SSD FAQ

A: You should apply for disability benefits as soon as you become disabled. The law requires that you be disabled for 12 consecutive months to be eligible, but if your medical provider supports your application, it is better to start now. Claims can always be withdrawn, but it is better to start the process early. Get legal help at the outset.

It can take a long time to process an initial application for disability benefits, three to five months. Over 72% of initial applications are denied nationally, which underscores the benefit of having experienced legal help before you even begin the process.

If you apply for Social Security, disability benefits will not begin until the sixth full month of disability, and only after a lengthy application process. Supplemental Security Income (SSI), SSI disability benefits are paid for the first full month after the date you filed your claim, or, if later, the date you become eligible for SSI. There is a 24-month wait for Medicare eligibility, it begins in the 25th month after your onset date as determined by Social Security. Medicaid or MediCal begins immediately for SSI recipients.

The final award rate for disabled-worker applicants has varied over time, averaging nearly 45 percent for claims filed from 2000 through 2009. The percentage of applicants awarded benefits at the initial claims level averaged just 28 percent over the same period and ranged from a high of 37 percent to a low of 26 percent. The percentage of applicants awarded at the reconsideration and hearing levels are averaging 3 percent and 13 percent, respectively. Denied overall disability claims at all stages have averaged nearly 53 percent.

You have to have been disabled, or expect to be disabled, for at least one year to be eligible.

So, if you expect to be out of work for one year or more on account of illness or injury, you should file for Social Security disability benefits. Do NOT wait until the year has elapsed before you begin. Get legal help at the outset.

The final award rate for disabled-worker applicants has varied over time, averaging nearly 45 percent for claims filed from 2000 through 2009. The percentage of applicants awarded benefits at the initial claims level averaged 28 percent over the same period and ranged from a high of 37 percent to a low of 26 percent. The percentage of applicants awarded at the reconsideration and hearing levels are averaging 3 percent and 13 percent, respectively. Denied overall disability claims at all stages have averaged nearly 53 percent.

To apply for Social Security disability benefits, you will need to complete an application

for Social Security Benefits and the Disability Report. You can also print the Disability Report, complete it and return it to your local Social Security office. Social Security may be able to process your application faster if you help them by getting any other information they need. While it is possible to apply on your own, we recommend seeking legal help at the outset. It can make the difference between a well presented claim that is successful, and one that is denied and must go through many months of appeals.

You can also apply on your own by calling the toll-free number, (816) 415-4560. Representatives there can make an appointment for your application to be taken over the telephone or at any convenient Social Security office.

People who are deaf or hard of hearing may call toll-free “TTY” number, 1-800-325-0778, between 7 a.m. and 7 p.m. on Monday through Friday.

Cases are generally handled on a contingency basis.

That means the representative receives a fee only if you win your case. Normally the fee is 25% of your back benefits and must be approved by Social Security. This fee is set by federal law.

If you do not win your case there is no fee. There are also costs in each case for which you may be responsible. These costs are charges paid to doctors for medical records ad=nd will be discussed in detail with you before we agree to work together.

How does Social Security define disability?

Social Security defines disability as the:

“…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 continuous period of not less than 12 months.”

While this is the hard line of the law, there are many variables. We would be happy to discuss these details with you.

Social Security determines disability by use a five-step process to decide if you are disabled.

Here are the questions Social Security asks:

Are you working?

If you are working and your earnings average more than a certain amount each month, you generally will not be considered disabled. The amount you can earn changes each year, see the current figure across all the programs. If you are not working, or your monthly earnings average the current amount or less, the state agency then looks at your medical condition.

Is your medical condition “severe”?

For the state agency to decide that you are disabled, your medical condition must significantly limit your ability to do basic work activities—such as walking, sitting and remembering—for at least one year. If your medical condition is not that severe, the state agency will not consider you disabled. If your condition is that severe, the state agency goes on to step three.

Is your medical condition on the List of Impairments?

The state agency has a List of Impairments that describes medical conditions that are considered so severe that they automatically mean that you are disabled as defined by law. If your condition (or combination of medical conditions) is not on this list, the state agency looks to see if your condition is as severe as a condition that is on the list. If the severity of your medical condition meets or equals that of a listed impairment, the state agency will decide that you are disabled. If it does not, the state agency goes on to step four.

Can you do the work you did before?

At this step, the state agency decides if your medical condition prevents you from being able to do the work you did before. If it does not, the state agency will decide that you are not disabled. If it does, the state agency goes on to step five.

Can you do any other type of work?

If you cannot do the work you did in the past, the state agency looks to see if you would be able to do other work. It evaluates your medical condition, your age, education, past work experience and any skills you may have that could be used to do other work. If you cannot do other work, the state agency will decide that you are disabled. If you can do other work, the state agency will decide that you are not disabled.

You do not have to wait until the workers’ compensation ends, and you should not wait that long.

An individual can file a claim for Social Security disability benefits while receiving workers’ compensation benefits. Offset calculations are made to equalize any overpayment from either program.

Social Security must consider the combination of impairments that an individual suffers from in determining disability.

Many, perhaps most claimants for Social Security disability benefits have more than one health problem and the combined effects of all of the health problems must be considered.

For disability insurance benefits, it all depends upon how much you have worked and earned in the past.

A national average is $1129.

For disabled widow’s or widower’s benefits, it depends upon how much the late husband or wife worked and earned. For disabled adult child benefits, it all depends upon how much the parent worked and earned.

For all types of SSI benefits, there is a base amount that an individual with no other income receives. Other income that an individual has reduces the amount of SSI which an individual can receive. Each year we all receive a report from Social Security about our retirement benefits. This report also has the dollar figure you’d receive if you were disabled. A spouse and children are also eligible in most cases.

Benefits can be paid for up to one year prior to the date of the claim, if the medical records support this.

For a Disabled Adult Child, benefits begin as of the onset date, but benefits cannot be paid more than six months prior to the date of the claim.

If there have been prior applications, skillful legal help may allow you to reopen that old application and reach back for more benefits. The medical records must support this and other criteria must be met. This is one of the most critical differences between having an attorney and doing an application on your own. Social Security will not be suggesting avenues to reopen old applications. Our experience and skill in crafting your case argument could result of an earlier onset date.

SSI benefits begin at the start of the month following the date of the claim .For Disability Benefits and for Disabled Widow’s and Widower’s Benefit, the benefits begin five months after the person becomes disabled.

Please contact us as early as possible so we can be sure you get all the benefits you deserve.

You should appeal immediately.

Getting legal help is essential.

If you appeal within 10 days after being notified that your disability benefits are being ceased, you can ask that your disability benefits continue while you appeal the decision cutting off your benefits. You may also want to talk with an attorney about representation on your case, but you should file the appeal immediately.

The question in a disability review is whether there has been “medical improvement.” Getting a letter from a treating physician is very important, and that is essentially what the letter needs to say, that there has not been medical improvement.

There are several ways to apply for a Social Security disability claim.

The first is to go to the Social Security District Office and file the claim in person. Now applications can also be made online at http://ssa.gov/. Another way is to call Social Security at 1-800-772-1213. They will make an appointment for a telephone interview for you. Once the interview is finished they will send necessary forms for you to fill out. All the basic information will have been collected during the phone interview.

Although a claimant may apply on his own, it is important to understand that over 72% of initial applications are denied. The final award rate for disabled-worker applicants has varied over time, averaging nearly 45 percent for claims filed from 2000 through 2009. The percentage of applicants awarded benefits at the initial claims level averaged just 28 percent over the same period and ranged from a high of 37 percent to a low of 26 percent. The percentage of applicants awarded at the reconsideration and hearing levels are averaging 3 percent and 13 percent, respectively. Denied overall disability claims at all stages have averaged nearly 53 percent.

Getting legal help at the outset of the claim could make the difference between winning, or being denied and spending many months or years appealing.

Although an applicant can proceed unrepresented, the success rates are significantly different for represented and unrepresented claimants.

The final award rate for disabled-worker applicants has varied over time, averaging nearly 45 percent for claims filed from 2000 through 2009. The percentage of applicants awarded benefits at the initial claims level averaged just 28 percent over the same period and ranged from a high of 37 percent to a low of 26 percent. The percentage of applicants awarded at the reconsideration and hearing levels are averaging 3 percent and 13 percent, respectively. Denied overall disability claims at all stages have averaged nearly 53 percent.

Social Security does its best to process cases, but the backlogs are well known. A good attorney will gather all the necessary information THE FIRST TIME, and increase your chances for success.

Social Security’s position is that it is not up to your doctor to determine whether or not you are disabled.

In the Social Security situation, this is a legal determination, not a purely medical one. This means that a simple statement from a doctor saying a person is disabled is not enough. Social Security wants to see the diagnosis, the supporting symptoms, signs and laboratory tests, and then it will make a decision about whether the condition fits into its own legal framework for disability.

Framing the case so that it fits into the language and technical requirements of Social Security is the most valuable skill we offer clients.

The claims process for disability benefits is generally longer than for other types of Social Security benefits.

It can take up to six months at each of the disability application and appeal levels. The wait for a hearing has grown as the backlog of cases grows – in many cities it is well over a year. Our office will help you gather this information and file.

To complete the application, you should gather the following information:

• Your Social Security number;
• Your birth certificate or other evidence of your date of birth (if you do not have a birth certificate, you may request one from the State where you were born);
• Your military discharge papers, if you were in the military service;
• Your spouse’s birth certificate and Social Security number if he or she is applying for benefits;
• Your children’s birth certificates and Social Security numbers if they are applying for benefits;
• Your checking or savings account information, so your benefits can be directly deposited;
• Names, addresses, and phone numbers of doctors, hospitals, clinics, and institutions that treated you and 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 in the past 15 years and the kind of work you did;
• A copy of your W-2 Form (Wage and Tax Statement), or if you are self-employed, your federal tax return for the past year;
• Dates of prior marriages if your spouse is applying.

The documents presented as evidence must be either originals or copies certified by the issuing agency. SSA cannot accept uncertified or notarized photocopies as evidence since they cannot verify their authenticity. Do not delay filing for benefits just because you do not have all of the information you need. The Social Security office will be glad to help you.

If you are applying for Supplemental Security Income benefits you also need the following:

• information about the home where you live, such as your mortgage or your lease and landlord’s name;
• payroll slips;
• bank books;
• insurance policies;
• car registration;
• burial fund records;
• and other information about your income and the things you own.

Medicare is a federal medical insurance program.

It attached to Social Security Disability Insurance claims. You must be an insured worker with an earnings record for this to cover you. For the disabled, after a claim is favorably decided, Medicare will begin the first day of the 25th month after the established onset date.

Medicare or MediCal is a state funded insurance program for the
indigent.

You must have less than $2000 in assets to be eligible for SSI and for Medicaid. A person found disabled under the SSI program is immediately eligible for this coverage.

You can file for Social Security disability benefits on the day that you become disabled if you believe that you will be out of work for one year or more.

Sometimes social workers can help you and your family make the initial contact with Social Security. Our office is always ready to help with an initial application. Having the case framed properly from the outset can make the difference between winning at the initial application, or enduring many months of appeals.

Although an applicant can proceed unrepresented, the success rates are significantly different for represented and unrepresented claimants. The final award rate for disabled-worker applicants has varied over time, averaging nearly 45 percent for claims filed from 2000 through 2009. The percentage of applicants awarded benefits at the initial claims level averaged just 28 percent over the same period and ranged from a high of 37 percent to a low of 26 percent. The percentage of applicants awarded at the reconsideration and hearing levels are averaging 3 percent and 13 percent, respectively. Denied overall disability claims at all stages have averaged nearly 53 percent. Social Security does its best to process cases, but the backlogs are well known.

A good attorney will gather all the necessary information THE FIRST TIME, and increase your chances for success.

Social Security has two programs that pay disabled people. One is SSI (Supplemental Security Income); the other is “regular” Social Security, or SSDI. There is a lot of confusion about these two programs in the mind of the public.

SSDI

The SSDI or “regular” disability program pays a claimant based on the money paid into Social Security during a lifetime. The amount is determined by how much has been paid in, divided by years of life expectancy. Payments may also be sent to a spouse and children. Eligibility includes Medicare two years after entitlement date.

SSI

The SSI program is an entitlement program, paid to people who have not worked regularly during the past five years. There is an asset limitation and a household income limitation for eligibility as well. There is immediate state Medicaid coverage with this program.

While they wait the many months and even years that an appeal takes, many have had to declare bankruptcy, some even died while awaiting hearings. After that initial denial, many become discouraged and drop out of the process.

People need help getting the right decision the first time, and that’s where we come in. For claimants with attorney representation, the success rate is up to 80% favorably concluded. In some cases, an experienced attorney can expedite the process of issuing a favorable decision.

To qualify for Social Security disability benefits (SSDI) or Supplemental Security Income (SSI), you must have an impairment that prevents any kind of full time work, even the lightest job.

Your disability must have lasted or be expected to last 12 consecutive months.

The Social Security disability program is America’s safety net. It includes the so-called “regular” disability program (SSDI), the program that calculates benefits based on a work record within the past five years. There is also Supplemental Security Income (SSI), for people with no appreciable earnings record. SSI protects the very young, the homeless, the mentally ill – people whose impairments make them unemployable.

Before even arriving at the question of whether a person is disabled, Social Security screens applicants for SSI eligibility, based on financial assets and countable income. The medical disability standard is the same for all Social Security disability programs. It is also possible to be eligible for both SSI and “regular” Social Security disability payments.

If past earnings cause the SSDI payment to be low, it may be supplemented up to the SSI amount if all financial qualifications are met. SSI eligibility entitles a person to immediate state Medicaid coverage in most cases. SSDI gives entitlement to Medicare after a waiting period.

The basic monthly SSI payment in 2010 has been $674 for one person or $1011 for a disabled couple. SSI has an asset limitation and evaluates resources (the things you own) to see if you have more than $2000 for an individual or $3000 for a couple. The value of a home and usually of a car is excluded. There is no asset limit for SSDI, it is like an insurance policy.

Cash is a countable asset for SSI, as are bank accounts, stocks and bonds. It also includes earnings and anything that can be converted to cash. Social Security benefits count, and so do other pensions and the value of goods and services you are given by someone else – such as food, clothing and shelter.

To get SSI, you are required to apply for any other available benefits, like food stamps, Medicaid and VA benefits.