1. What is the definition of disability used by Social Security?
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. What types of Social Security disability benefits are there?
There are five major types of Social Security disability benefits. Disability Insurance Benefits are the most important type of Social Security disability benefits. It goes to individuals who have worked in recent years (five out of the last ten years in most cases) who are now disabled. Disabled Widows/Widowers 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 benefits. The child must have become disabled before age 22. For Disability Insurance Benefits, Disabled Widows and Widowers 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 (SSI) 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 SSI benefits paid to children under the age of 18 who are disabled. Disability is defined differently for children.
3. How do I apply for Social Security disability benefits?
Disability Professionals Llc can assist you in applying for Social Security disability benefits by contacting us 1-(866) 678-1832. Professional staff can answer questions and a representative can begin the fight for you by taking over and completing the entire application and/or appeals process for you. Don’t wait. For very month you wait to apply you may be passing up benefits you are entitled to.
4. How long do I have to wait after becoming disabled before I can file a claim for Social Security benefits?
Not even one day. You can file for Social Security disability benefits on the very same day that you become disabled. Many people make the mistake of waiting months or even years of becoming disabled before filing a Social Security disability claim. Still, there is no reason to file a Social Security disability claim if you have only a minor illness or one which is unlikely to last a year or more.
5. Do I 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. You do not have to wait until it has been a year. You can apply and be approved if it looks like you will be disabled for at least a year.
6. 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, etc.), there is no way for you to tell in advance whether you will be found disabled by Social Security. If you feel that you are disabled and will not be able to return to work in the near future, you should file for Social Security disability benefits.
7. 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.
8. Who decides if I am disabled?
After you file a Social Security disability claim, your case is sent to a disability examiner at the Disability Determination Service office in your state. The disability examiner, usually working with medical staff, makes the initial decision on your case. If your claim is denied and you request reconsideration, your case is sent to another disability examiner at the Disability Determination Service office in your state, where it goes through much the same process. If your claim is denied at consideration, you may request a hearing. At this point, your case is sent to an Administrative Law Judge who works for Social Security. The Administrative Law Judge holds a hearing and makes an independent decision upon the claim. This is the only level at which you and the decision maker get to see each other.
9. What can I do to improve my chances of winning my Social Security disability claim?
Get under medical care and stay under medical care as best you can. It is possible to be approved for Social Security disability benefits even if you are not under medical care, but it is harder. The two most common reasons Social Security Administration has a right to deny claims is if you use drugs or alcohol OR you are not doing all that is possible to improve your health. SSA regulations allow them to deny you benefits if they find the use of drugs or alcohol is a contributing factor to why you cannot work full time. Beyond that, the most important thing is simply to file your claim for disability benefits with Social Security. After your claim is filed, the most important thing that you can do is keep appealing – and stay under medical care as best you can. Most claims are denied at the initial level, but many cases heard by an Administrative Law Judge are approved. Having representation to handle your claim is helpful.
Statistically, claimants who employ a representative to handle their claim are more likely to win than those who do not have someone representing them.
10. Why does Social Security turn down so many claims for disability benefits?
There is no simple answer for this question. One reason is that there is no easy way to determine whether an individual is disabled. Most people who are disabled suffer from pain or mental illness. There is no way to measure pain, nor any good way to measure the severity of mental illness. A second reason is that Social Security is more concerned with making sure that everyone who is receiving Social Security benefits is “truly” disabled than with making sure that everyone who is disabled receives Social Security benefits. An underlying reason is that Congress has always believed that, given a chance, many people will fake disability in order to get benefits.
11. What do I do if Social Security denies my claim for disability benefits?
First, do not be surprised. Over 70% of Social Security disability claims are denied 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, an appeal should be filed, that is, file a request for reconsideration. Over 90% of reconsideration appeals are denied. Then a second appeal should be filed, requesting a hearing with an Administrative Law Judge. More cases are approved at a hearing level than either of the first two levels. Consider hiring a representative, if you do not already have one, to assist in the handling of the appeals and presenting your case in the proper manner. Claimants who are assisted by a representative win a good deal more often than those who are not represented.
12. After I file the initial claim for Social Security disability benefits, how long does it take before Social Security makes an initial decision?
On average between 4-6 months, but that is an average. Some cases are decided faster and some slower.
13. Should I gather medical or other records before filing my claim?
No. Go ahead and file the claim. Social Security will tell you if they need anything from you. A lot of people waste a lot of time and energy trying to get records that Social Security is not even interested in.
14. What is “reconsideration”?
It is the first level of appeal at Social Security. When a claim for Social Security disability benefits is denied at the initial level, you may request reconsideration. Your case is sent to a different disability examiner for a new decision. Unfortunately, about 85-90% of the time the reconsideration decision is the same as the initial decision – a denial.
15. 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.
16. How long does it take for Social Security to make a reconsideration determination on my Social Security disability claim?
Again, on average between 4-6 months, but that is an average. Some cases move slower than others.
17. How long does it take to get a hearing on a Social Security disability claim?
If you are denied at the reconsideration level and then request a hearing, the wait time can vary from about 12-15 months.
18. Why does it take so long to get a hearing?
Social Security does not have enough employees to get its work done. Social Security and its employees are unhappy that you have to wait so long but until Congress and the White House give Social Security enough money to hire more employees, there is little that the Social Security Administration can do.
19. What is the Social Security hearing like?
The hearings are informal. The only people certain to be there are the Administrative Law Judge, a hearing reporter who operates the recording equipment, you and your Representative if you have one. In many cases, the Administrative Law Judge has a medical expert and or a vocational expert present to testify at the hearing. There is no jury nor is there an attorney at the hearing representing Social Security trying to get the Judge to deny you. Most Judges now do not allow spectators (family, friends, County Workers, etc..) in the hearings. Most hearings last less than an hour.
20. What are video hearings like?
In a video hearing the Administrative Law Judge is at another location. You see him or her on a television screen. The Administrative Law Judge sees you on a television screen at his or her end. It is not the same as being in the same room, but most people are satisfied with video hearings. If you do not like the idea of a video hearing, you can insist on a live hearing. Insisting on a live hearing may cause further delay, however.
21. If the Administrative Law Judge denies my claim, can I appeal anymore?
Yes. You can appeal to the Appeals Council which is still within Social Security.
22. What is the Appeals Council?
The Appeals Council exists to review Administrative Law Judge decisions. The Appeals Council headquarters are in Falls Church, Virginia. Neither the claimant, nor the Representative sees the people at the Appeals Council who are working on the case. It can take up to one year to get a decision from the Appeals Council.
23. If I am approved for Social Security disability benefits, how much will I get per month?
For Disability Insurance benefits, it all depends upon how much you have earned in the past. For Disabled Widows or Widowers benefits, it depends upon how much your late husband or wife earned, as well as your age at the time you go on benefits. For Disabled Adult Child benefits, it all depends upon how much your father or mother 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 receives will reduce the amount of SSI paid.
24. How far back will they pay benefits if I am found disabled?
Disability Insurance benefits cannot begin until five full months have passed after you become disabled. In addition, benefits cannot be paid more than one year prior to the date of your claim. SSI benefits cannot be paid until the beginning of the month after the month in which you file your claim.
25. If I win my claim, how long will it be before I get paid?
In most cases, you will receive some money within one to two months after a “favorable” decision. It can take longer to get everything paid if you are approved for two types of disability benefits at the same time or if you have been receiving workers compensation or a State disability benefit.
26. How do Representatives who represent Social Security disability claimants get paid?
In most cases, the Representative receives one-quarter of the back benefits up to a certain dollar amount if you win, and no fee if you lose. You will have to pay the representative back for anything that he or she had to pay out of pocket to get medical records on you.
27. I am already on Social Security retirement benefits. Can I get Social Security Disability benefits?
Maybe. You can get both at the same time. You cannot get disability benefits at all after full retirement age. However, if you are on early retirement benefits and have not yet reached full retirement age, you can apply for Disability Insurance benefits. If you are found disabled, you will be switched to Disability Insurance benefits, which will pay more per month.
28. 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. You may also want to talk to a representative about representation on your case, but do not let that delay you in filing the appeal quickly. You only have ten days!
29. What is the difference between Medicare and Medicaid?
The short answer is that Medicaid is a poverty program and Medicare is not. Most disabled people who get Medicaid get it because they are on SSI. To get SSI and thereby get Medicaid, you have to be poor and disabled. Medicaid pays doctors at low rates. So people who have only Medicaid sometimes have a hard time finding a doctor they like.
Medicaid does pay for prescription medications. Medicaid can go back up to three months prior to the date of a Medicaid claim. 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 thing about Medicare is that it does not begin until after a person has been on cash disability benefits for two years and there is only a limited prescription drug benefit.
30. I am on sick leave/short-term disability from my employer. Can I file for Social Security disability benefits now? Do I have to wait until the sick leave is exhausted?
You do not have to wait until the sick leave is exhausted. You can file for Social Security Disability benefits now, if you believe that you will be out of work for a year or more.
31. I am a disabled veteran receiving VA disability benefits. Can I file a claim for Social Disability benefits?
Military veterans deemed disabled by the VA can file a claim for Social Security disability benefits also. Even active duty military personnel can file a claim for Social Security disability benefits if they have discontinued their regular duties due to illness.
32. I was hurt on the job. I’m drawing worker’s compensation. Can I file for Social Security disability benefits now or should I wait until the worker’s compensation ends?
You do not have to wait until the worker’s compensation ends. You 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. If you don’t file the claim as soon as possible, there may be a gap between the time the worker’s compensation ends and the Social Security disability benefits begin.
33. Can I get both workers compensation and Social Security disability at the same time?
Yes, in most states, Social Security disability benefits are offset, or reduced, because of workers compensation benefits paid. In a few states it is the other way around – workers compensation benefits are reduced because of Social Security disability benefits. In almost all cases, there are still some Social Security disability benefits to be paid even if you are receiving workers compensation benefits. As important as workers compensation is, Social Security disability is more important because, unlike workers compensation, Social Security disability can last for the rest of your life.
34. 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 them all. Most claimants for Social Security disability benefits have more than one health problem. Each one must be considered, as well as the combined effect of all of the health problems.
35. I know someone who is on Social Security disability and he does not look a bit disabled. Why do they put these freeloaders on benefits?
When it comes to disability, looks can be deceiving. There are many people who look healthy but who are quite disabled by anyone’s standard. There are also a few people who look quite sick, but actually are fairly healthy. Many people who suffer from severe psychiatric illnesses are physically healthy and able to do things like mow their yards or shovel snow. It’s very hard to get on Social Security disability benefits. The vast majority of people drawing Social Security disability benefits really are quite sick.