It is an astonishing fact that 70% of all disability claims are denied on the first application filed with the Social Security Administration. Hiring an attorney significantly improves your chances of being approved and reduces stress at a difficult time. If you are even considering filing a disability claim, call our office for a free telephone consultation. We will advise you on the strength of your case and explain the application process.
At Shankman and Associates, we have the knowledge, and the compassion, to help you get the benefits you deserve. Our disability attorneys know how to present a case in the light most favorable to you. We will help you focus on the facts that will be most persuasive to the Social Security Administration and craft an argument that your disability falls under one or more of Social Security’s list of impairments. We will also advise you how to gather the appropriate medical evidence to submit with your application.
The Social Security Administration (SSA) administers two programs to help individuals who have a long-term disability: Social Security Disability Insurance (aka SSDI) and Supplemental Security Income (aka SSI). The legal definition of disability for Social Security is being unable to be gainfully employed for at least 12 consecutive months because of a diagnosed mental or physical disease or injury.
Most employees pay Social Security taxes which are used to pay your future retirement wages. However, if you become disabled before retirement age, you may be eligible for disability benefits.
FAQ: SSI DISABILITY BENEFITS
WHAT IS THE DIFFERENCE BETWEEN SSDI AND SSI?
When you work long enough and pay Social Security taxes, you become “insured” and Social Security Disability Insurance pays benefits to you if you suffer a total disability. Some benefits may be paid to certain family members. SSDI does not pay benefits for partial or short-term disability.
SSDI is available to disabled individuals who have worked long enough, and recently enough to earn Social Security “credits”. The number of credits needed to qualify for SSDI benefits depend on your age when you become disabled. Generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year you become disabled. However, younger workers may qualify with fewer credits.
SSI, or Supplemental Security Income, is available for disabled individuals who have not earned enough credits, although many people are eligible for both SSI and Social Security Benefits. SSI is designed to help aged, blind, and disabled people and children who have little to no income. Blind or disabled children are also eligible for SSI.
HOW DOES THE PROCESS WORK?
SSA will use a 5-step process, in the form of questions, to determine whether you are disabled. If any of the questions are answered “incorrectly”, the process ends. You will not be considered disabled and the remaining questions will not be asked.
- Are your working?
- Is your condition “severe”?
- Is your condition found in the Social Security list of disabling conditions?
- Can you do the work you did previously?
- Can you do any other type of work?
This five step process is used at every level of application and appeal.
HOW MANY LEVELS ARE THERE?
There are four levels of application, review and appeal: 1) Initial application; 2) Disability Determination Services (DDS); 3) Office of Disability Adjudication and Review (ODAR); and, 4) Appeals Council.
Unfortunately, SSA denies almost every applicant at the first level. If you are denied, you have 60 days to appeal to Disability Determination Services. DDS will review your initial application and allow you to submit more documentation regarding your disability. It will then use the 5-step process to determine whether your denial should be reversed or upheld.
If you are denied at the second level, you may appeal to the Office of Disability Adjudication and Review (ODAR). The window to appeal to this level is also 60 days. ODAR is the third level and it grants you the right to a hearing before an Administrative Law Judge. If you were denied at level one and two, ODAR is your best shot to get your denial reversed. The hearing requires you to offer objective evidence of your disability and may require you to testify as to what you can or cannot do. A SSA vocational specialist may attend the hearing as well. This individual will testify in his or her opinion about whether you are able to work, and if so, what types of jobs you are able to do.
If you are denied at this level, you have the right to appeal to the Appeals Council. The Appeals Council will review your file and apply the same analysis. However, it will give the Administrative Law Judge’s decision great weight. Therefore, many appeals at this final level are denied.
AT WHAT POINT DO I GET PAID?
Once you are deemed disabled, SSA will calculate your monthly benefits. This may take a few weeks or up to a few months. Your benefits will begin on the date SSA determines to be the onset of your disability. Benefits can be awarded to you on a retroactive basis for up to one year prior to the initial application (assuming you are able to prove that you were disabled at that point). If you are awarded past due benefits, you will receive one lump sum. From there, you will receive your monthly benefits at the beginning of each month. After two years of receiving benefits, you will be automatically eligible for Medicare, regardless of your age.
HOW DO LEGAL FEES GET PAID?
Your lawyer’s fees will come directly from SSA. We get paid only if you prevail on your claim. SSA will generally pay your lawyer an amount equal to either 25% of your past due benefits or $6,000.00, whichever is less. Any additional fees must be reviewed and approved by SSA.
As you can see, the process is deadline-driven, often confusing and stressful for anyone who is already dealing with a disability and its ramifications. The disability team at Shankman & Associates will take the stress off your shoulders and present the best possible case for a disability award.