Frequently Asked Questions about Social Security Disability and SSI Disability Benefits
- Do I have to be disabled for 12 months before I can apply for Social Security or SSI disability benefits?
No. You just have to have a health condition (mental or physical or both) that is expected to last 12 months or longer. I recommend that you apply as soon as possible since the Social Security Administration takes forever in issuing its determinations in regards to Social Security disability claims and SSI disability claims.
- What is the difference between Social Security Disability and SSI Disability?
Disability Insurance benefits are paid to individuals who have worked long enough and paid enough taxes into the system in order to qualify for coverage. The amount of monthly Disability Insurance benefits is dependent on the worker’s past wages. People who have won an award of Social Security Disability Insurance benefits will also be entitled to Medicare benefits two years after their first disability benefits check is owed to them. SSI (Supplemental Security Income), on the other hand, is paid to individuals who may not have worked long enough to qualify for Social Security Disability Insurance benefit or who may not have worked at all. In order to get SSI Disability benefits, an individual must prove that they are disabled and poor. Social Security has strict rules on how poor you have to be in order to get and keep SSI disability benefits. SSI recipients are under a continuing obligation to disclose any additional income and are subject to having their benefits reduced if their financial situation changes. SSI recipients get Medicaid benefits.
- My doctor has written a note saying that I am disabled. Why does Social Security continue to deny my claim?
I wish it was that easy to get Social Security or SSI disability benefits. The Social Security Administration is supposed to consider the assessment of a treating physician, but they – not your doctor - are the final decision maker on whether your health conditions are so severe that you are unable to do any type of employment. It is important for you to produce the medical evidence (treatment notes, hospitalization records, x-rays and other diagnostic test results) that will support your case. The final decision is drawn from the totality of the medical evidence. A simple note from your doctor isn’t enough by itself.
- I received a denial of my claim. I am so frustrated – it’s like they didn’t even read my medical records. What can I do?
Appeal. Any time you receive a denial or decision that you don’t like - file an appeal. You have to be assertive. Social Security is hoping that you get so frustrated and discouraged that you won’t fight back. If you believe that you cannot work, keep fighting your case.
- How long do I have to file an appeal?
In most cases, you must file a written appeal within 65 days of the date on the denial letter (60 days plus 5 days for mailing). But be careful: read the denial notice that you received. Notices from the Social Security Administration frequently contain the information that you need to know about which appeal to file and the deadline for doing so. In some cases, you must file an appeal within 10 days of the date of the notice in order to keep your benefits paid during the course of the appeal.
- How long does it take before my case goes in front of an Administrative Law Judge?
It all depends. But, generally speaking, it is not unusual for people to wait one year and longer before their Social Securtiy or SSI case gets set for a hearing date before an Administrative Law Judge. Some areas are less congested than others and the lines waiting for a hearing are not as long. But if your case is a contested one (as most are), don’t expect Social Security to move much faster than a glacier.
- Is it possible to appeal further if it turns out that the Administrative Law Judge turns down my case?
Yes. If you receive an unfavorable hearing decision – or if your hearing decision is only partially favorable – you can file an appeal to the Appeals Council back East. Make sure that you at least file the notice of appeal within 65 days of the date of the unfavorable decision. Also: be aware that you can file a lawsuit in United States District Court if the Appeals Council denies you.
- I’m broke and I can’t work. How can I afford to have an attorney represent me on a Social Security or SSI Disability case?
Simple. If you are trying to get Social Security or SSI disability benefits, a lawyer will take your case on a contingent fee basis. This means that the lawyer will be paid only if you win your case. If you lose, the lawyer loses also and no attorney’s fees are owed. Attorney’s fees are paid out of the back or past-due benefits that are owed to you by the Social Security Administration while your case has been on appeal. The standard fee for attorney’s fees in these cases is: 25% of the past-due benefits or $5,300 – whichever is the smaller amount.
- How do I make the best decision about which lawyer to represent me?
I recommend calling up whoever you’re considering hiring. Talk to the Social Security attorney directly. See if you get a good feeling about the person that you’re talking to. In some ways it remains a leap of faith, but usually people can distinguish those that are sincere from those that are blowing smoke. Be wary of any firm where you can’t talk to the attorney directly or that makes a big deal out of winning a ridiculously high percentage of their cases. That probably signals too high of a volume of cases, statistic inflation or a policy of only taking the easy cases.
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