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Social Security Disability Frequently Asked Questions

How do I qualify for Supplemental Security Income benefits?

Supplemental Security Income benefits (SSI) are paid to individuals with substantial disabilities, who do not have an established work record and have assets and income below established federal poverty level guidelines. Generally, the applicant must have less than $2,000.00 in cash and/or less than $3,000.00 in total "assets." Assets are items of value, such as coin collections, cars, ATV's, stereo systems, large televisions, expensive computers, cash value life insurance, antiques, collectibles, etc.. Income guidelines vary, depending on the makeup of the household of the applicant and whether the income is: the applicant’s, that of another household member “earned,” “passive,” divisible with dependants, etc.. Due to the number of variables, it is best to discuss eligibility with the Social Security Administration.

SSI applicants can be children or adults. Children with medical conditions that interfere with a child's ability to develop evenly with their contemporaries (others in their age group), can receive financial and medical assistance from the Federal government to help them obtain financial support, extra training, appliances, medical devices, medical attention and educational assistance, so that they don't fall even farther behind their contemporaries. There are special rules for children that a lawyer can fully explain in a face to face meeting.

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How do I qualify to get disability wages loss benefits?

As you work for an employer, your employer deducts "FICA" and "medicare" taxes, equal to 7.65% of your wages (up to a certain limit). This is your "insurance premium" to get Social Security coverage for all Social Security wage earner programs (disability, retirement, widow/widower and child benefits).

Social Security usually only pays disability wage benefits if you have, or the person you claim from has, a sufficient earnings record as of the date of disability. A sufficient earnings record requires that you have worked the equivalent of 5 years out of the 10 full years that immediately come before you are disabled. In order for you to have worked a creditable year, you must have earned at least $5,200.00 of reportable income. You can combine "partial" credit years. You are given credit for "quarter" of a year for each $1,300.00 you earn during the year. Self-employed persons also can obtain coverage if they report their earnings and pay self-employment taxes, so as to have the same number of employment credits.

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What qualifies as a disability to get SSI or SSD benefits?

Social Security requires that a claimant have a medically determinable condition that results in more than a minimal interference with the claimant’s daily activities. Such condition can be the result of an illness or injury. In addition, if the condition is accompanied by the specific symptoms and required severity listed in the Social Security Regulations (20 C.F.R., Part 404, Subpart P, Appendix 1), the claimant automatically medically qualifies for disability benefits. If the condition doesn’t exactly match the requirements of a “listed” condition, a claimant can still obtain benefits if the medical condition prevents (1) the claimant from engaging in the kinds of work the claimant has done during their relevant work life, (2) or from engaging in any job that exists in the national economy in significant numbers, which the claimant might otherwise be qualified for based upon age, education and acquired skills. For more information, check the Social Security Website (www.ssa.gov).

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If I qualify for disability benefits (SSI or SSD), how do I get them?

You apply at any Social Security District Office, apply on-line, or call the Social Security Administration (1-800-772-1213), to request that they set up an appointment for you to file for disability benefits. You may also submit an application over the telephone, by setting up a telephone interview. Papers will then be sent from the Administration to you after the telephone interview. The administration is then supposed to gather medical information to determine if you are disabled.

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How long does my disability have to last in order to qualify for benefits?

Your disability must be disabling for a minimum of twelve continuous months. You cannot “piggy back” conditions to qualify, by having a sequence of conditions. At least one condition must be disabling for twelve continuous months.

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If I qualify, how much do I get?

For SSI applicants, there is a formula for benefits that takes into consideration whether you are on your own or being supported by someone else, whether you got assistance from any government agencies, whether anyone helped you with some of your necessities, whether you had assets at any time that may have disqualified you for benefits for a period, and whether you (or others in your household) had income that may have disqualified you for benefits for a period of time. There is a "cap" on those benefits for each category of eligibility. An attorney or the administration can tell you whether you can get the maximum or a reduced benefit. The current maximum individual benefit is over $700.00 per month.

For SSD, your benefit is a factor of your earnings for your entire work history. The higher your earnings, the greater your benefit. There are also benefits for your dependants, depending on your earnings record. Certain offsets are available to Social Security if you get money from other disability sources. Due to the number of possibilities, it is best to talk to the Administration or a lawyer to get an accurate amount.

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If I don’t medically qualify for disability, when do payments start?

If your disability is deemed to be serious enough so that it will keep you out of work for over twelve (12) calendar months continuously, Social Security will commence payments for SSD as of the sixth (6th) full month following the initial date when you were found by the Administration to have been totally disabled. For SSI, payments are made starting the first month following your application or the first month following the date your disability, whichever is later.

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If I wait longer than five months before I apply for disability, do I lose anything?

You are entitled to obtain retroactive SSD benefits for up to one year before you apply for the benefits. You can only get SSI benefits after you have applied. If you are denied without a hearing, you can reapply within one year of a denial and the Administration can reopen the first claim. Then you would be eligible for payment at the earliest possible date. If you have previously been denied, but feel that your condition has been disabling, or has gotten worse, it is very important to reapply within twelve (12) months of each denial and seek the assistance of a lawyer. You can still apply for disability and part of your disability can be retroactive. If you wait too long, you may lose some or all of the benefits, since some are only retroactive for up to one year from the date of application.

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Do I need an attorney to get disability benefits?

No, an application may be made on your own in the District office, on-line, or over the telephone. It will then be up to the Administration to request medical records and notify you of their decision. However, an attorney can be very helpful even at the initial application phase, by offering you advice, preparing you for the steps of the application, and preparing and submitting your application online and / or assisting the administration in getting medical reports.

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If I lose on my first application, is it worth while to appeal?

Most applications for disabilities are reviewed to see if the injury or illness conforms exactly to a list of impairments that have been published by the Social Security Administration in the Federal Code of Rules and Regulations. If your condition does not exactly match the conditions required in the Code, you will probably be denied. However, many disabling injuries or illnesses do not conform exactly to the signs and symptoms that are found in the Code. Therefore, many applicants who are truly disabled are denied simply because of the rules. Of the people who are denied, a sizable percentage are found disabled on appeal, so long as an appeal is filed within sixty-five (65) days of the date of the denial notice.

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Is it safe not to have a lawyer until I have to go to a hearing?

Not really. The earlier that an adequate medical basis can be set forth for the Administration, the greater the likelihood a favorable decision will take place. Therefore, the earlier that a lawyer is hired to assist you, the greater the chance that the right medical records, with the right conclusions, will be before the Social Security Administration. Additionally, the review process takes a year or longer if a Request for a Hearing is filed. Therefore, the earlier a lawyer gets involved, the greater the potential for an early decision in favor of a claimant.

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How do lawyers get paid in Social Security?

Social Security is very protective of the disabled and requires that any fee a lawyer may charge must be approved by the Administration. The most common method for attorneys to receive a fee is to sign a “Fee Agreement” with the client, which provides that the attorney will be paid 25% of retroactive benefits payable to the claimant, with a cap of no more than $6,000.00. This assures that the claimant will receive the vast majority of retroactive money due, as a result of disability. It also assures that excess attorney’s fees are not collected simply because a lawyer was hired. Additionally, even after a “Fee Agreement” has been signed, the claimant and the lawyer retain the right to object to the fee that is calculated on retroactive benefits, if it is either too high or too low; and, an Administrative Judge will review any objections to determine whether the fee is fair. A lawyer can instead file a “Fee Petition” if a claim is successful. The lawyer must indicate all time spent and what was done in a detailed manner. The Administration then determines if the fee request is fair for what was done. However, there is no “cap” on the fee that can be approved.

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How do I pay my lawyer?

Most frequently, 25% of your retroactive award is withheld on Social Security Disability and Supplemental Security Income as a matter of practice, when a lawyer is representing you. Under the Fee Agreement structure, if there are no objections to the 25% withheld, the fee is then sent directly by the Administration to the lawyer. For a Fee Petition, the fee is paid from the money withheld after the fee is approved. If the fee exceeds 25% of past-due benefits, the claimant must pay the balance to the lawyer directly. However, Social Security does not pay the expenses incurred by your attorney to obtain copies of your medical records, travel expenses, or copying and postage expenses. The expenses incurred by your attorney are your responsibility.

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