Obtaining Social Security Disability: Navigating the Maze

The rules and regulations governing Social Security disability benefits can be a confusing, especially when you or a loved one are sick or hurt. Arm yourself with a better understanding of the terms used and the process that you must follow.

What’s the difference between Social Security Disability (SSDI) and Supplemental Security Income (SSI)?

Both SSDI and SSI are programs run by the federal government to provide monetary benefits and Medicare to individuals who cannot work due to a medical disability.

SSDI is funded through payroll taxes taken out of your paycheck. While you are working, you pay into the system and accrue what Social Security calls “work credits.” When you stop working, you stop paying into the SSDI system. Work credits have an expiration date (typically about five years after you last worked.) To make a successful claim for SSDI benefits, you must prove you became disabled before the date your credits expired (also known as your date last insured). This can be done using medical records, reports and eyewitness testimony. If your “date last insured” is in the past when you apply, it can be more difficult to obtain benefits. SSDI benefit amounts are based on your wage history.

SSI is for individuals who do not have sufficient work credits to qualify for SSDI benefits, who are medically disabled and who have very few assets. To qualify for SSI, you must be disabled, and you must have less than $2,000 in assets as an individual or less than $3,000 in assets if you are married. It is possible to qualify for both SSDI and SSI if you made low wages at all of your past jobs. If you qualify for SSI, you will receive a maximum of $771 per month in the year 2019, and amount that is subject to cost of living increases each year.

I had an accident and will be out of work for about six months. Can I get Social Security benefits?

SSDI and SSI are long-term disability benefit programs, so you can only obtain benefits if you have been or expect to be disabled for at least 12 months. If you will only be off work for six months, you do not qualify. However, if you suffer a setback in your recovery and it looks like you will be off longer than expected, it may be worthwhile for you to apply.

How do I apply for benefits?

Contact Goodrich and Associates to begin the process. Once we have you fill out some initial paperwork, we can submit your SSDI application online. You do need to speak to a Social Security representative to file the SSI application.

I hear everyone gets denied. What are my chances?

Many people are denied SSDI benefits the first time they apply. At Goodrich and Associates, we have successfully obtained SSDI and SSI benefits for many people that have been denied.

To increase your chances of securing benefits, make sure to receive regular and continuing medical treatment for the condition that is preventing you from working. If Social Security sees that you haven’t been treated for a condition in years, they will assume that it means that the condition is not particularly serious. If you’re receiving treatment regularly from doctors who know you well and know just how much your conditions impact your life, that doctor can provide a credible third-party account to Social Security on why you cannot work and deserve benefits.

In addition, if you have a condition that can be treated by a specialist, don’t put off going to that specialist. Social Security does not always give significant weight to the opinions of family physicians when they are treating people for conditions that could or should be managed by a specialist. This is especially true in the mental health setting.

I got denied. Now what?

Call Goodrich and Associates immediately. We can help you file an appeal online and keep your case open and in line for a hearing in front of an administrative law judge (ALJ). We will personally sit down with you and file your appeal online while you wait with us. You have only 60 days from the date of your denial letter to file your appeal. If you do not file within those 60 days, you will need to start the application process all over again.

 How long will I have to wait for an appeal hearing?

The wait time for a hearing before an ALJ is currently 12 to 18 months. In most cases. there is little that can be done to speed up this process. If you are in a dire financial situation (foreclosure, eviction, utility shut-offs), it may be possible to speed up the process, but the wait time will still likely be at least six months. As you wait for a hearing, continue to receive regular treatment from your doctors, and update your attorney about any changes in your medical conditions. Your attorney will request copies of your medical records and keep Social Security updated.

What happens at a Social Security hearing?

Social Security hearings are held in administrative office buildings, not your local courthouse. In most hearings, your attorney will make a brief opening statement to the judge about why you need disability benefits. Typically, the judge will then ask you a series of questions, and the attorney will then have the opportunity to ask questions. Once you are done testifying, the judge and the attorney will ask questions of an individual known as a vocational expert about what kind of jobs – if any – someone with your limitations would be able to perform.

Such hearings last about an hour. In most cases, the judge will not issue a decision that day. Instead, you can expect a written decision from the judge by mail in about eight to ten weeks.

Can I work while I’m trying to get benefits?

You can work while you’re pursuing Social Security benefits, but you cannot earn more than approximately $1,000 per month before taxes and still qualify for benefits. Social Security reevaluates what they call Substantial Gainful Activity (SGA) every year, so the precise amount you can earn changes, but $1,000 is a good rule of thumb. If you earn above SGA for even one month while you are pursuing or receiving benefits, it can have a negative impact on your claim.

If you cannot work because of an injury or medical condition, you may be entitled to Social Security benefits. Jack Goodrich and Associates is a nationally recognized personal injury law firm. We offer a no-cost personal consultation concerning your case and can guide you through the process. Call 412-261-GOOD (412-261-4663).

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