Puerto Rico Disability Benefits: Qualify, Apply, and Get Approved
July 1, 2023 · 8 min read
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In 2022, the Social Security Administration (SSA) provided disability benefits to just over 160,000 Puerto Rico residents. They’re proof that, as intimidating as the application process may seem, you can successfully apply and win benefits. To help you get started, this guide will explain who’s eligible for benefits, how the application process works, and the monthly benefit payments you may receive.
What Puerto Rico disability program should I apply for?
Puerto Rico doesn’t administer its own disability program, so you can either apply for federal disability benefits or purchase a private disability insurance policy. If you live in Puerto Rico, you may be able to qualify for one of the following programs:
Social Security Disability Insurance (SSDI): The U.S. administers two different disability programs: SSDI and Supplemental Security Income (SSI). People whose primary residence is in Puerto Rico aren’t eligible for SSI, but they can qualify for SSDI. SSDI benefits are based on the income you’ve earned and taxes you’ve paid, so they’re the largest benefit amount of any disability program. SSDI recipients also receive Medicare health insurance.
Veterans disability benefits: If you’re an active duty or retired veteran who can’t work because of an injury you received in the line of duty, you can qualify for benefits through the Department of Veterans Affairs (VA). You can receive SSDI at the same time as VA benefits. Learn more about qualifying for VA disability.
Long-term or short-term private disability insurance: Many people have disability insurance through their employer, but you can also purchase a policy on your own. With private insurance, you can file a claim only if you had the policy before you had to stop working. Payments are typically worth up to 60% of your former paychecks and may last months or years. Even if you do qualify for long-term benefits, your insurer will probably require you to apply for SSDI or offset your payment amount.
Most Puerto Ricans with disabilities will qualify for SSDI benefits, so the rest of this guide will explain how to apply for that program. You can also reference our guide to the types of disability benefits to get help applying for the other programs.
Skip the reading. See which benefits you qualify for in 2-minutes or less.
How to qualify for disability in Puerto Rico
To qualify for SSDI, you’ll have to meet two sets of criteria. The first is the medical criteria related to your condition. The second is technical criteria, which have to do with your work history.
Medical qualifications for SSDI
To medically qualify for SSDI, you must have a medical condition or disability that keeps you from working, and your condition must prevent you from working for at least one full year. To prove that you meet these criteria, you’ll need to provide medical documentation from your doctors and healthcare providers.
If you’re over the age of 50, getting SSDI is easier because the SSA will only need to see that you can’t continue doing the kinds of jobs you’ve already done. If you're under age 50, you’ll have to prove that it’s impossible for you to do any kind of work — even if you retrain.
Technical SSDI qualifications
There are two technical criteria you need to meet for SSDI:
You’re 66 or younger (below your full retirement age).
You have enough SSA work credits, meaning you’ve paid enough taxes into Social Security. You’re more likely to qualify if you’ve worked at least five of the last 10 years. To see how many work credits you have, create a free account on SSA.gov.
Conditions that qualify for disability in Puerto Rico
The SSA offers a list of qualifying health conditions, all of which they commonly award benefits for. It’s important to note, though, that your condition doesn’t have to be on the list to qualify. You can win benefits as long as you can’t work because of your condition and it persists for at least a year.
According to recent data from the SSA, Puerto Rican disability recipients most commonly have the following conditions:
There are a few steps to the disability application process. Complete the main SSDI application first. Then move to the supplemental forms. A work history report will detail your work experience, while your function report will explain how your condition affects your daily life. The SSA may request additional forms or medical information as they review your application.
It’s possible to complete these forms on your own, but you can also finish the application with help from a disability lawyer.
You’ll need plenty of time to prepare the application. Plan on taking at least one to two hours to fill out the application, plus any time you need to gather your documents and records. A lawyer can help you complete the process faster, but there are some steps you should know:
Prepare all your personal records. Gather medical records, treatment forms, bank account information, work and income history, and contact information for your healthcare providers. Try to provide as much documentation as possible.
Make sure to fill out the whole application. You may face processing delays if you leave any questions or forms blank.
Answer questions honestly and consistently. The SSA will want to see that your medical and supplemental forms match the responses in your application. Be honest about your condition and how it affects you, including symptoms and pain levels.
Follow up with the SSA right after you submit. Make sure the SSA has received and is processing your application. If you work with a lawyer, they should handle this for you.
Respond to SSA requests immediately. The SSA will give you 10 days to respond, but responding faster will help avoid delays.
Many applicants prefer applying online, but applying in person can be a great option if you apply on your own. An SSA worker can explain what the application questions are asking and explain how the application process works. That said, only a lawyer can offer personalized legal advice, like how to make your answers stronger or details you should include or exclude.
Once you get started, you may find that you want help with your application. If so, working with a lawyer can be the most impactful option. Your lawyer will make your responses stronger, complete the application for you, follow up with the SSA, and represent you for any court hearings.
Disability lawyers also won’t charge you anything until after you win benefits, so you can get the help you need without having to immediately pay another bill.
Atticus is a law firm, which means we can provide advice on filling out your application and finding the right lawyer for your case. To get help, fill out our free 2-minute disability benefits quiz.
What happens after I apply for disability?
After you apply, the SSA will review your application to confirm whether you meet SSDI’s technical requirements. Disability Determination Services (DDS) will then make sure that you’re medically eligible. The SSA may request a phone interview, while the DDS may require a quick consultative exam with one of their doctors.
Even when reviews go smoothly, this can be a lengthy process. As of early 2023, applicants waited an average of six months for a decision.
Your chances of getting approved for benefits
You will likely go through a few rounds of denial and appeal before you receive the SSA’s final decision. The good news is that your chances of approval typically improve after a couple appeals.
The SSA rejects about 70% of initial applications. You can then file for reconsideration, but the SSA rejects 90% of those. At that point, you can appeal for a disability hearing in front of an administrative law judge (ALJ).
How long does it take to get disability benefits in Puerto Rico?
As of March 2023, the average wait in Puerto Rico was about 33 months — just under three years — from the time they applied until the time they were approved. This wait comes down to the multiple stages of appeal most applicants go through. The average wait times for each stage are:
Initial decision: 6.1 months (184 days)
Reconsideration decision: 6.1 months (183 days)
Wait time for a hearing: 20.5 months (plus 1-3 months to get a decision)
Keep in mind, wait times will vary by hearing office, which means your actual wait time will depend on which hearing office your application is assigned to. There are two hearing offices in Puerto Rico, and the wait time for each is below.
Wait time for a hearing
How to speed up the process
Unfortunately, you can’t speed up the process. That said, you can keep your application moving by preventing delays. Make sure you submit your application as soon as it's complete, then get in touch with the SSA right away. Stay on top of any requests from the SSA. Your lawyer can also keep your application moving by following up with the SSA as needed and handling your appeals.
On the bright side, you’ll be compensated for the wait once you get approved for disability. Your first disability check will include SSDI back pay benefits to cover the amount you would’ve received if you’d been approved earlier instead of having to appeal and wait.
Your benefit amount won’t change based on your medical condition or where you live. The biggest determining factors are the income you earned during your career and how much tax you’ve paid into Social Security.
You can see exactly how much your benefits will be through your SSA.gov account:
Applying for SSDI is stressful, but a lawyer can take much of the burden off your shoulders. Your lawyer can handle your appeals, follow up with the SSA, and appear for any court proceedings. This not only makes the application process easier, but it’s also why applicants who work with lawyers are more likely to get approved.
As you look for a disability lawyer in Puerto Rico, consider the following factors:
Reviews: Positive reviews are great, but you’re really looking for patterns in the negative reviews. One or two bad reviews isn’t necessarily a red flag, but if a lot of their customers had the same poor experience, it may be a sign the lawyer isn’t a good fit for your case.
Communication: You may not hear from your lawyer for months during waiting and processing periods, but they should be responsive to communications from you and the SSA.
Primary area of practice: Social Security disability law is unique so look for a lawyer who specializes in it. Someone who mostly practices in another area of law won’t have the necessary experience to help you make the strongest case for approval.
Location (somewhat): Local lawyers often know the judges and their leanings, but Social Security disability rules are the same in every state. Remote hearings have become common since the COVID-19 pandemic and a lawyer who only consults over the phone can still help you win benefits.
Atticus can help you find an experienced lawyer who will make your case a priority and treat you with respect. Start with our free disability benefits questionnaire and we’ll find you a qualified match. You’ll still get to choose whether to work with our lawyers, and you won’t pay anything until after you win benefits.
Ready to get benefits today?
Frequently asked questions about benefits in Puerto Rico
How do I qualify for disability in Puerto Rico?
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 to qualify for SSDI. For more on these requirements, read our full write up here.
What conditions qualify for disability in Puerto Rico?
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 Puerto Rico?
It takes an average of 6.1 months to get an initial disability decision in Puerto Rico. Most people who apply are initially rejected, and need to appeal this decision. If you appeal and go to a hearing, the process takes around three years on average. Read more: How Long It Takes to Get Approved for Disability Benefits
What’s the average SSDI payment in Puerto Rico?
The average SSDI payment in Puerto Rico is $1,197.17 per month. 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 Puerto Rico?
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 Puerto Rico have a state disability program?
No, there is no Puerto Rico disability program. Only five states (California, Hawaii, New Jersey, New York, and Rhode Island) have a state program. Puerto Ricans also can’t qualify for SSI, unfortunately.
See what you qualify for
How long has your condition made it hard to work?
Jackie Jakab is Atticus’s Legal Director. She’s a licensed attorney, a graduate of the University of Chicago Law School, and has counseled thousands of people seeking disability benefits.
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