What Is First Party Claim
A first party claim in Social Security disability is a claim you file directly with the Social Security Administration (SSA) for your own benefits. You are the claimant, acting on your own behalf, not someone filing on your behalf or seeking benefits through someone else's record. This applies to both SSDI (Social Security Disability Insurance) and SSI (Supplemental Security Income) applications.
How This Works in SSDI and SSI
When you file a first party SSDI claim, you are requesting monthly benefits based on your own work history and Social Security credits earned through payroll taxes. You must have accumulated at least 20 work credits in the 10 years before your disability began, though this varies by age at onset.
With SSI, you file a first party claim based on your current financial need and disability status, regardless of work history. The federal payment is $943 per month as of 2024, though some states provide supplemental amounts.
The SSA processes first party claims through a standard three-level review system. Initial determinations take 30 to 90 days on average. If denied, you can request reconsideration, then a hearing before an Administrative Law Judge (ALJ). In 2023, approximately 35% of initial SSDI claims were approved, while reconsideration approvals hovered around 15%. At the ALJ hearing level, approval rates jumped to roughly 60%, making representation at this stage particularly valuable.
Medical Evidence and Documentation
Your first party claim must include specific medical evidence demonstrating that your condition meets SSA's definition of disability. You need objective clinical findings from treating physicians, laboratory results, imaging studies, and mental status exams where applicable. The SSA requires evidence showing your impairment has lasted or is expected to last 12 months or result in death.
Common deficiencies in first party claims include insufficient treatment records, gaps in medical care exceeding 90 days, and lack of functional capacity assessments. An incomplete record often leads to initial denial. Gathering records from all treating sources before filing strengthens your case substantially.
Back Pay Calculation
If your first party claim is approved, you may receive back pay from your established disability onset date. For SSDI, back pay covers up to 12 months prior to your application date. For SSI, the waiting period is one month. The SSA deducts any interim benefits received during this period. With average SSDI payments around $1,350 monthly, back pay calculations can total substantial amounts, though attorney fees are capped at 25% of past-due benefits or $6,000, whichever is lower.
Common Questions
- Can I file a first party claim while still working? Yes, you can file while working, but your current earnings may affect SSI eligibility if you exceed the monthly limit ($1,550 in 2024). Work activity does not automatically disqualify you for SSDI if your impairments prevent substantial gainful activity, defined as earning $1,550 or more monthly.
- What happens if my first party claim is denied? You have 60 days to request reconsideration, then 60 days to file for an ALJ hearing. The entire appeal process typically takes 18 to 24 months. An estimated 60% of claimants with attorney representation at the ALJ hearing stage receive approval.
- How long does a first party claim take to process? Initial determinations average 60 days. Reconsideration adds another 60 to 90 days. ALJ hearings range from 6 to 18 months depending on your jurisdiction's backlog.
Related Concepts
- Third Party Claim - filed by someone on your behalf, such as a representative payee or legal guardian
- Proof of Loss - the documentation and medical evidence supporting your disability claim