I have practiced law since 1998. I have helped many people with Social Security problems get their benefits
and I have worked at all levels of Social Security appeals. More
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Under
the Social Security Act, "disability" means "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."
2.
How many different types of Social Security disability benefits are there?
There
are at least five major types of Social Security disability benefits.
Disability Insurance Benefits is the most important type of Social Security
disability benefits. It goes to individuals who have worked in recent years
(five out of the last 10 years in most cases) who are now disabled. Disabled
Widow's and Widower's Benefits are paid to individuals who are at least 50 and
become disabled within a certain amount of time after the death of their
husband or wife. The late husband or wife must have worked enough under Social
Security to be insured. Disabled Adult Child Benefits go to the children of
persons who are deceased or who are drawing Social Security disability or
retirement benefits. The child must have become disabled before age 22. For
Disability Insurance Benefits, Disabled Widow's or Widower's Benefits and
Disabled Adult Child benefits, it does not matter whether the disabled
individual is rich or poor. Benefits are paid based upon a Social Security
earnings record. Supplemental Security Income benefits, however, are paid to
individuals who are poor and who are disabled. It does not matter for SSI
whether an individual has worked in the past or not. SSI child's disability
benefits are a variety of SSI benefits paid to children under the age of 18 who
are disabled. The way in which disability is determined is a bit different for
children.
3.
How do I apply for Social Security disability benefits?
A
claimant can file a claim for Social Security disability benefits in several
ways: (1) online at SSA.gov; (2) in person at their local SSA office; or with
the help of an attorney. We file initial
claims on behalf of our clients. SSI
claims cannot be filed online yet.
4.
I am disabled, but I have money in the bank. Do I have to wait until this money
is gone before I apply for Social Security disability benefits?
No.
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, it does not matter how
much money you have in the bank. There is no reason to wait to file the
claim. A claim for SSI benefits IS based
on income and resources. Contact us if
you have questions about other differences between Disability and SSI.
5. How long do I have to wait after becoming disabled before I can
file for Social Security disability benefits?
You
can file for Social Security disability benefits the same day that you become
disabled. Many individuals make the mistake of waiting months and even years
after becoming disabled before filing a Social Security disability claim. An
individual who suffers serious illness or injury and expects to be out of work
for a year or more should not delay in filing a claim for Social Security
disability benefits. Sometimes my
clients say that they waited some period of time to apply because they were
told by someone that they had to.
Contact us if you have questions about applying for benefits.
6.
I am still on sick leave from my employer. Can I file for Social Security
disability now or do I have to wait until the sick leave is exhausted?
You
do not have to wait until the sick leave is exhausted. You should file for
Social Security disability benefits now, if you believe that you will be out of
work for a year or more.
7.
I got hurt on the job and am receiving worker's compensation benefits. Can I
file a claim for Social Security disability benefits now or must I wait until
the worker's compensation ends?
You
do not have to wait until the worker's compensation ends and you should not
wait that long. An individual can file a claim for Social Security disability
benefits while receiving worker's compensation benefits. It is best to file the
Social Security disability claim as soon as possible because otherwise there
may be a gap between the time the worker's compensation ends and the Social
Security disability benefits begin.
8.
Can I get both worker's compensation and Social Security disability benefits?
Yes,
buy there is an offset, which reduces Social Security disability benefits
because of worker's compensation benefits paid, but in virtually all cases, there
is still some Social Security disability benefits to be paid. In a few states
the offset works the other way - - worker's compensation benefits are reduced
because of Social Security disability benefits.
9.
How can I tell if I will be found disabled by Social Security?
Unless
your disability is catastrophic (such as terminal cancer, a heart condition so
bad that you are on a heart transplant waiting list, total paralysis of both
legs, etc.), there is no easy way for you to tell whether you will be found
disabled by Social Security. In the end, the decision of whether or not to
apply for Social Security disability benefits should not be based upon whether
or not the person feels that Social Security will find them disabled. Attorneys
familiar with Social Security disability can make predictions about who will
win and who will lose, but even they can seldom be sure. An individual should
make the decision about whether or not to file for Social Security disability
based upon their own belief about their condition. If the individual feels that
he or she is disabled and is not going to be able to return to work in the near
future, the individual should file for Social Security disability benefits. If
denied, the individual should consult with an attorney familiar with Social
Security disability to get an opinion as to the chances of success on appeal.
10. Do you have to be permanently
disabled to get Social Security disability benefits?
No.
You have to have been disabled for at least a year or be expected to be
disabled for at least a year or have a condition that can be expected to result
in death within a year.
11.
I have several health problems, but no one of them disables me. It is the
combination that disables me. Can I get Social Security disability benefits?
Social
Security is supposed to consider the combination of impairments that an
individual suffers 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.
12.
I got hurt in an automobile accident. I am disabled now, but I expect that I
will be able to return to work after I recover. Should I file for Social
Security disability benefits?
If
you expect to be out of work for a year or more on account of illness or
injury, you should file for Social Security disability benefits.
13.
How does Social Security determine if I am disabled?
Social
Security is supposed to gather your medical records and carefully consider all
of your health problems, as well as your age, education, and work experience.
In general, Social Security is supposed to decide whether you are able to do
your past work. If Social Security decides that you are unable to do your past
work, they are supposed to consider whether there is any other work which you
can do considering your health problems and your age, education, and work
experience.
14.
Who decides if I am disabled?
After
an individual files a Social Security disability claim, the case is sent to a
disability examiner at the Disability Determination agency in your state. This
individual, working with a doctor, makes the initial decision on the claim. If
the claim is denied and the individual requests reconsideration, the case is then
sent to another disability examiner at the Disability Determination agency,
where it goes through much the same process. If a claim is denied at
reconsideration, the claimant may then request a hearing. At this point, the
case is sent to an Administrative Law Judge who works for Social Security. The
Administrative Law Judge makes an independent decision upon the claim. This is
the only level at which the claimant and the decision maker get to see each
other.
15.
Why does Social Security consider my age in determining whether I am disabled?
Social
Security has to consider age, because that is what the Social Security Act
requires. As people get older, they become less adaptable, less able to switch
to different jobs to cope with health problems. A severe foot injury which
might cause a 30- year- old to switch to a job in which he or she can sit down
most of the time, might disable a 60- year- old person who could not make the
adjustment to a different type of work.
16.
Is there a list of illnesses that Social Security considers disabling?
Not
really. Because most types of illness can vary from minor to severe, there is
no one simple list of illnesses which Social Security considers to be
disabling. However, if an illness has reached a very severe level with certain
medical hallmarks, Social Security will award benefits on the basis of medical
considerations alone.
17.
What can I do to improve my chances of winning my Social Security disability
claim?
Be
honest and complete in giving information to Social Security about what is
disabling you. Many claimants, for instance, fail to mention their psychiatric
problems to Social Security because they are embarrassed about them. In almost
all cases, individuals who were slow learners in school fail to mention this
fact to Social Security, even though it can have a good deal to do with whether
or not the Social Security disability claim is approved. Beyond being honest
and complete with Social Security, the most important thing that you can do is
just keep appealing and hire an experienced person to represent you. It is
important to appeal because most claims are denied at the initial level, but
are approved at higher levels of review. It is important to hire an experienced
person to represent you because you do not understand the way Social Security
works. Statistically, claimants who employ an attorney to represent them are
much more likely to win than those who go unrepresented.
18. If I am approved for Social
Security disability benefits, how much will I get?
For
disability insurance benefits, it all depends upon how much you have worked and
earned in the past. 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.
19.
How far back will they pay benefits if I am found disabled?
For
Disability Insurance Benefits and for Disabled Widow's and Widower's Benefits,
the benefits cannot begin until five months have passed after the person
becomes disabled. In addition, benefits cannot be paid more than one year prior
to the date of the claim. For a Disabled Adult Child, there is no five-month
waiting period before benefits begin, but benefits cannot be paid more than six
months prior to the date of the claim. SSI benefits cannot be paid prior to the
start of the month following the date of the claim.
20.
What do I do if Social Security denies my claim for Social Security disability
benefits?
First,
do not be surprised. Only about 30% of Social Security disability claims are
approved at the initial level. If you are denied at the initial level, unless
you have already returned to work or expect to return to work in the near
future, you should appeal, that is, file a request for reconsideration. You
should also consider employing an attorney to represent you.
21.
Why does Social Security turn down so many claims for disability benefits?
There
is no simple answer to this question. One reason is that there is no simple way
to determine whether an individual is disabled. Most people who are disabled
suffer from pain. There is no way of determining whether or not another
individual is in pain, much less how much pain they are in. A second reason is
that Social Security over the years has been more concerned with making sure that
everyone who is receiving Social Security disability benefits is
"truly" disabled than with making sure that everyone who is disabled
receives Social Security disability benefits. An underlying reason is that
Congress has always believed that, given a chance, many people will
"fake" disability in order to get benefits.
22.
I only want to get back the money I put in Social Security. Why do they make it
so hard for me to get my own money back?
Actually,
when you file a Social Security disability claim, you are not trying to just
get "your own money" back. The money that an individual may have paid
into Social Security over the years would not last very long if that was all
that an individual could draw from Social Security.
23.
What is "reconsideration"?
When
a claim for Social Security disability benefits is denied at the initial level,
the claimant may then request "reconsideration" of that decision. The
case is then sent to a different disability examiner for a new decision.
Unfortunately, about 80% of the time the reconsideration decision is the same
as the initial decision - a denial.
24.
Who makes the reconsideration determination?
A
disability examiner at the Disability Determination Section makes the
reconsideration determination. Most of the time, the claimant does not see the
disability examiner or even know his or her name.
25.
What are my chances of winning at reconsideration?
Statistically,
about 10% of the time a claimant wins at reconsideration.
26.
Do I have to go through reconsideration?
If
you want to appeal a denial of Social Security disability benefits, you have to
go through reconsideration. There is no way to avoid it.
27.
How long does it take to get a hearing on a Social Security disability claim?
There
is much variation around the country. In a few areas of the country the wait is
only three months. In a few areas of the country the wait is more than a year.
28.
What is the Social Security hearing like?
The
hearings are fairly informal. The only people likely to be there are the judge,
a secretary operating a tape recorder, the claimant, the claimant's attorney,
and anyone else the claimant has brought with him or her. In some cases, the
Administrative Law Judge has a medical doctor or vocational expert present to
testify at the hearing. There is no jury nor are there any spectators at the
hearing. There is no attorney at the hearing representing Social Security
trying to get the judge to deny the disability claim.
29.
What are my chances of winning at a hearing?
We
find that about 70% of our Social Security disability hearings end in a win for
the claimant.
30.
If the Administrative Law Judge denies my claim, can I appeal any more?
Yes.
You can appeal to the Appeals Council which is still within Social Security. If
the Appeals Council denies the claim, you can file a lawsuit against the Social
Security Administration in federal court.
31.
What is the Appeals Council?
The
Appeals Council exists to review Administrative Law Judge decisions. The
Appeals Council is located in
32.
Can I appeal a case beyond Social Security to the Federal Courts?
Yes.
After being denied by the Appeals Council, it is possible for a claimant to
file a civil action in the United States District Court, requesting review of
Social Security's decision. A Social Security disability claim can go all the
way to the Supreme Court. Perhaps once every year or two years, the United
States Supreme Court actually hears an appeal about a Social Security
disability case.
33.
If I get on Social Security disability benefits and get to feeling better and
want to return to work, can I return to work?
Certainly
you can return to work. Social Security wants individuals drawing disability
benefits to return to work and gives them every encouragement to do so. For
persons receiving Disability Insurance Benefits, Disabled Widow's and Widower's
Benefits, and Disabled Adult Child Benefits, full benefits may continue for a
year after an individual returns to work. Even thereafter, an individual who
has to stop work in the following three years can get back on Social Security
disability benefits immediately without having to file a new claim. In SSI
cases, things work a differently, but there is still a strong encouragement to
return to work.
34. Do I really have to hire a lawyer
to represent me in my Social Security disability claim?
No.
You can go through all of the levels of review on your own, if you wish, but
statistically claimants who are represented by an attorney win a good deal more
often than those who are not represented.
35.
How do lawyers who represent Social Security disability claimants get paid?
In
almost all cases, the attorney receives one- quarter of the back benefits if
the claimant wins and no fee if the claimant loses.
36. If Social Security tries to cut off
my disability benefits, what can I do?
You
should appeal immediately. 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.
37.
My doctor says I am disabled so why is Social Security denying my Social
Security disability claim?
Social
Security's position is that it is not up to your doctor to determine whether or
not you are disabled. It is up to them and they will make their own decision
regardless of what your doctor thinks.
38.
VA says I am disabled, so why is Social Security denying my Social Security
disability claim?
It
is Social Security's position that VA decisions are not binding upon them.
Social Security and VA have very different standards for approving disability
claims.
37. I am disabled by mental illness.
Can mental illness serve as the basis for a Social Security disability claim?
Yes.
Mental illness is a frequent basis for awarding Social Security disability
benefits.
38.
Will it help if I ask my Congressional Representative to help me get Social
Security disability benefits?
Many
Social Security disability claimants become frustrated with claim delays and
eventually ask their
39.
How long does it take before Social Security makes a decision once I file a
claim for Social Security disability benefits?
In
most cases Social Security makes the first decision within four months.
40.
How long does it take for Social Security to make a reconsideration
determination on my Social Security disability claim?
In
most case Social Security makes the reconsideration determination within four
months.
41.
How long does it take for Social Security to act upon a request for Appeals
Council review?
About
a year, maybe longer.
42. What is the difference between
Medicare and Medicaid?
The
short answer is that Medicaid is a poverty program and Medicare isn't. Many
disabled people who get Medicaid get it because they are on Supplemental
Security Income (SSI). This is called “categorical” Medicaid eligibility. To
get SSI and thereby get Medicaid you have to be poor and disabled. Medicaid
pays doctors at very low rates. People who have only Medicaid can have a hard
time finding doctors willing to take them on as patients. Medicaid does pay for
prescription medications. Medicaid can go back up to three months prior to the
date of a Medicaid claim. Note that it is possible to apply for Medicaid
directly - through a local Medicaid office - without having a companion claim
for SSI.
For
Medicare it does not matter whether you are rich or poor. If you have been on
Disability Insurance Benefits, Disabled Widows or Widowers Benefits or Disabled
Adult Child Benefits for 24 months you qualify for Medicare. The good thing
about Medicare is that it pays doctors at a higher rate than Medicaid. Almost
all doctors are happy to take Medicare patients. The bad things about Medicare
are that it does not begin until after a person has been on cash disability
benefits for two years and that it generally does not pay for prescription
medications.
43.
If I get Social Security disability benefits will I get Medicare?
If
you are approved for any kind of Social Security disability benefit other than
SSI you will get Medicare after you have been entitled to Social Security
disability benefits for two years.
44.
If I get Social Security disability benefits will I get Medicaid?
If
you are approved for SSI you will get Medicaid. It is possible to get both
Medicare and Medicaid if you are entitled to SSI and some other type of Social
Security disability benefit.
45.
What can an attorney do to help me get my benefits.
An
attorney will explain the process to you; gather medical evidence for your
case; advise you on tests that may help to prove your disability; make sure
that all deadlines are met in your case; and assist you at the Administrative
Law Judge hearing.