Frequently Asked Questions About Social Security Disability Benefits

What is the definition of disability used by the Social Security Administration?[wpex more=”Read more” less=”Read less”]The Social Security Act says that disability means the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.”[/wpex]

How do I apply for Social Security disability benefits?[wpex more=”Read more” less=”Read less”]Call Disability Specialists toll free at 1-800-642-6393 as soon as you believe that you or your child have a disabling condition. You can stay in the comfort of your own home while we do all the work. We will complete all forms by telephone and mail and gather and submit all medical evidence for you.[/wpex]

How long do I have to wait after becoming disabled before I can file for Social Security disability benefits?[wpex more=”Read more” less=”Read less”]Don’t wait a single day. You can file for Social Security disability benefits on the same day that you become disabled. If you have a serious illness or injury that will keep you from working for a year or more you should contact Disability Specialists immediately for assistance in filing your claim for Social Security disability benefits.[/wpex]

Do I have to wait until my sick leave is exhausted before I file a disability claim?[wpex more=”Read more” less=”Read less”]No. Sick leave has no effect on your eligibility for Social Security disability benefits. If you believe that you will be out of work for a year or more, you should call Disability Specialists toll free at 1-800-642-6393 now to file your claim.[/wpex]

Can I file a claim while I am receiving Worker’s Compensation?[wpex more=”Read more” less=”Read less”]Yes. Start your claim for Social Security disability benefits while you are still receiving worker’s compensation benefits. Otherwise there may be a gap between the time the worker’s compensation ends and the Social Security disability benefits begin causing you severe financial hardship.[/wpex]

Can I get both Worker’s Compensation and Social Security disability benefits?[wpex more=”Read more” less=”Read less”]Yes. Your Social Security disability benefits will be reduced because of the worker’s compensation benefits paid; but in virtually all cases, you will still receive some Social Security disability benefits. In a few states the offset works the other way; worker’s compensation benefits are reduced because of Social Security disability benefits. Either way, you will receive more income if you receive both Worker’s Compensation benefits and Social Security disability benefits than if you receive benefits from either program alone.[/wpex]

I am disabled now, but I expect that I will be able to return to work after I recover. Should I file for Social Security disability benefits?[wpex more=”Read more” less=”Read less”]If you expect to be out of work for a year or more because of illness or injury, you should file for Social Security disability benefits.[/wpex]

Can a stay-at-home mom receive disability benefits?[wpex more=”Read more” less=”Read less”]If you have worked five out of the past 10 years before becoming disabled, you may have enough earnings in to qualify for Social Security disability insurance. For individuals 31 years old or less, the requirements are a little different; since individuals have not had such a long time to work. Even if you’ve never worked outside the home, you will qualify for Supplemental Security Income (SSI) if you are disabled and poor.[/wpex]

How can I tell if I will be found disabled by Social Security?[wpex more=”Read more” less=”Read less”]If you believe that you or your child are disabled, you should call Disability Specialists toll free at 1-800-642-6393 for a free analysis of your chances. Unless your disability is catastrophic (e.g., 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 to tell whether you will be found disabled by Social Security. We will use our years of experience with the Social Security Administration to provide you with our best prediction.[/wpex]

What diseases qualify a person for Social Security disability benefits?[wpex more=”Read more” less=”Read less”]Any disease or combination of diseases can qualify you for disability benefits if it makes you unable to work for at least a year or will result in death. The mere fact that you have a specific disease does not by itself determine if you are disabled.[/wpex]

Can a mental illness serve as the basis for a Social Security disability claim?[wpex more=”Read more” less=”Read less”]Yes. Mental illness is a frequent basis for awarding Social Security disability benefits. We will make sure that the Social Security Administration properly considers problems caused by your mental illness.[/wpex]

I have several health problems, but no one of them disables me. It is the combination that disables me. Can I get Social Security disability benefits?[wpex more=”Read more” less=”Read less”]The Social Security Administration must consider the combination of impairments that you have when determining if you are disabled. Disability Specialists makes sure that the Social Security Administration considers all your conditions when reaching a decision. If your combination of illnesses will prohibit work for at least a year then you can qualify for disability benefits.[/wpex]

My doctor says I am disabled. Will I automatically qualify disability benefits?[wpex more=”Read more” less=”Read less”]No. Your doctor cannot determine whether or not you are disabled under the Social Security Act. By law, the Social Security Administration must reach an independent decision regardless of what your doctor says, but Disability Specialists can help make sure that the Social Security Administration properly considers your doctor’s opinion when reaching a decision.[/wpex]

If the Veterans Administration (VA) says I am disabled, will I automatically qualify for disability benefits?[wpex more=”Read more” less=”Read less”]No. The Social Security and the Veteran’s Administration (VA) have very different standards for approving disability claims. The Social Security Administration must make a new and independent decision. Disability Specialists can help make sure that the Social Security Administration gets all your VA medical records and that the opinions of your doctors at the VA are properly considered.[/wpex]

If I am 70% disabled, do I get 70% of my Social Security disability benefits?[wpex more=”Read more” less=”Read less”]No. Under the Social Security Act, you are either disabled or not disabled. There are no percentages of disability, nor any percentages of disability benefits.[/wpex]

How does Social Security determine if I am disabled?[wpex more=”Read more” less=”Read less”]Social Security is supposed to gather your medical records and carefully consider all of your health problems as well as your age, education, and work experience. 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. Disability Specialists will make certain that all these steps are followed for your Social Security disability benefits claim.[/wpex]

Who decides if I am disabled?[wpex more=”Read more” less=”Read less”]After you file a Social Security disability claim, your medical records and your responses to questions on various forms are sent to a disability examiner at the Disability Determination agency in your state. That individual, working with a doctor, makes the initial decision on the claim. If the claim is denied, you can request reconsideration of your evidence. Your case is then sent to another disability examiner at the Disability Determination agency, where the same process is repeated. If a claim is denied at reconsideration, you may then request a hearing before 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. Each of these steps has strict deadlines. Disability Specialists will make sure that every step is completed on time.[/wpex]

What can I do to improve my chances of winning my Social Security disability claim?[wpex more=”Read more” less=”Read less”]The Social Security Administration is one of the world’s largest bureaucracies. Applying on your own can be an over-whelming task for a disabled person. Claimants who use a representative have a much better chance of getting what they deserve. Disability Specialists has won tens of thousands of claims over more than 20 years. We know the system from the inside out and we will use that knowledge to help you win your claim.[/wpex]

How long does it take before Social Security makes a decision once I file a claim for Social Security disability benefits?[wpex more=”Read more” less=”Read less”]In most cases Social Security makes the first decision within four months to six months. If you aren’t granted disability benefits as a result of your initial application, then there are several levels of appeal that you can pursue until you win your claim. Here’s a list of the approximate times for each level:

  • Initial Application: 4 to 6 months
  • Reconsideration: additional 4 to 6 months
  • Hearing Before a Judge: additional 12 to 15 months
  • Appeals Council: Additional 12 to 30 months
  • Federal District Court: Additional 12 to 36 months

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If I am approved for Social Security disability benefits, how much will I get paid?[wpex more=”Read more” less=”Read less”]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 that an individual can receive. Disability Specialists can provide you with an estimate once we are familiar with your situation.[/wpex]

How much does it cost to have Disability Specialists help me?[wpex more=”Read more” less=”Read less”]Disability Specialists is paid only if we obtain benefits for you. If we don’t get you benefits, we are paid nothing no matter how long we worked for you and no matter how much money we spent attempting to get you benefits. For some cases, there is no charge to you because we are paid by the state or county government to assist you. For other cases, the law limits our fee to a percentage of the past due benefits that we obtain for you and our fee is paid to us by the Social Security Administration. For every case, nothing is taken from your monthly benefit check and you have no upfront costs.[/wpex]

What are the primary disability programs under Social Security?[wpex more=”Read more” less=”Read less”]

  • Title XVI – Supplemental Security Income (SSI)
  • Title II – Retirement, Survivors and Disability Insurance (RSDI)

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How do I establish non-medical entitlement to these programs?[wpex more=”Read more” less=”Read less”]

  • RSDI pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes.
  • SSI pays benefits based on financial need.

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What is a medically determinable impairment?[wpex more=”Read more” less=”Read less”]It is an impairment that results from anatomical, physiological, or psychological abnormalities which can be shown by medically acceptable clinical and laboratory diagnostic techniques. It cannot be based only on the individual’s statement of symptoms.[/wpex]

What is a Protective Filing Date (PFD)?[wpex more=”Read more” less=”Read less”]This is the date your disability claim was initiated with SSA. If approved for SSI benefits, you can receive payment no earlier than the month after your PFD. If approved for RSDI benefits, you can receive benefits no earlier than 12 months prior to your PFD.[/wpex]

What is an Alleged Onset Date (AOD)?[wpex more=”Read more” less=”Read less”]This is the date you claim you became disabled[/wpex]

What is a Date Last Insured (DLI) and what effect does it have on a claim for Title II benefits?[wpex more=”Read more” less=”Read less”]This is the date your work credits for RSDI benefits expire. Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year.The number of work credits you need to qualify for disability benefits depends 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.IMPORTANT: Remember that whatever your age is, you must have earned the required number of work credits within a certain period ending with the time you become disabled. If you qualify now but you stop working under Social Security, you may not continue to meet the disability work requirement in the future.[/wpex]

What is a CE?[wpex more=”Read more” less=”Read less”]Usually, Disability Determination Services (the State agency responsible for developing medical evidence and making the initial determination on whether or not a claimant is disabled or blind under the law) tries to obtain evidence from your own medical sources first. If that evidence is unavailable or insufficient to make a determination, DDS will arrange for a consultative examination (CE) to obtain the additional information needed. Your treating source is the preferred source for the CE, but the DDS may obtain the CE from an independent source[/wpex]

What forms are commonly requested by DDS?[wpex more=”Read more” less=”Read less”]

  • Activities of Daily Living: a detailed accounting of what you do in a normal day.
  • Work History Report: a summary of all jobs you’ve held in the last 15 years.

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I got a notice of decision stating I was not found disabled, what next?[wpex more=”Read more” less=”Read less”]You have 60 days within which to file an appeal.[/wpex]

I missed my appeal deadline. Do I have any options?[wpex more=”Read more” less=”Read less”]You have two options. If you have good cause for missing your deadline, you can ask Social Security to accept your appeal beyond the 60 day deadline. If you do not have good cause, you can start a new claim.[/wpex]

What types of Social Security disability benefits are there?[wpex more=”Read more” less=”Read less”]There are five types of Social Security disability benefits:

  • Disability Insurance is awarded to disabled adults who have worked in recent years (usually at least five out of the last 10 years).
  • Disabled Widow’s and Widower’s Benefits are paid to an individual who is at least 50 and becomes disabled within a certain amount of time after the death of his or her spouse. The late spouse must have worked long enough to have paid enough credits into Social Security to be insured.
  • Disabled Adult Child Benefits go to the disabled children of a parent who was drawing Social Security disability or retirement benefits at the time of death. The child must have become disabled before age 22.
  • Supplemental Security Income benefits are paid to individuals who are poor and It does not matter for SSI whether an individual has worked in the past or not.
  • SSI child’s disability benefits are paid to children under the age of 18 who are disabled and who’s family is very poor.

For Disability Insurance Benefits, Disabled Widow’s or Widower’s Benefits and Disabled Adult Child benefits, it does not matter whether the disabled individual is rich or poor.  Benefits are paid based upon a Social Security earnings record.

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Is there a list of illnesses that Social Security considers disabling?[wpex more=”Read more” less=”Read less”]There is a list called Compassionate Allowance that includes very severe disorders that will qualify a person for disability if other technical conditions are met (e.g., monthly earnings average less than $1,000, etc.)  The disorders on that list will apply to only a few claimants.  Most disorders vary from minor to severe so Social Security does not consider a diagnosis alone as evidence of disability.  If an illness has reached a very severe level, Social Security will award benefits based medical considerations alone.[/wpex]

Why does Social Security consider my age in determining whether I am disabled?[wpex more=”Read more” less=”Read less”]Social Security has to consider age, because that is what the Social Security Act requires.  As people get older, they become less adaptable and less able to switch to different jobs in response to health problems.[/wpex]

What do I do if Social Security denies my claim for Social Security disability benefits?[wpex more=”Read more” less=”Read less”]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 file a request for reconsideration.[/wpex]

Why does Social Security turn down so many claims for disability benefits?[wpex more=”Read more” less=”Read less”]One reason is that there is no simple way to determine if an individual is disabled.  Most people who are disabled suffer from pain, but it is difficult to determine the severity of that pain and the extent to which it prohibits any full time work.  A second reason is that Social Security is more concerned that everyone who is receiving Social Security disability benefits is genuinely disabled than with ensuring 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 to get benefits.[/wpex]

I only want to get back the money I put in Social Security.  Why do they make it so hard for me to get my own money back?[wpex more=”Read more” less=”Read less”]When you are awarded Social Security disability benefits, you are not going to just receive your own money back.  The money that an individual paid into Social Security over the years would not last very long if that was all that individual could draw from Social Security.  Most people will draw much more than they paid into the system and the difference is made up by the workers paying into the system who have not filed for benefits.[/wpex]

What is reconsideration?[wpex more=”Read more” less=”Read less”]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.[/wpex]

Who makes the reconsideration determination?[wpex more=”Read more” less=”Read less”]A disability examiner at the claimant’s state Disability Determination Service makes the reconsideration determination.  Most of the time, the claimant does not see the disability examiner or even know his or her name.[/wpex]
What are my chances of winning at reconsideration?[wpex more=”Read more” less=”Read less”]About 20% of the time a claimant wins at reconsideration.[/wpex]

Do I have to go through reconsideration?[wpex more=”Read more” less=”Read less”]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.[/wpex]

What is the Social Security hearing like?[wpex more=”Read more” less=”Read less”]The hearings are fairly informal. The only people likely to be there is the judge, a court recorder operating a tape recorder, the claimant, the claimant’s representative, and anyone else the claimant has brought with him or her.  In some cases, the Administrative Law Judge has a physician, psychologist, or vocational expert present to testify at the hearing.  There is no jury or spectators. There is no attorney at the hearing representing Social Security trying to get the judge to deny the disability claim.[/wpex]

What are my chances of winning at a hearing?[wpex more=”Read more” less=”Read less”]Nationwide, over half of the claimants who have a Social Security disability hearing win.  Some judges are more strict, but many are more generous.[/wpex]

If the Administrative Law Judge denies my claim, can I appeal any more?[wpex more=”Read more” less=”Read less”]Yes. You can appeal to the Appeals Council, which is still within Social Security.[/wpex]

What is the Appeals Council?[wpex more=”Read more” less=”Read less”]The Appeals Council exists to review Administrative Law Judge decisions.  The Appeals Council is located in Falls Church, Virginia, and neither the claimant nor the claimant’s representative sees the people at the Appeals Council who are working on the case.  The appeal is conducted entirely by paper.[/wpex]

Can I appeal a case beyond Social Security to the Federal Courts?[wpex more=”Read more” less=”Read less”]Yes. After being denied by the Appeals Council, it is possible for a claimant to file a civil action in the United States District Court, requesting review of Social Security’s decision.  A Social Security disability claim can go all the way to the Supreme Court.  Perhaps once every year or two years, the United States Supreme Court hears an appeal about a Social Security disability case.[/wpex]

If I get on Social Security disability benefits and get feeling better and want to return to work, can I return to work?[wpex more=”Read more” less=”Read less”]Yes!  Social Security wants individuals drawing disability benefits to return to work and gives them help to do so.  For persons receiving Disability Insurance Benefits, Disabled Widow’s and Widower’s Benefits, and Disabled Adult Child Benefits, full benefits may continue for a year after an individual returns to work.  Even thereafter, an individual who has to stop work in the following three years can resume Social Security disability benefits immediately without having to file a new claim.  In SSI cases, things work a differently, but there is still a strong encouragement to return to work.[/wpex]

Do I really have to hire someone to assist me with my Social Security disability claim?[wpex more=”Read more” less=”Read less”]No.  You can go through all the levels of review on your own, if you wish, but statistically claimants who hire a representative win a good deal more often than those who are not represented.  The Social Security Administration thinks that representatives are so helpful that if you have a hearing and you haven’t hired a representative, the judge will recommend that you reschedule the hearing to give you time to hire one.  That rescheduling could delay your hearing by as much as a year or more!  If you insist on going forward without a representative, you will be asked to sign a waiver agreeing that you acted against the judge’s recommendation.[/wpex]

Can alcoholics and drug addicts get Social Security disability benefits?[wpex more=”Read more” less=”Read less”]Congress prohibits Social Security from paying disability benefits based on dependence on alcohol or other drugs, but persons with chemical dependence are more likely than a typical person to get sick in other ways.  Other physical and mental disorders can qualify a person with a chemical dependence for Social Security disability benefits if it can be proven that the other disorder would remain disabling even if the claimant stopped using alcohol or another drug.[/wpex]

I know someone who is on Social Security disability and he does not look a bit disabled.  Why do they put all of these freeloaders on benefits?[wpex more=”Read more” less=”Read less”]When it comes to disability, looks can be very deceiving.  There are many people who look quite healthy but who are quite disabled by anyone’s standard.  For instance, many individuals who suffer from very severe psychiatric illness are physically healthy and able to do things such as mow their yards.[/wpex]

Can I get Social Security disability benefits even if I’ve never held a job and had FICA taken from my paycheck?[wpex more=”Read more” less=”Read less”]If you are poor enough, you can qualify for Supplemental Security Income (SSI) if you are disabled and even if you have never worked in the past.  It is also possible to qualify for Disabled Adult Child Benefits on the account of a parent if you became disabled before age 22 or for disabled widow or widower’s benefits on the account of a deceased spouse.[/wpex]

I am a widow.  I have not worked for many years.  I am disabled.  Can I get Social Security disability benefits?[wpex more=”Read more” less=”Read less”]If you are over 50 and became disabled within seven years after your spouse died or within seven years after you last drew on your mother’s or father’s benefits from Social Security, you can get Disabled Widow’s or Widower’s Benefits.  Perhaps more important, if you are poor, you can draw Supplemental Security Income benefits no matter what age you are or when you became disabled.[/wpex]

I have a daughter who has been disabled by cerebral palsy since birth and has never been able to work.  Can she get disability benefits from Social Security?[wpex more=”Read more” less=”Read less”]Very possibly.  If the child is under 18 and you are poor enough, the child may be able to qualify for SSI child’s disability benefits.  If the child is over 18, she may be able to qualify for SSI disability benefits based on her own income and medical condition without regard to the income of her parents.  If her father or mother is drawing Social Security benefits of some type or is deceased, the child may be eligible for disabled adult child benefits.[/wpex]

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?[wpex more=”Read more” less=”Read less”]Social Security is not supposed to cut off disability benefits for an individual unless his or her medical condition has improved.  Social Security conducts reviews to determine whether or not individuals already on Social Security disability benefits are still disabled but the vast majority of individuals who are reviewed will have their Social Security disability benefits continued.[/wpex]

If Social Security tries to cut off my disability benefits, what can I do?[wpex more=”Read more” less=”Read less”]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 a representative about help with your case, but you should file the appeal immediately.[/wpex]

Will it help if I ask my Congressional Representative to help me get Social Security disability benefits?[wpex more=”Read more” less=”Read less”]Many Social Security disability claimants become frustrated with claim delays and eventually ask their U.S. Representative or U.S. Senator to help.  The local Congressional office typically will have staffers who are experienced with Social Security procedures and personnel.  A “Congressional Inquiry,” as it is called at Social Security, may help to get a stalled process moving again but the inquiry will have no impact on how Social Security decides the outcome of the case.[/wpex]

I am disabled.  I need help with medical bills even more than I need a cash income.  How do I get help with medical bills?[wpex more=”Read more” less=”Read less”]Getting help with medical bills is usually tied up with getting cash benefits, that is, you don’t start getting help with medical bills until after you start getting the cash benefits, so you have to keep going with the Social Security disability claim to get the help with medical bills.[/wpex]

What is the difference between Medicare and Medicaid?[wpex more=”Read more” less=”Read less”]The short answer is that Medicaid is a poverty program and Medicare isn’t.  Many disabled people who get Medicaid get it because they are on Supplemental Security Income (SSI).  This is called categorical Medicaid eligibility.  To get SSI and thereby get Medicaid you have to be poor and disabled.  Medicaid pays doctors at very low rates.  People who have only Medicaid can have a hard time finding doctors willing to take them on as patients.  Medicaid does pay for prescription medications.  Medicaid can go back up to three months before the date of a Medicaid claim.  Note that it is possible to apply for Medicaid directly, through a local Medicaid office, without having a companion claim for SSI.For Medicare it does not matter whether you are rich or poor.  If you have been on Disability Insurance Benefits, Disabled Widows or Widowers Benefits or Disabled Adult Child Benefits for 24 months you qualify for Medicare.  The good thing about Medicare is that it pays doctors at a higher rate than Medicaid.  Almost all doctors are happy to take Medicare patients.  The bad things about Medicare are that it does not begin until after a person has been on cash disability benefits for two years.  You can pay for an additional benefit that will cover prescription medications.[/wpex]

If I get Social Security disability benefits will I get Medicare?[wpex more=”Read more” less=”Read less”]If you are approved for any kind of Social Security disability benefit other than SSI you will get Medicare after you have been entitled to Social Security disability benefits for two years.[/wpex]

If I get Social Security disability benefits will I get Medicaid?[wpex more=”Read more” less=”Read less”]If you are approved for SSI you will get Medicaid.  It is possible to get both Medicare and Medicaid if you are entitled to SSI and some other type of Social Security disability benefit.[/wpex]

How far back will Social Security pay benefits if I am found disabled?[wpex more=”Read more” less=”Read less”]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 before 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 before the date of the claim.  SSI benefits cannot be paid before the start of the month following the date of the claim.[/wpex]

Do I have to wait until all my money is gone before I apply for Social Security disability benefits?[wpex more=”Read more” less=”Read less”]If you have worked in recent years or if you are applying for Disabled Widow’s or Widower’s benefits or Disabled Adult Child benefits, it does not matter how much money you have in the bank or what you own.  File your claim now before you develop financial hardship or before your financial situation worsens.[/wpex]