SSDI QUESTIONS
SSDI COMMON QUESTIONS - NJ Social Security
Disability Lawyer
SSDI COMMON QUESTIONS
Attorneys cost a fortune! How much will it cost me to have an attorney
assist me in obtaining benefits?
Nothing. You
will not pay a single penny. The United
States’ government has enacted laws which prohibit attorneys from charging
Social Security applicants a fee.
Attorneys are only paid on successful applicantions and that payment
comes directly from the Social Security Administration (SSA), out of your back
benefit. (For an explanation on the back
benefit, please read below.) ANY attorney
or agency that attempts to charge you a fee is in violation of federal law.
Federal law states attorneys (and non-attorney
applicant representatives) may only receive either the lesser of 25% of the
claimant’s back benefit OR $6,000.00. In
other words, the maximum an attorney will receive from a claimant’s back
benefit is $6,000.00, but your attorney may receive substantially less
depending on the award. Contact the
Simon Law Group today to speak to an attorney about your disability
application! 800-709-1131
free lawyer
attorney evaluation
Please note: attorneys are permitted to charge
clients for costs incurred in pursuing an applicant’s appeal.
Are Social Security Disability Insurance (SSDI)
benefits awarded only to applicants who are permanently disabled?
No. Benefits
may be awarded to applicants with non-permanent disabilities if their condition
and/or impairments persist for over 12 months and meet the criteria on the
Social Security Administration’s List of Impairments. Contact the Simon Law Group today for a free
consultation to discuss your specific situation. 800-709-1131. Often, a careful review of your medical
records is the only way to determine whether you should apply or how successful
your application may be.
I have cancer and I am presently disabled, but my
doctor thinks I will be able to work again after treatment. Should I apply for
Social Security Disability benefits?
Yes. If you
are expected to be out of work for a year or more you should apply.
If my application is approved, how is my back
benefit calculated?
The Social Security Administration (SSA) pays out to
successful applicants past-due benefits for the calendar year prior to the date
the successful application is filed.
This is sometimes referred to as a “back benefit.” SSA provides this benefit even if they find
the applicant was disabled much earlier than twelve (12) months prior to the
application’s filing. This means that,
if you filed to SSDI on October 2, 2013 and that application was accepted – at
any stage in the application process – your back benefit would be calculated
from October 2, 2012.
However, applicants must be advised that this
process can involve multiple applications over a period of months or even
years. The benefit is not calculated
from one year prior to the date of the applicant’s first application; it is
calculated from the date of the successful application. Potential SSDI applicants are strongly
encouraged to speak with an attorney knowledgeable about these matters. Call our attorneys today for a free
consultation! 800-709-1131
Speak with an
Attorney
In Supplemental Security Income (SSI) cases
applicants will only get paid from the date of the successful application.
How long will it take for SSA to review my
application and make a decision?
When applying for SSI or SSDI, applicants need to be
aware the process can take months, even years in some cases. It is typical for an initial application to
be decided upon within six (6) months – the more information in your initial
application the longer it takes, the less comparable the applicant’s condition
is to the conditions on the List of Impairments, the longer it takes. And so on.
After your application is reviewed, it will very likely be denied. Most first-time applicants are denied, but
this does not mean you are not disabled or not entitled to benefits.
Once an application is denied, there is a (usually)
two-step appeals process.* The first
step is called “Reconsideration.” If
your application was denied and you think that determination was wrong, for any
reason, you should seriously consider filing for reconsideration. The Simon Law Group’s attorneys can assist
you in this process and advise you on whether your case warrants
reconsideration. Be aware, you have
sixty (60) days to file for reconsideration.
Typically, reconsideration can take six (6) weeks to several months to
complete. Call the Simon Law Group today
to get started on your appeal.
800-709-1131
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Now
If your application is again denied, the second step
in the appeals process is a hearing in front of an administrative law judge
(ALJ). The ALJ hearing is very similar
to an informal trial – you may present evidence in the form of medical
documentation and witness testimony (including your own.) The ALJ hearing must be requested within
sixty (60) days of the denial of the reconsideration. The hearing may not be scheduled, however,
for several months; in fact it may take a year or more to get in front of the
ALJ. Thereafter, it can take more months
to get a decision on your case.
If you need help with any part of the appeals
process, the attorneys at the Simon Law Group are here to help. At this stage in the process, it can be
critical to have an attorney’s assistance – mistakes can cost you a lot of time
and effort best reserved for taking care of yourself. Call us today. 800-709-1131
The foregoing timelines are estimates, only. SSA timelines are constantly changing based
on demand. Currently, demand for
benefits is at an all-time high.
* In most states, a Reconsideration remains the
first step in the appeals process, however, some states have done away with the
Reconsideration phase altogether, and appeals are made directly to an
administrative law judge for a hearing.
My appeal before the ALJ was denied – what can I do?
If SSA’s denial of your application was upheld by an
ALJ, there is a further level of appeal.
Most states have an Appeals Council that hears appeals from ALJ
determinations. If your application was
denied, and that denial was upheld by the ALJ, and you disagree with that
determination, you must file an appeal immediately following the denial.
For those states that no longer utilize an Appeals
Council, applicants must file a civil suit in U. S. District Court.
In most cases, applicants should also reapply for
SSI and/or SSDI benefits at this time.
This is especially so where the applicant’s condition has worsened
significantly since the initial application was filed.
If my application is accepted and I am granted
benefits, how much will I receive?
The simple answer here is that it’s difficult to
say; SSA uses a very complicated mathematical formula that takes into account
your work history at several periods to craft your benefit amount. Each applicant’s situation is
different. Benefits awards are based on
a number of factors, including the applicant’s age, the amount of money they
have deposited with Social Security over their lifetime (through payroll taxes,
usually). Periodically, the SSA sends
each worker a print out of all your work information as it relates to Social
Security. That information also
indicates how much each applicant would receive as a benefit if the applicant
were to receive SSI or SSDI benefits that year.
If you do not have the most recent sheet, do not be concerned. SSA runs new calculations for all successful
applicants.
Typically, the younger the applicant, the less
benefit the applicant will receive.
What are Disabled Widow’s Benefits?
The Disabled Widow’s Benefit is a program where the
claimant can seek benefits based on their deceased spouse’s work history and
earnings record. Historically, this
benefit was used by wives who did not have careers because they were
homemakers, but it is not limited to women.
To qualify for this benefit, the applicant must be at least 50 years old
and file the application within seven (7) years of the death of the qualified
spouse.
What are Divorced Spouse’s Benefits?
A claimant can apply for benefits based on his or
her divorced spouse’s earnings record. If you were married to your ex-spouse
for ten (10) or more years, are at least 62 years old, and are currently
unmarried you should qualify.
What is the SSA’s Five Step Sequential Evaluation
Process?
SSA uses a five step process when evaluating a
claimant’s application for disability benefits or supplemental income. This step-by-step process was developed to
streamline the application process by permitting SSA to make a final
determination on the claimant’s application as quickly as possible. SSA will deny an application if it fails to
meet any step in the sequence, rather than complete the entire analysis to
determine whether any steps are not met by the claimant’s condition(s).
Step 1: SSA
will determine whether the claimant is engaging in “substantial gainful
activity” (SGA). In other words, SSA
wants to know if the claimant has a job and is actively working. Generally, if an individual shows earnings
from employment or self-employment above specific levels set out in the
regulations, it is presumed that he or she has demonstrated the ability to
engage in SGA. If an individual engages
in SGA they are not disabled regardless of how severe their physical or mental
impairments are.
If you are applying, or thinking of applying, for
SSI or SSDI benefits and you are working, call the Simon Law Group to discuss
your situation. Our attorneys can assist
you in the application process.
Step 2: If SSA finds the claimant is not engaging in
substantial, gainful activities, they will next need to determine whether the
claimant has a medically determinable impairment or combination of impairments
that are “severe.” An impairment is considered “severe” by SSA if it
significantly limits an individual’s ability to perform basic work activities.
Step 3: If SSA finds the claimant’s condition to be
severe enough, they will next determine whether the claimant’s impairment or
combination of impairments meets or medically equals the entry on SSA’s Medical
Listing of Impairments, a list of medical conditions which are automatically
approved for disability benefits. If an individual has a condition that is the
same as or equal to the severity of that condition listed, they are found
disabled and eligible for benefits. If a claimant’s condition does not meet the
criteria established in the Listings, then the application must proceed to Step
4.
Step 4: If the claimant’s condition does not meet
the criteria in the Medical Listing of Impairment analysis described in Step 3,
SSA will determine the claimant’s Residual Functional Capacity (RFC). Once determined, SSA will determine whether
the claimant’s RFC permits him or her to perform the type of work he or she did
prior to becoming disabled. If it is
determined that the claimant cannot do this past work, SSA will move forward to
the final step in the analysis.
Step 5: If
SSA has determined the claimant cannot do past work after establishing the
claimant’s RFC, they will next consider the claimant’s Residual Functional
Capacity, age, education and work experience and whether there is any other
work the claimant can do going forward.
What can I do to help win my Social Security case?
There are a number of things a claimant can do to
help SSA make a favorable determination:
1.
Submit all medical records you have to Social Security when you first
apply.
2.
Continue to get medical treatment and try not to miss appointments.
3. If
you are denied…appeal right away.
4. If
you start to see a new doctor, have a hospital stay or go for a new test…tell
Social Security or your representative immediately.
5.
Whether you are handling the case by yourself or you have a lawyer,
always stay involved.
6. The
Social Security process is long and frustrating. Never take it out on Social
Security employees, it will not help but it can hurt your case.
7.
Every few months check the status of your case with your lawyer or the
local District Office where you filed.
8. If
you don’t already have a lawyer, consult with a lawyer at the Simon Law Group
who can help guide you through this process. (<hyperlink contact us
page>)
9.
Speak to your doctor and see if he or she will complete a Residual
Functional Capacity (RFC) form. These forms can be obtained from SSA or from
your attorney representative.
10. Keep
a journal of your day-to-day life and how your condition affects you. In this
journal, note things like any side effects from your medications, how your
daily living is affected by your disability, sleeping patterns, etc.
Should I apply for SSI, SSDI or both?
Deciding which benefit to apply for is entirely
dependent on each individual case. Claimants with limited resources should
apply for SSI. Anyone who has worked for
a significant amount of time should see about applying for SSDI. Keep in mind
many people may qualify under both programs. Contact the Simon Law Group to
discuss with a qualified attorney who handles Social Security disability to see
which program you qualify for.
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Will Social Security grant benefits to those who
have my particular illness or injury?
Whether SSA grants benefits to an individual
claimant is entirely dependent upon that individual’s history and
condition. The issue is not so much the
type or extent of the illness (though those are factors) but “how does your
condition limit your ability to work and enjoy life?” For example, consider a hypothetical:
Jim has herniated spinal discs at L4, and L5. They cause significant discomfort and
radiating pain down through his right leg.
He cannot sit still for long periods, and walking and standing for more
than ten (10) minutes causes extreme pain and fatigue. His back problems prevent him from carrying
heavy objects and, while Jim has a high school diploma, he has not been in
school in almost forty years. Jim is 52
years old and has spent his life working as a plumber. Now, because of his back he can no longer
practice the only trade he knows. As a
result, Jim begins to suffer depression that further affects his life and
family. Jim begins working with a
psychologist who prescribes medications that cause Jim to gain significant
weight and further limits his ability to move independently. Jim applies for SSDI.
In Jim’s case, he may very well be an excellent
candidate for SSDI. On the other hand,
SSA may feel he can perform other work in his field (like answering telephones
at his plumbing service and doing data entry) and deny his claim. Without a thorough review of his medical
records and other documentation, it’s difficult to say. If you think your illness, injuries, and/or
conditions may qualify you for SSI or SSDI, call the Simon Law Group today for
a free consultation. 800-709-1131
Find out if
you qualify
I have more than one illness or injury, will Social
Security consider them separately or in combination when reviewing my claim?
SSA evaluates each claim by reviewing all of the
claimant’s claimed conditions together.
SSA will determine how the claimant’s several conditions work together
to affect his or her ability to work. In
fact, SSA must evaluate all claimed conditions – even those which are not
deemed sufficiently severe. Contact the Simon Law Group to speak with an
attorney will make sure all of your conditions are considered by SSA
Contact the Simon Law Group today to find out if you
qualify for benefits. 800-709-1131
§ SSDI
Questions
§ SSDI
Eligibility
§ Duration
Work Test
§ Applying
for Benefits
§ Appeal
SSDI Denial
§ 5
Step Process to Determine Benefits
§ SSDI
Disability Grid
