Social Security Disability
Disabled persons are left to deal with the challenges of trying to support themselves and their families without the ability to work due to physical, mental or psychological disabilities. For these people, Social Security disability benefits are available through the Social Security Administration (SSA).
Generally, there are two types of Social Security disability benefits:
Social Security disability benefits (SSDI/ Title II)
Supplement Security Income benefits (SSI/ Title XVI)
While a person may be entitled to both types of benefits, there are some basic eligibility criteria differences between these two types of benefits. However, the definition of “disability” is virtually identical for both types of benefits.
SSDI benefits are available to disabled people who have engaged in work activities for a majority of their adult life, worked approximately five (5) of the previous ten (10) years prior to applying for disability benefits, and have paid Social Security taxes.
SSI benefits are for those with very limited assets It is designed to help aged, blind, and disabled people, who have little or no income. The money is to help disabled persons meet basic needs such as food, clothing, and shelter.
It is possible to collect both SSDI and SSI benefits. Unfortunately, some people who are disabled do not qualify for either benefit. Children can receive disability benefits, either as a result of their disability or because of the disability of a parent.
Basically, a person is considered “disabled” by the Social Security Administration if they suffer from “physical or mental impairment(s) of such severity that they are not only unable to do their previous work but cannot, considering their age, education, and work experience, engage in any other type of substantial gainful work existing in the national economy.” More simply, a person cannot do they type of work they use to do, if any, not perform another job based on their age, education or prior work experience. The “physical or mental impairments” must also be such that are expected to result in death, or have or are expected to last for a continuous period of at least 12 months.
In determining disability the SSA examines your physical and mental conditions, education, age and experience. The SSA scrutinizes each medical condition based on federal regulations using a five-step sequential evaluation process to determine disability. If a person fails any of the steps, except #3, their claim will be denied. The steps, with what answer needs to continue to move forward, are:
(1) Are you working?
• If you are working in 2011 and your earnings average more than $1,000.00 a month, you generally cannot be considered disabled.
(2) Is your condition “severe”?
• Your condition must interfere with basic work-related activities for your claim to be considered.
(3) Is your condition found in the list of disabling conditions?
• The SSA has a list of medical conditions that are considered so severe they automatically mean that you are disabled. If not, a residual functional capacity analysis is done.
(4) Can you do the work you did previously?
(5) Can you do any other type of work?
• Here the analysis is whether there are jobs in the “national economy” that you could do. In making this determination, the SSA looks at your medical conditions and the restrictions they impose and how would affect your ability to work, your age, education, and work experience.
When examining your medical conditions the SSA examines your ability to perform:
Physically exerting activities such as sitting, standing, walking, lifting, carrying, pushing, and pulling;
Manipulative and postural activities such as reaching, handling large objects, using your fingers, feeling, stooping, balancing, climbing stairs or ladders, kneeling, crouching, crawling;
Tolerate certain environmental conditions such as temperature extremes, wetness, humidity, noise, hazardous working conditions like moving machinery or heights, dust, fumes, odors, gases, poor ventilation, vibrations;
See, hear, and speak;
Maintain concentration and attention;
Understand, remember and carry out instructions;
Respond appropriately to supervisors, co-workers, and usual work situations; and
Cope with changes in a work setting.
If you are found disabled, the amount of benefits you get depends on the type of benefit. SSDI benefits are based, in part, based on what you have paid into the system. SSI payments are a fixed amount meaning each person receiving SSI will receive roughly the same amount. In addition, if your disability began in the past, you will receive a certain amount of past due or “back” benefits depending on the date your disability actually began. These past due benefits are usually paid in a lump sum.
Disabled persons receiving SSDI benefits become eligible for Medicare after a period of time. Persons receiving SSI benefits might be immediately entitled to Medicaid.
The majority of people seeking SSA disability benefits are initially denied. After being denied, a person must seek a “Reconsideration,” which is a request for the SSA to re-review your application and eligibility for disability benefits. If your “Reconsideration” is denied your next level of appeal is a hearing before an Administrative Law Judge. If a person is initially denied, their best chance of winning is when they get to appear before the Administrative Law Judge. Unfortunately, due to a significant backlog of cases, it usually takes two years or more from your initial application before you would see an Administrative Law Judge.
There are time limits that must be followed appealing a denial of your disability claim. In most cases, if you fail to meet the deadline, you must file new application, which will cause you to lose back benefits and just makes the process that much longer.
Federal law and regulations govern the attorney fees that a lawyer may collect for representing a disabled person in Social Security disability cases. Generally, the attorney fee is the lesser of 25% or $6,000.00 of any past due benefits. Attorney fees are awarded against any future benefits, which would be any benefits from the date you are determined to be disabled.
Please contact Lapin Law Offices if you have or are interested in applying for Social Security disability benefits or if your claim has been denied.