What is Social Security Disability?
If you have a disease, condition or disability that limits or prevents you from employment, you may be eligible to receive government assistance in the form of Social Security Disability benefits (SSD). SSD provides cash benefits on a monthly basis for persons who are totally disabled. In most cases you must be suffering from a condition that has or will prevent you from being employed for at least twelve months or a condition that will result in your death. In applying for these benefits there may be several levels of appeal that must be pursued. A denial at any one level or a past denial, may not disqualify you from receiving benefits.
Seven Important Questions and Answers About Social Security
What Disability benefits are available?
You may receive benefits when you are adjudicated disabled; it’s not only an old-age program. Benefit payments for disability are based on your average earnings. In most disability cases, you must have worked 20 quarters (that is, 5 years) directly preceding the onset of disability.
How does Social Security Administration define disability (SSD)?
You are disabled if you have a physical or mental condition(s) that prevents you from engaging in any substantial gainful employment and the condition is expected to last for 12 months or to result in death. Medical evidence is necessary to prove your inability to work.
What is SSI (Supplemental Security Income)?
SSI stands for Supplemental Security Income. It’s a program run by Social Security. It pays monthly benefits to the elderly, the blind, and people with disabilities who meet certain income requirements.
Can you collect Worker’s Compensation and Social Security together?
Yes, however, your Social Security disability benefit will be reduced so that the combined amount of the Social Security benefit you and your family receive plus your workers’ compensation payment does not exceed 80 percent of your average current earnings.
Can you request Social Security to estimate your Disability Benefits?
Yes, by going to going to your local Social Security office and requesting Form SSA-7004-SM-OPI, Request for Earnings and Benefits Estimate Statement.
Is it easier to prove disability for Social Security benefits for those approaching advanced age (50+)?
Yes, the combination of advanced age, severe mental or physical impairment, and limited work experience can seriously affect a Claimant’s ability to perform a significant number of jobs in the national economy.
Will Social Security consider both your work-related disability as well as your non-work-related in determining your entitlement to benefits?
Social Security will consider the combined effect of all your disabilities and impairments without regard to whether they are work-related or not. If there is a combination of severe medical impairments will be considered to determine if you are disabled.
Social Security Disability
HOW DO I KNOW WHETHER OR NOT I AM DISABLED?
Being disabled means that you are not able to work because of an injury, illness, or medical condition. Under the Social Security Act, "disability" is defined as an "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months." Social Security pays only for total disability. No benefits are payable for partial disability. Your total disability does not have to be permanent, but it must be expected to last at least one year.
WHAT KINDS OF DISABILITY BENEFITS CAN I EXPECT TO RECEIVE?
It depends on which types of benefits you are eligible to receive. There are five types of Social Security Disability benefits:
- DIB (Disability Insurance Benefits): You are considered to be "insured" under the Social Security Act if you have worked at least 5 out of the last 10 years. You can only receive DIB benefits if you are insured and your insured status has not already expired.
- Disabled Widow’s and Widower’s Benefits: If you are at least 50 years old and become disabled within a certain amount of time after the death of your spouse, you may be eligible for these benefits. However, your spouse must have worked enough years for you to be eligible.
- Disabled Adult Child Benefits: If you are the adult child of a person who is deceased or who is currently drawing Social Security disability or retirement benefits, you may be eligible for these benefits. You must have become disabled prior to your 22nd birthday.
- SSI (Supplemental Security Income): If you have no income or source of support, you may be eligible for SSI. Your eligibility does not depend on how much you have worked, but it does depend on your assets and the amount of money you have in the bank.
- Disabled Children: A different set of rules applies to disabled children and in some circumstances, parents may apply for disability benefits on behalf of their disabled child. It is advisable to contact a Social Security attorney to discuss your options under this category.
WHEN SHOULD I APPLY FOR SOCIAL SECURITY DISABILITY BENEFITS?
As soon as possible. You can file the very day you become disabled. There is no advantage to waiting before filing a claim, nor is there a minimum age requirement for filing claims.
DO I HAVE TO USE UP ALL OF MY MONEY AND ASSETS BEFORE I CAN BE ELIGIBLE FOR SOCIAL SECURITY DISABILITY BENEFITS?
Absolutely not! If you have worked in recent years or if you are applying for Disabled Widow’s or Widower’s benefits or Disabled Adult Child benefits, you should go ahead and apply. There is no advantage to waiting to file a claim.
HOW DO I APPLY FOR SOCIAL SECURITY BENEFITS?
There are four ways you can apply:
- Call your local Social Security office and tell them you wish to apply over the phone.
- Visit your local Social Security office and complete a written application.
- Call the Social Security Disability information line at 1-800-772-1213 Monday through Friday between 7 a.m. and 7 p.m. (If you are deaf or hard-of-hearing, call their toll-free TTY number, 1-800-325-0778, Monday through Friday between 7 a.m. and 7 p.m.)
- Apply on-line at www.ssa.gov
WHAT INFORMATION WILL I NEED TO COMPLETE MY APPLICATION?
Information About You:
- Your Social Security number and proof of your age
- Names, addresses and phone numbers of doctors, hospitals, clinics and institutions that treated you and the dates of treatment
- Names of all medications you are taking
- Medical records from your doctors, therapists, hospitals, clinics and caseworkers
- Laboratory and test results
- A summary of where you worked and the kind of work you did
- Your most recent W-2 form, or your tax return if you’re self-employed
You may also need:
- Information About Family Members:
- Social Security numbers and proof of age for each person applying for benefits
Dates of prior marriages if your spouse is applying
HOW DOES SSA DETERMINE WHETHER OR NOT I AM DISABLED?
Supposedly, SSA will collect information from your treating doctors, your medical records, details on your impairments, and carefully consider all of your health problems, both individually and in combination. In addition, SSA factors in your age, level of education, and past work experience. If SSA decides that you are unable to do your past work, they will then decide if there is any other work that you could do given your health problems, your age, education, and work experience.
WHAT IF I AM DENIED BENEFITS?
Don’t be surprised! Most people are denied after their first application. You can appeal the denial by filing a Notice of Reconsideration with the Social Security Administration, but you must do so within 60 days of your receipt of the denial. It is a good idea to contact a lawyer who specializes in Social Security for help with your case. If you are denied benefits a second time, you can still appeal by filing a "Request for Hearing before an Administrative Law Judge," but again you only have 60 days to file a request. If you have not yet hired a lawyer to help you with your claim, now is the time to think seriously about seeking legal counsel! Although you do not need a lawyer to attend the hearing, claimants who are represented by legal counsel dramatically increase their chances of success at the hearing.
WHAT HAPPENS AT THE HEARING?
The hearing is the first time that someone other than a Social Security agent reviews your file. Your file is transferred to the Office of Hearings and Appeals to be reviewed by an Administrative Law Judge. It is a chance for a neutral party, independent of the Social Security Administration, to review your claim and collect live testimony from you about your impairments and the effect of those impairments on your daily activities. The hearing is private and relatively informal. If you have hired a lawyer, the lawyer will ask you a series of questions designed to educate (and hopefully persuade) the Administrative Law Judge on your impairments and how they interfere with your ability to work. Legal counsel is critical at the hearing level, because the judge may prefer to have medical advisors and/or vocational experts testify at the hearing about your ability to work. These advisors and experts often speak only in very legal and technical terms. Many claimants do not understand their testimony and therefore cannot effectively cross-examine these witnesses on their own. Although the judge may elect to have vocational experts or medical advisors testify at your hearing, it is comforting to note that no one in the room works for Social Security. There are no witnesses at the hearing who can cross-examine, ridicule, or pick on you during your testimony. Usually the judge will ask only a few questions and leave the rest of the questions to your attorney.
WHAT HAPPENS IF THE ADMINISTRATIVE LAW JUDGE DENIES MY CLAIM?
There is still a chance to appeal the denial. You have 60 days from the date you receive the judge’s opinion to send a letter to the Appeals Council addressing why you believe the judge is incorrect in his decision. An attorney who specializes in Social Security Disability can be of tremendous assistance at this stage because the attorney can write a brief to the Appeals Council on your behalf. Experienced Social Security attorneys can prepare appeal briefs which specifically identify the law as it applies to the judge’s errors. This greatly increases the likelihood that the Appeals Council will review your case and remand it back for another hearing.
WHAT IF I CANNOT AFFORD AN ATTORNEY?
At Bagolie Friedman we do not charge clients for consultations. You can call our office any time and schedule an appointment with a Social Security attorney, free of charge. If we are successful in your claim, we are entitled to 25% of your past-due benefits, but no more than $4,000. This fee is statutory and set by the Social Security Act. All that we require from Claimant’s is that they sign our fee agreement, which must be approved by the Social Security Administration or an Administrative Law Judge prior to our receiving our benefits. SSA sends the claimant a copy of our fee statement so that you will know exactly how much the attorney is entitled to be paid.
DO I NEED TO APPLY SEPARATELY FOR MEDICARE OR MEDICAID?
No. If you are found disabled and are entitled to SSI, Medicaid is automatic. If you are found disabled and entitled to DIB, Medicare is automatic. You can get Medicaid and Medicare if you are approved for both SSI and DIB.
IF I AM INJURED ON THE JOB, CAN I COLLECT BOTH WORKER’S COMPENSATION AND SOCIAL SECURITY DISABILITY?
Yes. There is an offset in benefits, which your attorney can explain to you during your free consultation. There is also no reason to wait until your Worker’s Compensation claim is settled before filing for Social Security Disability.
IF I AM FOUND DISABLED, HOW MUCH MONEY CAN I EXPECT TO GET FROM SSA?
It depends. How much you receive for your disability insurance (DIB) depends on how much income you have earned and how much you have worked in recent years. Surviving spouses and children will receive an amount based on their deceased spouses’ or parent’s earnings and years worked. Disabled children receive an amount based on their parent’s earnings and years worked. Basically the amount received depends on how much Social Security tax you have paid over the years.SSI is a statutory set amount for each individual or married couple. Unlike DIB, your SSI amount is based entirely on financial need. SSI is reserved for claimants with very little or no income, no source of support, and no assets. You can collect SSI even if you have never worked a single day.
CAN SSA TAKE AWAY MY BENEFITS?
Yes. If you are awarded disability benefits, or if you have already been receiving disability benefits, it is customary for the SSA to step in every few years and review your claim. If SSA finds that you are able to work and that your condition has improved, they may send you notice that they intend to discontinue your benefits. If you receive notice that SSA intends to stop your benefits, the first thing you must do is appeal within the 10 day deadline. Then, you should contact an attorney about representing you during the appeal.
Social Security Disability
Studies show that one out of four young workers will become disabled some time during his or her lifetime. The Social Security Administration pays cash benefits to people who are unable to work for a year or more because of a disability. Benefits continue until a person is able to work again on a regular basis, and a number of work incentives are available to ease the transition back to work.
Why Should I Hire a Social Security Attorney?
The process of applying for early social security disability benefits can be long and frustrating. Most people who apply for social security benefits are turned down a minimum of two times. Without legal help, it may take up to 2 ½ years to get benefits! Bagolie Friedman can help speed up this process so you can take care of your injury and family. According to the Social Security Administration, a "Disability" can be physical, emotional, or a combination of both. In order to obtain benefits, you must prove your disability is severe enough to keep you from working in any paying job for at least 12 consecutive months. Factors that influence the legal finding of disability are the claimant’s age, education, work experience, compliance with medical treatment, daily activities and the kind and extent of treatment. We’ll help you gather all the relevant information and show the Administration that you deserve benefits.
How Disability Is Determined
The process used to determine if you are disabled is a step-by-step process involving five questions. They are:
1.Are you working? If you are and your earnings average more than $780 a month in 2002 or $800 a month in 2003, you generally cannot be considered disabled.
2. Is your condition severe? Your impairments must interfere with basic work-related activities for your claim to be considered.
3. Is your condition found in the list of disabling impairments? The Social Security Administration maintains a list of impairments for each of the major body systems that are so severe they automatically mean you are disabled. If your condition is not on the list, a decision has to be made if it is of equal severity to impairments on the list. If it is, your claim is approved. If it is not, go to the next step.
4. Can you do the work you did previously? If your condition is severe, but not at the same or equal severity as an impairment on the list, then the Administration must determine if it interferes with your ability to do the work you did in the last 15 years. If it does not, your claim will be denied. If it does, your claim will be considered further.
5. Can you do any other type of work? If you cannot do the work you did in the last 15 years, the Administration then looks to see if you can do any other type of work. They consider your age, education, past work experience, and transferable skills, and review the job demands of occupations as determined by the Department of Labor. If you cannot do any other kind of work, your claim will be approved. If you can, your claim will be denied.
Statute of Limitations
You need to know that the law allows only a limited period of time for social security disability claims to be brought and we can help you determine how much time you have left. If you do not file your claim within the time provided by law, it may be dismissed and you may be denied benefits. You should apply at any Social Security office as soon as you become disabled. (You may file by phone, mail, or by visiting the nearest office.) However, Social Security disability benefits will not begin until the sixth full month of disability. This "waiting period" begins with the first full month after the date the Social Security Administration decides your disability began.
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