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Frequently Asked Questions

1. Do I have to wait one year after becoming disabled to apply for disability insurance benefits?

You should apply for disability as soon as you become disabled.

If your application is approved, your first Social Security disability benefits will be paid for the sixth full month after the date your disability began, but not earlier than one year prior to the date you filed your initial application.

Source: www.ssa.gov (2012).

2. How do I apply for Social Security disability benefits?

You have a number of options when it comes to filing your initial application for Social Security disability benefits.

If you wish, we are available to guide you through the application process and help you file your initial application. Our extensive knowledge and experience with disability law and procedures will provide you with the tools you need to establish a strong case right from the start of the often lengthy claims process.

However, if you would like to file an application on your own, you can find an online application at www.ssa.gov or make an appointment to apply in person by calling the Social Security Administration directly at 1 (800) 772-1213, Monday through Friday, 7:00 a.m. to 7:00 p.m.

Do remember, though, that in accordance with the regulations regarding the collection of fees, your attorney will receive the same fee for advocating on your behalf, whether it is from day one or ten minutes before your hearing. So the earlier you retain representation, the greater the opportunity you have to benefit from the knowledge and experience an attorney can provide you.

3. Do I need to hire an attorney to handle my Social Security disability case?

Many people choose to handle their own cases. However, an attorney familiar with Social Security's laws and procedures can provide an invaluable service to you. Ultimately, the decision whether or not to seek the services of an attorney is an important choice left to each individual to decide.

4. What is the difference between Social Security Disability Insurance ("SSDI") benefits and Supplemental Security Income ("SSI") benefits?

Social Security Disability Insurance ("SSDI"):

  • This program is financed with Social Security taxes paid by workers, employers, and self-employed persons.
  • The worker will get Medicare coverage automatically after receiving disability benefits for two years.
  • To be eligible for a Social Security benefit, the worker must earn sufficient credits based on taxable work to be "insured" for Social Security purposes.
  • - Disability benefits are payable to: blind or disabled workers their children widow(er)s adults disabled since childhood
  • - The amount of the monthly disability benefit is based on the Social Security earnings record of the insured worker.

Supplemental Security Income ("SSI"):

  • This program is financed through general revenues from taxes, meaning benefits are not based on your prior work history.
  • In most states, beneficiaries will automatically be eligible for Medicaid.
  • SSI benefits are payable to: individuals age 65 or older adults who are disabled or blind children who are disabled or blind
  • Eligibility requirements:
    • have limited income and resources meet the living arrangement requirements a U.S. citizen or national, or in one of certain categories of aliens.
  • The monthly payment varies up to the maximum federal benefit rate, which may be supplemented by the state.

Source: www.ssa.gov (2012).

5. How does the Social Security Administration define disability?

In 2010, the Appeals Council processed over 106,000 requests for review, but still had over 106,000 requests for review to process at the beginning of 2011.

About 25 percent of the Appeals Council's actions require the signatures of two Administrative Appeals Judges. The Appeals Council anticipates receiving over 130,000 new requests for review this year and over 13,000 requests for 2012.

The exact timeframe is difficult to predict. To the extent possible, the Appeals Council tries to process cases in the order received. In fiscal year 2010, the average processing time for a request for review was about 11 and a half months from the date the request was filed until the Appeals Council released its final action. The Council was able to process about two-thirds of its actions in 365 days.

6. What process does the Social Security Administration use to determine whether I am disabled?

The Social Security Administration relies upon the five-step sequential evaluation process to make disability determinations. The sequential evaluation process is a series of five "steps," which are followed in a set order. If you are found to be "disabled" or "not disabled" at a particular step, the evaluation process stops there.

Although the following summary of the sequential evaluation process is intentionally brief, do not be lulled into a sense that this is a simple undertaking. Like almost any area of the law, within these five steps are many nuances which are best navigated with an expert along one’s side.

Step 1: Is the claimant engaging in substantial gainful activity? Here, your work activity, if any, is considered. If you are engaging in substantial gainful activity, the Social Security Administration will find that you are not disabled and end the inquiry here.

Step 2: Does the claimant have a severe impairment? At step two, it is necessary to determine whether the claimant has a severe impairment, though the term "severe" can be somewhat misleading. Generally speaking, a claimant’s impairment, or combination of impairments, is severe if it significantly impacts at least one basic work activity.

Step 3: Does the claimant have an impairment that meets or equals a listing? To be found disabled at this step, the claimant must have an impairment that meets or medically equals one of the listings in the Listing of Impairments. The Listing of Impairments is a set of medical criteria for disability, and is set forth in Appendix 1 of the Social Security disability regulations. If a claimant is found disabled at this step, the evaluation process ends, and there is no need to inquire into the claimant’s ability to do past or other work, which are steps four and five. If the claimant does not meet or medically equal a listing, then the evaluation process automatically moves on to the fourth step.

Step 4: Can the claimant perform past relevant work? At step four, if a claimant can perform past relevant work, he or she will be found not disabled. If the claimant cannot perform past relevant work, the inquiry moves on to the last step.

Step 5: Are there other, less demanding jobs the claimant can perform? If it is determined there is other work that a claimant can perform, the decision will be to deny benefits, unless the number of such jobs is not "significant." However, if there is no other work the claimant can perform, he or she will be awarded benefits.

7. Can noncitizens receive Social Security benefits?

In certain cases, yes. To qualify for benefits, all noncitizens first must meet the same eligibility requirements as United States citizens. Additionally, a noncitizen or alien worker assigned a Social Security number (SSN) on or after January 1, 2004 must meet additional eligibility requirements. If you are subject to this provision, neither you nor your dependents can qualify for benefits based on your earnings unless you meet one of the following:

  • You were assigned an SSN based on your authorization to work in the United States at any time on or after January 1, 2004, or
  • You were admitted to the United States at any time as a nonimmigrant visitor for business (B-1) or as an alien crewman (D-1 or D-2).

Once an alien worker has met eligibility criteria, there must be evidence of the lawful presence of the beneficiary. That means before we can pay out benefits for any given month, we must have evidence during that month the beneficiary was either:

  • A United States citizen;
  • A United States national; or
  • An alien lawfully present in the United States.

Source: www.ssa.gov (2012).

8. Do disabled children qualify for benefits?

There are two Social Security disability programs children can qualify for:

A. The Supplemental Security Income (SSI) program This program provides monthly payments to children from birth to age 18 based on disability or blindness if the child's:

a. Impairment or combination of impairments meet the definition of disability for children; and

b. Income and resources of the parents and the child are within the allowed limits.

B. The Social Security Disability Insurance (SSDI) program. This program provides monthly benefits to an adult child (a person age 18 or older) based on disability or blindness if the adult child's:

a. Impairment or combination of impairments meets the definition of disability for adults;

b. Disability began before age 22; and

c. Parent(s) worked long enough to be insured under Social Security and is receiving retirement or disability benefits or is deceased.

Under both programs, the child must not be doing any substantial work and must have a medical condition that has lasted or is expected to last for at least 12 months or to result in death.

Source: www.ssa.gov (2012).

9. Can an adult who has been disabled since childhood receive benefits on a parent’s earnings record?

Yes. An adult disabled before age 22 may be eligible for child’s benefits if a parent is deceased or receiving retirement or disability benefits. We consider this a child’s benefit because it is paid on a parent’s Social Security earnings record. We make the disability decision using the disability rules for adults. The adult child including an adopted child or, in some cases, a stepchild, grandchild, or stepgrandchild—must be unmarried, age 18 or older, and have a disability that started before age 22.

Source: www.ssa.gov (2012).

10. How does a disabled widow or widower become entitled to benefits?

Benefits may be payable to a widow or widower with a disability if the following conditions are met: The widow or widower is between ages 50 and 60; The widow or widower meets the definition of disability for adults; and The disability started before the worker's death or within seven years after death.

Note: If a widow or widower caring for the deceased individual’s children receives Social Security benefits, he or she is eligible if disability starts before those payments end or within seven years after they end.

Source: www.ssa.gov (2012).

11. Can I work while I am receiving disability benefits?

Special rules make it possible for people receiving Social Security disability benefits to work and still receive monthly payments.

A trial work period allows you to test your ability to work for at least nine months. During your trial work period, you will receive your full Social Security benefits regardless of how much you are earning as long as you report your work activity and you continue to have a disabling impairment. In 2011, a trial work month is any month in which your total earnings are over $720, or if you are self-employed, you earn more than $720 (after expenses) or work more than 80 hours in your own business. The trial work period continues until you have worked nine months within a 60-month period.

After your trial work period, you have 36 months during which you can work and still receive benefits for any month your earnings are not "substantial." In 2011, the Social Security Administration generally considers earnings over $1,000/month ($1,640/month if you are blind) to be substantial. No new application or disability decision is needed for you to receive a Social Security disability benefit during this period.

Source: www.ssa.gov (2012).

12. How do workers’ compensation or public disability benefit payments affect Social Security disability payments?

Both workers’ compensation and public disability benefit payments may reduce your and your family's Social Security benefits.

Workers’ compensation defined: A workers’ compensation benefit payment is made to a worker because of a job-related injury or illness. It may be paid by federal or state workers’ compensation agencies, employers, or insurance companies on behalf of employers. Public disability benefit defined:

Public disability benefit payments that may affect your Social Security benefit are those paid under a federal, state or local government law plan. Examples are civil service disability benefits, temporary state disability benefits, and state or local government retirement benefits based on disability.

Social Security disability benefit reduction: The Social Security disability benefits you and your family receive are reduced if the combined total amount, plus your workers’ compensation payment, plus any public disability benefit payment you receive exceeds 80 percent of your average pre-injury/illness earnings.

Source: www.ssa.gov (2012).

13. What are compassionate allowances?

The compassionate allowances initiative speeds up disability claims processing for applicants whose medical conditions are so severe their conditions obviously meet Social Security's standards. The Compassionate Allowances List of medical conditions permits Social Security to target the most obviously disabled individuals for approval based on objective medical information.

Source: www.ssa.gov (2012).

14. How long does the hearing process normally take?

The average amount of time needed to process a hearing request during fiscal year 2010 was 426 days. The Social Security Administration is continually working to reduce the time it takes us to process your request for hearing.

Source: www.ssa.gov (2012).

15. When will I receive my hearing decision?

If a hearing is necessary, the Social Security Administration strives to send you a decision within 30 days after the administrative law judge (ALJ) makes a decision. The amount of time varies from case-to-case depending on a number of factors, such as:

  • If additional information required after the hearing; 
  • If new evidence was received after your hearing but before you received a decision; or 
  • If the ALJ determined a supplemental hearing was necessary.

Source: www.ssa.gov (2012).

16. What are the levels of appeal if I disagree with the decision made on my claim?

There are four levels in the appeals process:

  • Level I – Reconsideration: A complete review of the claim by someone other than the person who made the original decision. We reevaluate all evidence, plus any additional evidence submitted and make a new decision. If you disagree with the reconsidered decision, you can choose to go to the next level of the appeals process. To request a reconsideration, use the Form SSA-561-U2 (Request for Reconsideration), or you can file your disability appeal online. 
  • Level II – Hearing: Conducted by an administrative law judge (ALJ). You and your attorney, if you have one, may come to the hearing and present your case in person. The ALJ will evaluate all the evidence on record, including any additional evidence brought to the hearing, and will make a decision. To request a hearing by an ALJ, use the Form SSA-501 (Request for Hearing by Administrative Law Judge), or you can file your disability appeal online. 
  • Level III – Appeals Council: The Appeals Council may issue its own decision, return the case to the ALJ to issue another decision, or accept the ALJ's decision. To request an appeal, use the Form HA-520-U5 (Request for Review of Decision/Order of Administrative Law Judge). You cannot file an appeal online. 
  • Level IV – Federal Court Review: If you disagree with the Appeals Council's decision, you have the right to file a civil suit in Federal District Court.

Source: www.ssa.gov (2012).

17. How long will it take to begin receiving benefits?

It generally takes approximately 60 days to begin payment of benefits once a claim is allowed.

Source: www.ssa.gov (2012).

18. How long does it take for the Appeals Council to process a Request for Review?

In 2010, the Appeals Council processed over 106,000 requests for review, but still had over 106,000 requests for review to process at the beginning of 2011.

About 25 percent of the Appeals Council's actions require the signatures of two Administrative Appeals Judges. The Appeals Council anticipates receiving over 130,000 new requests for review this year and over 13,000 requests for 2012.

The exact timeframe is difficult to predict. To the extent possible, the Appeals Council tries to process cases in the order received. In fiscal year 2010, the average processing time for a request for review was about 11 and a half months from the date the request was filed until the Appeals Council released its final action. The Council was able to process about two-thirds of its actions in 365 days.

Source: www.ssa.gov (2012).

Palacios Disability, P.A.
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