical and technical criteria — and be able to clearly prove to the SSA that you meet those criteria. SSDI and SSI have their own technical requirements, but they share medical requirements.
Medical qualifications for SSDI and SSI
The main medical qualification for disability benefits is that you have a disability or medical condition that makes it impossible for you to work. Your doctor will need to verify that they expect your condition to last for at least one year or the rest of your life.
You can automatically meet this medical requirement if you have a terminal condition that’s listed on the SSA’s compassionate allowance list.
If you’re over age 50, qualifying for disability is easier. At that age, you only need to prove that you can’t keep doing the work you already do. Qualifying under the age of 50 can be harder because you have to prove that your condition makes it impossible for you to do any job — even jobs you haven’t done before or would need to receive additional training to do.
Technical SSDI qualifications
To qualify for SSDI, you must meet the following:
1. You’re 66 or younger.
2. You have enough work credits, which you earn based on how much you’ve paid enough in Social Security taxes during your career. People who’ve worked for at least five of the last 10 years often qualify. The best way to check how many work credits you have is to create a free mySocialSecurity account on SSA.gov.
Common conditions that qualify for disability in Pennsylvania
The SSA awards Social Security disability benefits for many different conditions, as long as those conditions make it impossible for the applicant to work and are expected to continue for more than a year.
The most recent SSA data shows the most common conditions among Pennsylvania residents who receive disability benefits:
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How to apply for disability in Pennsylvania
The main SSDI and SSI application is the most important part of the process. But to successfully apply for disability, you’ll also have to fill out some common supplemental forms. The first is a work history report, which asks you to describe your previous work experience. The second is a function report, where you’ll explain how your condition affects your daily life.
You can apply on your own, though working with a disability lawyer can greatly simplify the process because they’ll know what forms you need, how to answer the questions well, and what medical documents the SSA will want from you.
The reality is that the application is time-consuming. Set aside plenty of time to fill it out, which includes gathering all required documents. A lawyer can help manage your materials for you, but here’s what you can do:
Gather all your personal records. Your records should include anything relevant to your condition. This means medical records and treatment forms. But you’ll also need bank account information, your work or income history, and contact information for relevant healthcare providers.
Submit the application and all supplemental documents. Missing forms or skipping questions will lead to processing delays.
Keep your answers consistent. The SSA checks for inconsistencies, so make sure your responses across all forms match. Your answers also need to line up with your medical records. Be honest about your limitations, like pain levels and the symptoms associated with your condition.
Follow up with the SSA right after you submit. Since the SSA receives thousands of submissions, following up ensures they’ve received and are processing yours. You can contact them yourself, or your lawyer can handle this for you.
Respond to SSA requests immediately. You’ll have 10 days to respond to the SSA’s requests, but respond faster to avoid processing delays.
If you choose not to work with a lawyer, consider applying in person at an SSA office. The SSA staff can explain what the questions are asking. That said, they can’t give you personalized legal advice, like to say whether or not your answers are strong. If you do choose to work with a lawyer, they can help you fill out and then submit the application on your behalf.
Working with a disability lawyer is the best way to get help with your application. They can strengthen your responses, answer all your questions, complete the application for you, and follow up with the SSA to keep the process on track. This can make the application process much less stressful.
After you apply for disability, the SSA will review your application and confirm that you meet all technical requirements. Disability Determination Services (DDS) will verify your medical eligibility, which often requires a quick consultative exam with an SSA doctor. DDS may also request additional medical information from you.
The SSA will then make a decision on your application. This process takes about six months on average.
Your chances of getting approved for benefits
Unfortunately, getting approved for disability is difficult — even if it’s already impossible for you to work. Most people have to go through several stages of appeal. But your chances of getting approved are higher at some stages.
After the first time they apply, more than 70% of applicants are rejected. Then applicants can file for reconsideration. The SSA rejects 90% of reconsiderations. But even if you do get rejected, you can appeal for a court hearing in front of an administrative law judge (ALJ).
Appearing in front of an ALJ is intimidating, but your chances of getting approved are higher at this stage than at any other stage. As of 2022, more than 50% of applicants who appeared in front of a judge won their claim. Applicants with a lawyer are also three times more likely to win benefits.
In 2022, applicants waited an average of 6.1 months, or 184 days, to receive an initial decision. It takes an average of another 6.1 more months, or 183 days, to receive a decision on reconsideration requests. After that, the amount of time it takes to get a hearing depends on which SSA hearing office handles the appeal.
In Pennsylvania, the average wait time to get a hearing is about 14 months. That means the average Pennsylvania applicant waits about two years and three months from the time they apply until the time they’re approved.
The table below shows average wait times at the eight Pennsylvania hearing offices.
Because the application process can take years, we always recommend that you apply as soon as possible. It’s also important to respond to all SSA requests quickly, as that’s really the only way you can prevent delays and therefore keep the process moving as quickly as possible. A lawyer can also help by following up with the SSA and keeping up with appeals.
While the process is long, the wait will pay off. Your first SSA check will include months or even years of back pay benefits to cover the payments you missed while waiting for a decision.
How much are disability benefits in Pennsylvania?
Benefit amounts vary from one applicant to the next. In Pennsylvania, your benefit amount will vary based on whether or not you qualify for SSDI or SSI. Some people can also receive benefits from both at the same time.
Average SSDI payments in Pennsylvania
In 2023, the maximum monthly SSDI payment is $3,627. Although that is the program’s maximum, the average SSDI payment for Pennsylvania residents was less than half of that at $1,365.92 per month.
Your specific medical condition has no impact on your benefit amount. Rather, your personal income and work history are the determining factors for how much you receive each month.
You can find out how much your benefits will be with an SSA account:
The maximum monthly amount you can get through SSI is $914 in 2023, but the average payment for Pennsylvania residents is $648.94 per month.
The SSA will determine your monthly income to find a benefit amount. Your benefit will be the monthly maximum minus any money you receive each month, such as from part-time work. Your SSI checks will be $914 if you have no other income.
Applying for SSI and SSDI is stressful, even before you consider the long wait times. A disability lawyer can make a difference. A good lawyer will take some of the time and frustration off your shoulders by answering all your questions and guiding you through every stage of the process. They’ll communicate with the SSA, handle your appeals, help make your case in front of a judge, and even cross-examine witnesses if necessary.
If you’d like to search for a Pennsylvania disability lawyer, here are some considerations:
What their reviews say: If previous applicants have liked working with a lawyer, you probably will too. But instead of just looking for positive or negative reviews, look for patterns. Are all the negative reviews saying the lawyer doesn’t show up or never responds? That may be a sign the lawyer isn’t the right fit for you.
Their primary area of practice: Disability benefits are a unique area of the law. It can help to work with lawyers who specialize in disability cases, not in other legal areas.
Where they’re located: Pennsylvania has several hearing offices. A lawyer local to you or your hearing office may know the judges, and that knowledge could help them fight your case. But it’s also possible to find excellent remote counsel. Social Security disability rules are the same in every state, so a lawyer can still represent you and help you win benefits if you only speak with them over the phone.
How they communicate: Your lawyer should communicate openly and clearly with you. Look for lawyers who are willing to let you ask all of your questions. This is also a great way to ensure you’ll have peace of mind throughout the process.
How long their practice history is: Look for a lawyer who has a track record of winning disability cases. Their practice history is a good indication that they have what it takes to win your case, too. Don’t totally discount new lawyers, though. Just be aware it’s more difficult to confirm that they have the right skills to navigate the application process.
Finding a good lawyer isn’t easy. Here at Atticus, we’ve been vetting disability lawyers for years. We can match you with someone who’s a good fit for your claim and who will treat you with the respect you deserve. If you want help finding a lawyer, fill out our disability quiz and we’ll reach out to help you further.
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Frequently asked questions about benefits in Pennsylvania
What qualifies you for disability in Pennsylvania?
To qualify for disability you need to have a condition that prevents you from working for at least a year. You’ll also need to meet certain work history requirements (for SSDI) or be within certain income limits (for SSI). For more on these requirements, read our full write up here.
What conditions qualify for disability in Pennsylvania?
Any condition that will prevent you from working for a year or more can qualify for disability benefits. Some of the most common conditions include musculoskeletal disorders, mental disorders, nervous system diseases, and circulatory system diseases. See our full list of conditions that qualify here.
How long does it take to get approved for disability in Pennsylvania?
It takes an average of 6.1 months to get an initial disability decision in Pennsylvania. Most people who apply are initially rejected, and need to appeal this decision. If you appeal and go to a hearing, the process takes just over two years on average. Read more: How Long It Takes to Get Approved for Disability Benefits
How much does disability pay in Pennsylvania?
The average SSDI payment in Pennsylvania is $1,365.92 per month. The average SSI payment is $648.94. What you’ll earn depends on your income, or the amount you’ve historically paid into the Social Security program. Read more on what amount you can expect.
How should I prepare my disability application in Pennsylvania?
Answer the application questions truthfully, consistently, and succinctly. You should also ensure that you gather and submit all your medical records with your application. The SSA paperwork can be complicated, so our legal team has written a full guide to the application here.
Does Pennsylvania have a state disability program?
No, Pennsylvania doesn't have its own state disability program. Only five states have a state program (California, Hawaii, New Jersey, New York, and Rhode Island). Residents of Pennsylvania can apply for federal disability programs (SSDI and SSI). Read more about SSDI and SSI here.
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