Disability can pose an insurmountable obstacle to earning a living. If you or a family member suffer from an injury or disease that prevents you from working, or is expected to prevent you from working for one year or longer, then you may be entitled to Social Security Disability benefits. The Social Security Administration (SSA) is a federal agency that administers retirement and disability benefits. The Social Security Administration (SSA) defines a disability as the inability to engage in substantial gainful activity (SGA) due to an impairment or combination of impairments. To be considered disabled, a person must ordinarily establish that he or she cannot perform his or her past work and also must establish an inability to perform other types of employment. To get Social Security Disability benefits, you must apply. How much a person receives as a benefit depends on his or her work history, resources, and other available income. If you have been denied benefits by the Social Security Administration (SSA) or are simply considering whether you should apply, please contact us today. To learn more about Social Security Disability, please read on.
Social Security Disability – Programs and Benefits
- Social Security Programs
The Social Security system provides two benefit programs for disabled persons: Social Security Disability (Title II) and SSI (Supplemental Security Income).
Social Security Disability (Title II) is for workers covered by Social Security who have contributed to a Social Security account while working for a specified period of time, usually five out of the last ten years of work. Disabled widows and widowers of Social Security wage earners may also qualify.
SSI (Supplemental Security Income) provides disability benefits for low income persons not covered by Social Security. It can also be added to Social Security benefits which are lower than a certain minimum level. Second, the employee’s sole recourse against the employer for work related injuries is a worker’s compensation claim. The worker is not permitted to bring a suit against an employer or co-worker for work related injuries.
- Social Security Benefits
Social Security disability beneficiaries typically receive two primary benefits: a monthly check and medical benefits. The amount of the monthly check is determined by a formula that takes into account the amount paid into Social Security and the length of time of employment.
SSI (Supplemental Security Income) does not require previous employment and monthly benefits are based upon “need”, considering the individual’s other income and assets. Special rules apply for legal residents who are not citizens.
Disability and Claims – The Process
- What does it mean, legally speaking, to be “disabled”?
The standard of disability that must be shown is the same for both programs. You must have physical or mental problems – or a combination of problems – severe enough to keep you from working in any regular paying job for at least 12 months. A disability due to drug and alcohol addiction is not covered, but certain physical and mental conditions caused by a prior addiction may be covered.
When considering disability, the test is not whether you would be offered a job, but whether there are jobs that you could perform.
For those over 55 years old, new regulations allow a more realistic look at age, education, and experience in making this test.
- The Application Process
For either Social Security or SSI, an application for disability benefits may be filed at your local district Social Security Office. The Social Security Disability lawyers at Finbury, Sullivan can assist you in filing a disability application in the appropriate cases, particularly if you have been disabled for at least twelve months with documented significant disability.
If your claim is denied, you should not become discouraged. Statistics show that 80-90% of the applications are denied the first time. If your claim has been denied, you should contact an attorney experienced with Social Security Disability claims. The lawyers at Finbury, Sullivan can discuss the circumstances of the case with you and give you an opinion of the merits of your claim. The sooner that one of our attorneys starts working on the case, the better chance we have of being successful. GENERALLY A CLAIM IS REVIEWED AND A DECISION MADE WITHIN THREE MONTHS.
If your claim has been denied the next step in the process is a “Request for Reconsideration” or, depending on the situation, a “Request for Review by a Federal Official. THIS REQUEST MUST BE FILED WITHIN 60 DAYS OF THE INITIAL DENIAL AND CAN BE ACCOMPANIED BY ADDITIONAL MEDICAL EVIDENCE IN SUPPORT OF YOUR CLAIM. THESE ARE GENERALLY PROCESSED WITHIN THREE (3) MONTHS.
If a denial at the prior level occurs then one must file an appeal and request a hearing; this can take six-twelve months to be scheduled.
The hearing is the most crucial stage of the appeal process, where representation by Finbury, Sullivan is extremely helpful. An Administrative Law Judge will preside over the hearing and testimony will be taken under oath, but the hearing is generally somewhat informal. It is private, usually held in a small room with only the Administrative Law Judge and his or her assistant, you, your attorney, and possibly your spouse or a friend. ON OCCASION A VOCATIONAL EXPERT OR PHYSICIAN MAY ALSO BE ASKED TO AID THE JUDGE IN HIS DECISIONMAKING. THE PROCESS IN NOT SUPPOSED TO BE ADVERSARIAL.
The medical records will be admitted into evidence. You will be asked questions, either by the Judge or by your attorney, which you must answer to the best of your ability or recollection. The Administrative Law Judge may ask questions of the attending experts to talk about the possibility of training for a new job and the severity of the medical condition. One of our attorneys will prepare you thoroughly for the hearing, so there is no need to be apprehensive. Its purpose is to seek the truth and to carry out the purpose of the Social Security Act.
The Judge usually will not announce a decision at the hearing. A written decision will be sent to your lawyer and to you. It typically takes at least two to three months after the hearing to receive the decision, if not longer. You should always contact your lawyer after you have received a decision from the Administrative Law Judge. AFTER THAT POINT IF ONE IS SUCCESSFUL IT THEN TAKES THE LOCAL OFFICE ABOUT THREE MONTHS TO GATHER INFORMATION AND START THE CHECKS.
IF UNSUCCESSFUL ONE HAS THE RIGHT TO APPEAL WITHIN SIXTY DAYS TO THE APPEALS COUNCIL, AND THEREAFTER TO THE FEDERAL DISTRICT COURT FOR THE AREA WHERE THE CLAIMANT RESIDES.
Do you have a claim? Contact us for your free consultation.