social Security disabilityBACKGROUND (from www.mbstiller.com)

1. Question – What are the requirements to receive Social Security Disability Income?

Answer:

  1. 1.Generally you must have earned Social Security “insurance,” which usually (but not always) means you must have had a full-time job for five out of the last 10 years before your “disability.”
  2. 2.You must be “disabled,” which means you are not able to do significant, gainful activity (SGA), for a 12-month period, or not likely to be able to do so over a 12-month period from the date you are disabled.
  3. 3.“Significant gainful activity” (SGA) means not being able to earn more that $800 a month on a “sustainable basis,” which means 8 hours a day and 5 days a week on a consistent basis. The $800 maximum amount is increased periodically by the Social Security Administration.
  4. 4.You must be able to show you cannot do work based on your age, education, and functional limitations.
  5. 5.You must be able to show that you cannot do any of your past relevant work and cannot do any other work. For example, even if there are still jobs available that you are able to do, but don’t wish to do or don’t pay what you are used to earning, you still may not be considered disabled.
  6. 6.The disability must be due to a “severe impairment” that is supported by doctors. You must be able to show you are unable to perform many activities of daily life.

2. Question –  How do I apply for Social Security disability benefits?

Answer – The best, surest way to file a Social Security disability claim is to go to the nearest Social Security office in person and wait (often for a few hours) to see someone to file the claim in person. In the alternative, a person may contact Social Security by telephone and arrange for a telephone interview to file the claim.

3. Question – I used to work but lately I have been staying home taking care of the kids. I have now become sick. Can I get Social Security disability benefits?

Answer – Possibly. If you have worked five out of the 10 years under Social Security before becoming disabled, you will have enough earnings in to potentially qualify for Social Security disability benefits. For individuals 31 or less, the requirements are a little different, since such individuals have not had such a long time to work. Unless a person has been staying home and taking care of their children for quite a long time, however, it is very possible that they will qualify for Social Security disability benefits based upon their own earnings. Also a homemaker, if poor enough, can qualify for Supplemental Security Income (SSI) whether he or she has worked in the past or not.

4. Question – How long do I have to wait after becoming disabled before I can file for Social Security disability benefits?

Answer – Not even one day. You can file for Social Security disability benefits on the very 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. There is no reason to file a Social Security disability claim if one has only a minor illness or one which is unlikely to last a year or more. However, 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.

 5. Question – 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?

 Answer – No, 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.

6. Question – I got hurt on the job. I am drawing worker’s compensation benefits. Can I file a claim for Social Security disability benefits now or should I wait until the worker’s compensation ends?

Answer – 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.

7. Question – How can I tell if I will be found disabled by Social Security?

Answer – 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.

8. Question – How does Social Security determine if I am disabled?

Answer – The Social Security Administration 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.

9. Question – Who decides if I am disabled?

Answer – 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.

 10. Question – What can I do to improve my chances of winning my Social Security disability claim?

Answer – 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. Statistically, claimants who employ an attorney to represent them are much more likely to win than those who go unrepresented.

11. Question – If I am approved for Social Security disability benefits, how much will I get?

Answer – 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.

12. Question – How far back will they pay benefits if I am found disabled?

Answer – 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.

13. Question –  What do I do if Social Security denies my claim for Social Security disability benefits?

Answer – First, do not be surprised. Only about 40% 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.

 14. Question – Why does Social Security turn down so many claims for disability benefits?

Answer – 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.

 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.

15. Question – Who makes a reconsideration determination?

Answer – 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.

 16. Question – What are my chances of winning at reconsideration?

Answer – Statistically, about 20% of the time a claimant wins at reconsideration.

17. Question – Do I have to go through reconsideration?

Answer – 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.

18. Question –  How long does it take to get a hearing on a Social Security disability claim?

Answer – Typically 6 Months

19. Question –  What are my chances of winning at a hearing?

Answer – Statistically, over half of the claimants who have a Social Security disability hearing win.

20. Question –  If the Administrative Law Judge denies my claim, can I appeal any more?

Answer – Yes. You can appeal to the Appeals Council which is still within Social Security.

 21. Question – Do I really have to hire a lawyer to represent me in my Social Security disability claim?

Answer – 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.

22. Question – I am already on Social Security disability benefits, but I am worried that my benefits will be stopped in the future. What are the chances of this happening?

Answer – Social Security is not supposed to cut off disability benefits for an individual unless his or her medical condition has improved. When Social Security reviews a case of someone already on Social Security disability benefits, they continue benefits in the vast majority of cases. In recent years, Social Security has been doing few reviews to determine whether or not individuals already on Social Security disability benefits are still disabled. This is changing and Social Security should be doing far more reviews in the next few years. However, the vast majority of individuals who are reviewed will see their Social Security disability benefits continued.

23. Question – If Social Security tries to cut off my disability benefits, what can I do?

Answer – 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.

24. Question –  My doctor says I am disabled so why is Social Security denying my Social Security disability claim?

Answer – 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.

25. Question – How long does it take before Social Security makes a decision once I file a claim for Social Security disability benefits?

Answer – In most cases Social Security makes the first decision within four months. 

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