Sheri R. Abrams, P.C.Attorney at Law
3915 Old Lee Highway Suite 22-A
Fairfax, VA 22030
WHAT ARE SOCIAL SECURITY DISABILITY BENEFITS?
Social Security Disability is a benefit received from the Social Security Administration by disabled workers and in some cases their dependents, similar to those received by retired workers.
Both programs are administered by the Social Security Administration. For most people, the medical requirements are the same and the person's disability is determined by the same process. The major difference is that SSI disability programs are made on the basis of financial need.
Social Security Disability Insurance (SSDI or DIB or Title II) is a program financed with Social Security taxes paid by workers, employers and self-employed persons. Disability benefits are payable to disabled workers, disabled widow(er)'s or adults disabled since childhood, who are otherwise eligible. Auxiliary benefits may be payable to a worker's dependents, as well. The monthly disability benefit payment is based on the Social Security earnings of the insured worker on whose Social Security number the disability claim is filed. When you become entitled to twenty-four (24) months of SSDI you are entitled to Medicare at a nominal cost.
Supplemental Security Income (SSI or Title XVI) is a welfare type program financed through general tax revenues. SSI disability benefits are payable to adults or children who are disabled, meet the income, resource and living arrangement requirements, and are otherwise eligible. No Auxiliary benefits are paid with SSI. The monthly amount of SSI payments are different in every state and can vary by the persons income and resources. You can be eligible for SSI even if you have never worked or paid taxes taxes under FICA. Generally, however, to be eligible for SSI payments you need to be a U.S. citizen or meet certain requirements for non-citizens. If you receive SSI you are entitled to Medicaid which is free.
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There is no minimum age. However, to qualify for Social Security Disability benefits, you must have worked long enough and recently enough under Social Security. You can earn up to a maximum of four (4) work credits per year. The amount of earnings required for to earn one credit increases each year.
The number of work credits you need for Social Security Disability Benefits depends on your age when you became disabled. Generally you need twenty (20) credits earned in the last ten (10) years ending with the year you became disabled. However, some younger workers depending on there age may qualify with fewer credits.
To receive benefits under the Social Security Disability program, you must have a physical or mental health problem (or a combination of problems) severe enough to keep you from working in any regular paying job for at least one year or result in death. The test isn't whether or not you are able to go back to your old job, and the test isn't whether or not you have been able to find a job lately. Rather, the test is whether you are capable of doing any job available in the national economy (even if this job involves different skills or pays less than your previous work.) By using an extensive set of regulations, the Social Security Administration takes into account your medical condition, your age, your abilities, your training and your work experience in deciding your case.
The Five Step Evaluation that Social Security uses to determine if you are disabled is as follows:
1) Are you working? If you are and you are earning more than the current SGA amount (currently $800 a month), you generally cannot be considered disabled;
2) Is your condition severe? Your impairment must be expected to last one year or result in death and interfered with basic work related activities;
3) Is your condition found in the list of disabling impairments? Social Security 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 condition is not on this list, Social Security has to decide if it is of equal severity to an impairment on this list. If it is, your claim is approved. If it is not, Social Security goes on to the next step;
4) Can you do the work you did previously? Does you condition prevent you from doing any work that you did in the last fifteen (15) years. If it does not, your claim will be denied. If it does, your claim will be considered further; and
5) Can you do any other type work available in the national economy? Social Security considers your age, education, past work experience, and transferable skills against 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.
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If you are found eligible for Social Security Disability benefits, you will get paid retroactive benefits beginning 5 full months after you become disabled, but only for a maximum of 12 months before you applied for benefits. (Please see below for additional information on duration and amount.)
A disabled claimant will receive the same monthly benefit that he or she would receive had he or she retired at full retirement age (65 years old or more depending on age). The sum of money received will depend on one's previous work record.
No, your benefit is based on the amount of your lifetime earnings prior to your disability and not the degree of your disability.
Ordinarily, disability payments from other sources do not affect your Social Security Disability benefits. However, if the disability payment that you receive is workers' compensation or another public disability payment (such as some civil service disability benefits, some military disability benefits, some Federal,
State or Local government retirement benefits which are based on disability) yours and your family's Social Security benefits may be reduced.
Your Social Security Disability benefit will be reduced so that the combined amount of the Social Security Disability benefit you and your family receive plus your workers' compensation payment and/or public disability payment does not exceed eighty percent (80%) of your average current earnings.
You will receive Social Security Disability benefits as long as you remain disabled and unable to work. Your benefits will not run out because you did not contribute enough into the Social Security system.
You should apply for Social Security Disability benefits as soon as possible after you become disabled and unable to work. You do not need to wait 12 months to apply, your disability need only be expected to last for at least one year or will result in death.
You can fill out an application for Social Security Disability benefits at the local Social Security office nearest to your home or by telephone. The address and telephone number of your local Social Security office can be obtained by calling 1-800-772-1213. When applying you should be prepared to give Social Security a list with the names, addresses and phone numbers of all the doctors, hospitals or clinics who have treated you for your condition. You should also bring a list of where you have worked in the past 15 years.
You will also need to provide Social Security with an original or certified copy of your birth certificate, your last earnings documents (W-2, last pay stub, statement of your employer, etc.) and copies (keep the originals) of any medical records you may be able to obtain.
Please note, however, that you should not delay filing for benefits if all documents are not immediately available.
Appeal! Many disabled people become disheartened and frustrated after they receive a disability benefits denial notice and do not appeal. This is often a mistake. Nationally, about 75% of all applicants are denied initially and about 90% are denied at the first appeal stage--Reconsideration. But many of these people ultimately receive their benefits, nationally about 70%.
What may be most frustrating about applying for Social Security Disability benefits is the process itself. Those who apply are often made to feel like they are asking for something that they do not deserve, and nothing could be further from the truth. Social Security Disability is not a welfare program; these benefits are paid for by you and were intended to act as a financial buffer in case you or a family member became seriously ill or injured. Therefore if you are unable to work, but you have been denied benefits, you should appeal.
You have the right to have an Attorney represent you in your Social Security Disability case. Statistics have shown that claimants represented by Attorneys have been much more successful than people without representation. You should seriously consider the advantages of having an Attorney represent you by examining what an Attorney would do in your Social Security Disability case.
Every case is different. Your Attorney's role depends on the particular facts of your case. However, a few of the things an Attorney may do are:
- Gather medical and other evidence
- Analyze your case under Social Security Regulations
- Contact your doctor and explain Social Security Regulations to obtain a report consistent with those regulations
- Obtain documents from your Social Security Disability file
- Ask that a prior application for benefits be reopened
- Advise you how to best prepare yourself to testify at your hearing
- Protect your right to a fair hearing by objecting to improper evidence and procedures
- If you win, make sure that the Social Security Administration correctly calculates your benefits
- If you lose, request review of the hearing decision by the Social Security Administration's Appeals Council
- If necessary, represent you in a Federal Court review of your case
Most Attorneys who handle Social Security Disability cases will accept them on a contingent fee basis of 25% of past-due benefit or $5,300 whichever is less. That is, there is no fee if you lose, although you will be obligated to pay any out-of-pocket expenses incurred by the Attorney in your representation. Such expenses usually involve charges for photocopying and payments to doctors and hospitals for medical records and reports, and other miscellaneous charges. Total expenses usually are less than $200.
As soon as possible, preferably as soon as your initial application is denied. An Attorney will then be able to start assisting you in determining if you are disabled, as that term is defined by the Social Security Act. You will then be able to decide whether or not you want to pursue the first appeal stage--Reconsideration; and your Attorney can begin developing ways to prove to the Social Security Administration that you are disabled.
Attorneys in Social Security Disability cases do much more than sit in at a hearing and ask a few questions. Much pre-hearing preparation, analysis and evidence gathering go into adequate representation for your case. For this reason you should not wait until a week or two before your hearing to contact an Attorney. The earlier an Attorney is able to start working on your case, the better your chances of winning.
Please note that not all Attorneys practice before the Social Security Administration. You will do best to find an Attorney familiar with the complex Social Security Disability regulations and the somewhat unusual Social Security Disability procedures.
NOTE: The opinions expressed in this article are the author's own and do not necessarily reflect the opinions of this website or Promotions Unlimited.
The above article is presented as a community service with the permission of the author.
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