Having an attorney can improve your chances at a successful claim. An experienced disability attorney can provide valuable guidance throughout the administrative process.
Once you apply, the SSA will ask you to complete several different detailed forms. Having an attorney assist you in filling out these forms can really make a difference down the line.
The SSA will also want to send you out for a physical exam and/or a psychological evaluation by one of their “consultative examiners." Your attorney would help you prepare for those evaluations.
Your choice of your attorney representative is one of the most important decisions you can make in pursuing a disability claim. Having an experienced disability attorney with a proven track record can make all the difference. Here are some things to consider:
- Will the attorney prepare you in person well in advance of any hearing?
- Will the attorney and/or his staff agree to meet with you as necessary throughout the administrative process?
- Does the attorney or the attorney’s staff return your calls?
- Will they meet with you in person as soon as your claim is filed and explain to you in comfortable terms the disability process, how to develop your claim, what to expect, etc.
- How many hearings has this attorney attended in the past year?
- Is the attorney a member of the National Association of Social Security Claimant Representatives? If so, is the attorney or at least one member of the attorney’s firm a Sustaining Member of this organization? Membership and a Sustaining Membership in this organization is an indication of how important this specialty area is to their practice.
- How much of their practice is devoted exclusively to disability claims?
- Are they licensed to practice law?
Attorney fees are 25 percent of any retroactive benefits you are owed with a cap of $6,000, whichever is less. You will pay no fees up front. No fees are owed unless we are successful in helping you obtain your benefits.
For more detailed information about attorney fees, see here.
A disability advocate is a professional representative that assists individuals who file for Social Security disability benefits. This representative has significant legal knowledge, but is not a lawyer with a law degree.
A disability advocate must still go through training and certification, ensuring he or she is qualified to address a claimant’s concerns.
The Administrative Process
The process time varies depending on when you get granted. After your initial application, it takes about 3 months on average to get a decision. If you are denied, the reconsideration may take another 2 months. If you are denied on reconsideration, you may have to wait about a year to get a hearing date in front of a judge.
When you file your initial application, the Social Security Administration will begin to take your application to a sequential step process.
The first question they ask is are you “engaged in substantial gainful activity?" This essentially asks are you currently working and making at least $1220 a month. If you are not, they will move on to the next step.
Do you have an impairment or combination of impairments that is likely to last more than 12 months or death? Do any of your “impairments” meet or equal in severity any of the medical conditions contained in the Social Security Administration’s List of Impairments.
Usually the answer to this question is no and the Social Security Administration moves on to the next question.
Do your impairments individually or in combination prevent you from doing any of the occupations that you have performed in the last 15 years? If the answer to that question is yes, then they will move on to the last question.
Are there any other jobs that exist in significant numbers in the national economy that you could perform on a sustained and regular basis.
This last question is the most complicated question of all because it will determine whether or not your claim will be granted. To answer this question they will look at four factors:
- Your age
- Your education
- Your Past Relevant Work
- What you are still capable of doing on a sustained and regular basis despite your physical and/or mental health limitations
During the initial and reconsideration stages of the process, all of your information is reviewed by examiners at Disability Determination Services. These examiners are not federal employees but are medical professionals (MDs, DOs, etc.) that are contracted by the government to assess your medical evidence.
At hearing level, your claim will be reviewed by the Administrative Law Judge assigned to your case.
The quick answer is yes.
But there are qualifications to your pursuing work during this process. Part of the evaluation of your disability claim involves determining whether you have the ability to work at a level that reaches "Substantial Gainful Activity." This means, "have you worked enough to make enough money to live?" The amount of money you can make monthly is determined by the Social Security Administration.
As long as you are making less than what is listed here, you are allowed to continue working.
Disability is defined as the inability to engage in any substantial gainful activity (SGA) because of any medically documented physical or mental impairment. The impairment has to last, or be expected to last at least 12 months, or be expected to result in death.
Social Security Disability Insurance (SSDI) and Supplemental Security Insurance are 2 different governmental programs that are managed by the Social Security Administration. For both programs, applicants have to meet medical eligibility, which is determined in the same manner for both programs. The main difference between SSDI and SSI is that SSDI is only available to workers who have accrued a certain number of work credits. This means the applicant needs to have worked for a consecutive number of quarters over a certain number of years. SSI benefits are available to low income individuals who either never worked, or haven't earned enough work credits.
When you file an application for benefits, you should apply for both. The SSA will determine your eligibility under either program.
The short answer to this question is yes, depending on the amount of SSDI benefits you receive, your household income, and resources. SSDI benefits are paid to you out of your own disability account that you have accumulated when working. Meanwhile, the maximum amount of SSI benefits you may receive is $782/month. Therefore, if the amount of money you receive from SSDI is less than $782.00, then SSI may pay you the difference up to a maximum of $782 a month.
When you apply for unemployment benefits you are required to affirmatively state that you are “ready and willing to work." When you apply for disability benefits, you are effectively saying “ I meet the Social Security Administration’s definition of disability, which is “there are no jobs that exist in significant numbers in the national economy that I are capable of performing on a sustained and regular basis." You are not saying that you cannot work. In fact, you are permitted to perform a limited amount of work even while receiving disability benefits. Also, if you are over the age of 50, the fact that you are receiving unemployment benefits becomes even less significant.
While both retirement benefits and disability benefits are offered by the Social Security Administration, they are different. Nearly every American worker can qualify for Social Security benefits at retirement age. These benefits are deducted from your paycheck and count towards your retirement benefits. Social Security Disability benefits assist individuals who cannot earn income due to a disability. You must meet medical eligibility requirements. If you are receiving Social Security Disability benefits when you reach full retirement age, your disability benefits automatically convert to retirement benefits, and the amount remains the same.
Yes. But you may not want to.
Retirement benefits are a separate program. Disability benefits are paid out of a fund that is different from the retirement fund. Each program has its own application process and rules. If you are between ages 62 and 67, you may be eligible for retirement benefits. However, if you apply for retirement benefits before you reach full retirement, your monthly benefits will be less than what you would have received had you waited until full retirement. Therefore, you would want to remain on SSDI until full retirement. Unless there is some reason to switch to a reduced retirement benefit, once granted disability, you are not required to switch to retirement benefits, nor would you want to switch.
Compassionate Allowances are a list of diseases and medical conditions that meet Social Security's standards for disability benefits. If you have one of these listed conditions, you would meet the medical eligibility requirements for disability benefits.
Click here for a full list of compassionate allowances.
Click here to be redirected to the Social Security Administration's local office finder.
Once you start receiving your Social Security Retirement benefits, you are no longer eligible for Social Security Disability benefits.
Receiving military retirement or VA disability benefits has no effect on your eligibility for Social Security Disability benefits.
Federal government employees hired before 1984 who are grandfathered into the Civil Service Retirement System do NOT qualify for Social Security Benefits, unless they earned enough benefits through another, non-government job. Government workers who are covered by the Federal Employees Retirement System are eligible for Social Security Benefits. State and local employees who are paying into a different system (like OPERS in Ohio), will not receive benefits because they typically are not paying into the Social Security System. These employees typically receive pensions from their employers.
Yes. Children may be eligible for benefits if their parents receive Social Security Disability. The children can be your biological child, adopted child, or stepchild. A dependent grandchild may also qualify. To receive benefits, a child must be unmarried and be:
- 18 or older and have a disability that started before age 22; or
- 18-19 years old and a full time student (no higher than grade 12); or
- Under age 18
Benefits will usually stop when the child reaches age 18.
When a person receiving Social Security Disability benefits passes away, the surviving spouse is eligible to receive their spouse's benefits, as long as you are at least 50 years old.
Children who are unmarried, and younger than 18 years old will receive 75% of their deceased parent's SSDI benefit until their 18th birthday.
Adult children 18 years and older may also be eligible to receive benefits from a deceased parent. If the child is under 19 years old and a full time student in high school, they will receive 75% of their parent's SSDI benefits up until high school ends, or 2 months before turning 19.
Disabled children, who became disabled before the age of 22 are also eligible to receive benefits, and they will receive 75% of their parents SSDI benefits as long as they are disabled and unmarried.
Understanding the Importance of Treatment
Technically, any impairment that is preventing you from working and has lasted or is expected to last at least 12 months or result in death could qualify you for benefits. Common impairments we see at our firm include:
- Degenerative Disc Disease
- Spinal injuries
- Herniated discs
- Diabetes with neuropathy
- Chronic issues to any weight bearing joint
- Ehlers Danlos
- Multiple Sclerosis
- Chronic Kidney Disease
- Heart issues (Hypertension, Heart attacks, etc.)
- Carpal Tunnel
- Head injuries
- Bipolar Disorder
Contact us with any questions you have regarding your impairments.
This can be tricky, because examiners evaluating your claim base their decisions on your medical records. Without medical evidence, they will not have any proof that you are unable to work.
If your insurance coverage is insufficient, and you do not have access to free or low cost medical services, Social Security would consider that an "acceptable reason" for failing to comply with treatment. However, if you qualify for low cost medical insurance, or Medicaid you should apply as soon as possible and begin seeing a physician regularly.
Also look into free or low cost medical services near you. Click here to see some free and income based clinics in Cincinnati, OH.
Social Security Disability Insurance (SSDI)
SSDI pays benefits to you and certain members of your family if you are "insured," meaning that you worked long enough and paid Social Security taxes.
Typically, you need to have earned 20 work credits within the last 10 years. "Work credits" are based on your total yearly wages, and you can earn up to 4 credits each year (one for every quarter). The amount needed for a work credit changes from year to year. For example, in 2020 you earn one credit for every $1410 you make.
See here for changes in work credits.
If granted a favorable decision, the amount of monthly income you will receive depends on your individual work history. If your onset date of disability is before your hearing date, you will also receive "back pay." This is a lump sum payment for the months that you qualified as disabled, but weren't getting a monthly payment yet.
See here for more information on calculating your SSDI payment.
SSDI requires that the total monthly income a disabled worker can receive is 80% of the amount earned while employed. So if the combination of your benefits exceeds that 80%, Social Security will often decrease your total benefits.
SSDI benefits are awarded to you based on your previous income. The income or inheritance of a spouse does not affect your benefits.
You must have been disabled for 5 months after your disability onset date before you can start receiving benefits.
Ticket to Work is a free and voluntary program that connects you with free employment services to help you prepare for work, and find or maintain a job. You will receive career counseling, vocational rehabilitation, and training in this program. People ages 18-64 qualify for the program.
See here for more information.
Yes, you can.
People who are approved for SSDI benefits will receive Medicare. However, SSDI recipients are not eligible to receive Medicare benefits until 2 years after they started receiving benefits.
In terms of what you receive, it will not affect you at all. SSA will simply change your SSDI benefits to a retirement benefit once you have reached full retirement age.
Supplemental Security Income (SSI)
SSI is a federal income supplement program that is funded by tax revenues (not Social Security taxes). It pays benefits to disabled adults and children with limited income and resources. SSI is available for those disabled adults who have not reached the "work credits" requirement needed for SSDI.
The basic monthly SSI payment for 2020 is $782 for one person, and $1175 for a couple. However, not everyone gets the same amount. You may receive less if your family has other income, i.e. a spouse's income.
If you get SSI, you usually can get SNAP and Medicaid benefits, too.
Additional income into your household, by a variety of means could reduce your SSI benefits.
Yes and no.
The intricacies of how SSI interacts with other benefits you may be receiving is complex. Give us a call so we can walk you through your specific situation.
Getting married will not affect your eligibility. However, if your new spouse has an income, it will affect the amount of benefits you receive. SSI takes your entire household income into account when awarding you benefits.
In Ohio, if you qualify for SSI benefits, you also get Medicaid health coverage automatically. No need to file a separate application.
PASS is a provision to help individuals with disabilities return to work. You could qualify if you are eligible for SSI benefits. Typically, SSI eligibility and payment amounts are based on income and resources. PASS allows disabled individuals to set aside money or resources they own to pay for items or services needed, without affecting the amount of their SSI benefits.
If you are receiving SSI and are 62 or over, you may be able to receive retirement benefits in addition to your SSI if you have worked and paid into Social Security long enough to be eligible. Contact us to review your options.