The SSA indicates that they approve approximately 35% of initial applications for SSD and SSI benefits. That means you have a 35% chance of winning your claim just by filing your application. If you are one of the lucky ones who get approved, you do not need a representative’s help. If however, you are one of the 65% of people whose application for benefits is denied, then you are faced with filing an appeal. Only 10% of people who file appeals win at the next level. With that said, our advice is that if you are denied, you better know how to file a stellar appeal. Going through the appeals process requires a great deal of time and effort in preparing evidence and appeals. It may also mean going to a hearing before a judge. Being represented by a reputable firm means that you are not trying to file appeals, gather evidence, do research and prepare for a hearing on your own.
Law firms often handle a vast myriad of different kinds of cases and thus focus their energies on many areas of law. We do not do that. We have one focus and one focus alone; disability. That focus and dedication to one area allows us to be on the pulse of changes and developments in realm of the SSA, specifically in the field of disability. We are members of the National Association of Disability Representatives (NADR) and anytime a new Social Security Ruling or important decision is issued, we know about it and immediately begin implementing those changes to better serve our clients.
In addition, lawyers are not required to do anything special to prove their knowledge and experience with Social Security law before representing claimants. That is not the case in our firm. We are run by an EDPNA, Christina Miller. Christina received the EDPNA designation and the right to represent disability claimants in their quest for benefits directly from the Social Security Administration. She was required to pass the SSA’s rigorous examination and meet all the educational, background and professional requirements to earn this designation. Therefore, we are quite proud to call ourselves a disability firm as that is the focus of who we are and what we do.
This is a very complicated question. See our blog article on this subject for a complete discussion of the two main types of disability benefits.
The basic answer to this question is that the SSA offers two types of disability programs; Social Security Disability (SSD) and Supplemental Security Income (SSI). SSD is the benefit for those who have paid into the system over a sufficient and recent enough period of time. SSI benefits are for those have not. To qualify for SSI, you must meet very stringent asset requirements as this benefit is intended for those are very limited financially.
The answer to this question depends upon many factors. Essentially, once your initial application for benefits is filed, the SSA should send you their decision within 30-90 days. If your application is denied, then an appeal called a request for consideration must be filed within 60 days (plus 5 for mailing) from the date on the denial letter. Once this appeal is filed, you should hear back within another 30-90 days. If you are denied at this second level, then a second appeal called a request for hearing must be filed. The same time frames apply to get this appeal filed. You have 60 days (plus 5 for mailing) from the date on the second denial. Once that document is filed, you wait for a hearing. The wait period is extremely long and varies from approximately 10 months to 18 months. So, it is not uncommon for people to wait a total of two or three years to get through the process, if they win at the hearing level. If you lose at the hearing level, you may file additional appeals from there; first to the Appeals Council and then to the Federal district court. The timeframes for these upper level appeals can easily span years.
This is a complicated question to answer because the rule given by the SSA is often not what we see applied in real life. The SSA indicates that you can work as long as you earn under what they call “substantial gainful activity”. In 2017, SGA is considered to be earnings of $1,170.00 per month for non-blind persons and $1,950.00 per month for those who are blind. While that is the hard and fast rule, in our practice, we find that anyone who is working has a much more difficult time qualifying for disability benefits. With that said, if you can work, you should. If you are attempting to work and failing because it is worsening your condition or it is something you can only do for very limited periods of time, then it may not be something you can do on a long term, consistent basis. These are things you need to consider.
The SSA does not impose any costs on claimants for the filing or pursuit of your claim for any type of benefits. If you hire a firm or representative to help you, they will have their own policies concerning what expenses and costs you are responsible for. Our firm does not charge our clients for any of the expenses or costs incurred with your claim. Our fee for services is paid directly by the SSA out of our client’s back benefits at a set rate determined by the federal government. We cover all of the costs concerning postage, obtaining records, copy fees, etc. as our gift to a client for choosing our firm. You will never receive a bill from us. We like to think of this policy as our way of alleviating one more of the many worries of our valued clients.
We get this question all the time and it’s a hard one to answer as it is different for everyone based on their individual situation. Some people collect State Disability Insurance benefits, others draw unemployment. Some folks paid into long term disability plans or take an early retirement through work. Unfortunately, some folks cannot draw on any of these programs and turn to government assistance in the form of housing assistance, food stamps, etc. If you have questions in this regard, visit the “resources” tab on our homepage for a full list of programs and services that may be able to offer you information or assistance.
Yes. You need to develop a good, solid record of your disability/disabilities. This record should include diagnostic results, notes from your doctors concerning how your disabilities impact your functional abilities and any hospital records concerning surgeries, ER visits, hospitalizations, etc. Part of our job as your representative will be to help you understand what evidence is needed to win your claim. We will work with you and all of your medical providers to develop this record and prepare it for submission to the SSA.
If you do not get approved for benefits at the initial application stage or the request for reconsideration stage, then your claim proceeds to the hearing stage. That means that your claim file is transferred to the local Office of Disability Adjudication and Review (ODAR). Your medical records obtained thus far by the SSA will be categorized into hearing exhibits and a hearing of your matter will be set. The hearing will involve a judge, a vocational expert, possibly medical experts, a hearing monitor, your representative and yourself. If you are not represented, the judge will ask you questions and consult the experts (on the record) and then dismiss you. If you are represented, your representative will interact with the judge and experts on your behalf. The judge will still ask you questions; however your representative will also present questions, evidence, legal argument, hypotheticals, etc. to the court and the experts to help win your case. If you choose our firm to represent you, we will ensure that all necessary medical evidence is obtained and submitted to the court prior to your hearing. We will also write a brief summarizing your work history, medical conditions and the legal and regulatory arguments that we feel will best win our case.
Two factors are considered when determining how many months of back benefits a person is entitled to. The first factor is the date you submitted your application for benefits. The second is your onset date (OD), or the date that the SSA determines your disability began. If you qualify for SSD, you can receive back benefits for up to 12 months prior to the date you submitted your initial application or back to your OD, depending upon whether or not your OD fell within that 12 month period. If you qualify for SSI, you can only get back benefits back to the date of your initial application. If the SSA finds that your OD was after your application was already submitted, then your back benefits would only be paid back to the OD.
With that said, there are a few other factors that come into play. First, if you filed a previous application, you may be able to use that filing as what is called a “protective filing”. This gets rather complicated, but it can be done. Second, if you qualify for SSD, you will face a 5 month waiting period. In most situations, you will have 5 months of benefits removed from the start of your back benefit period, meaning entitlement really does not start until 5 months after your OD. This waiting period does not apply to SSI benefits. Third, if you qualify for SSD, you will get your back benefits paid in one nice lump sum. If you qualify for SSI, you will not receive your back benefits in a lump sum; instead you will be paid small amounts of back pay (usually under $2000) at a time every six months until they are paid in full.
Unlike SSD, SSI is a disability program for people of limited assets who have not worked enough to qualify for SSD benefits. As such, you are required to meet many income and asset requirements to be eligible for this benefit. The SSA will consider what assets you have, the amount of money in your bank accounts, the value of your vehicle(s), possessions, stocks, bonds, property, etc.
For a complete list of the resources that the SSA counts and those they do not count in determining SSI eligibility, visit the SSA’s website at
https://www.ssa.gov/ssi/text-resources-ussi.htm
If you have a disabled child under the age of 18 or the age of 22 while still regularly attending school and you have a limited income and assets, your child may qualify for SSI benefits. The earned and unearned income of those in the home, as well as, the nature of the child’s disability will all be explored as there are several complicated factors that must be explored to determine if a child could be eligible for SSI benefits. You really need to sit down with a professional to explore your particular family’s situation to determine whether or not your child could qualify.
In many situations, if a parent is collecting SSD benefits, their children are usually eligible to receive dependents benefits as long as they are under the age of 18 and unmarried. “Children” can include biological children, adopted children and dependent stepchildren. However, there are also situations in which adult children and even grandchildren can collect dependent benefits. Dependents of parents receiving SSI benefits are not entitled to any benefits.
Possibly. If your husband was collecting SSD before he passed away, you were married to him for at least one year, you are 60 or older and you became disabled between the ages of 50-60 then you may be eligible for disabled widow’s benefits. These benefits may be significantly higher than drawing benefits on your own record, so you should definitely consider pursuing these benefits.
With that said, we should note that even if your particular situation does not match this one, there are a lot of benefit options to explore including divorced spouse’s survivors benefits, spouse’s survivors benefits, spouse’s retirement benefits, mother’s or father’s benefits, etc.
Unfortunately, no. Your VA records will be helpful to your SSD or SSI case, however, the VA and the SSA does not use the same system to determine disability or eligibility for benefits. So, a VA doctor saying you are disabled is not the same as the SSA determining that you are disabled.
Yes. The 2017 monthly benefit rate for a single person receiving SSI is $735.00 per month. Most states pay a supplement based upon the costs of living in the region where the person lives. In California, the 2017 supplement is $156 per month for those living with cooking facilities and $240.00 a month for those living without cooking facilities.
Yes. You can pursue a disability claim while continuing to draw early retirement as long as you can demonstrate that your disability began prior to age 65. If the SSA determines that you qualify for SSD benefits, then you will be paid the difference between the two benefit amounts and your ongoing retirement benefits would be paid at the higher rate going forward.
Unfortunately, each system determines disability for that particular system independently from one another. Just as discussed in #15 above, every system and program utilizes their own rules.
In most situations, the SSA will figure your disability benefits using a different formula to account for the monies you are receiving from work not covered by Social Security. If your pension is from earnings that were not taxed, the SSA will likely offset your disability benefits. If the pension is based upon taxed earnings (also called “covered” earnings), then there will likely not be an offset.
The law has a strict provision known as the “80% Rule”. This rule essentially dictates that the benefits you are collecting from all disability programs combined cannot be more than 80% of what you were earning when you were working. So, the SSA applies this rule to determine offsets. They will consider what your monthly rate of disability benefits (or your lump sum settlement) from any worker’s compensation claims combined with any monies you are drawing from state disability, certain state pensions and possibly other disability programs to determine what your SSD benefit rate should be to not exceed that 80% cap.