Social Security Disability
Social Security Disability refers to several related programs. The most familiar of which is Disability Insurance Benefits. It pays benefits to workers who have contributed to the Social Security system and have now become disabled.
Disabled Widows Benefits is for those widows and widowers who are disabled and whose spouses paid into the social security system prior to their death.
Disabled Adult Child Benefits go to the children of persons who are deceased or who are drawing Social Security disability or retirement benefits. The child must have become disabled before age 22.
To be eligible for each of the above benefits the following must be true: The person claiming benefits must meet the SSA’s definition of disabled and the person claiming benefits must be eligible due to payments to the social security system either their own payments, their deceased spouses, or their parent(s). Eligibility is not based on wealth or lack thereof.
Supplemental Security Income
Supplemental Security Income (SSI) is different from other disability benefits in that it is not dependent on having paid into the social security systems; it is dependent on assets and income. SSI benefits are available for both adults and children. The amount in benefits paid each month is based on the individual’s income or in the case of children, based on household income.
The Application Process
It is your right as an applicant for Social Security Disability benefits to have a representative. While most claimants do not consider retaining a lawyer until after the initial application has been denied, you may retain our services at any point in the process, including the initial application. Our fees must be approved by the SSA – we charge no fee unless we are successful in securing you benefits!
In order to be eligible for social security disability benefits you must meet the SSA’s definition of disabled. This being a severe physical or psychological impairment that prevents a person from working or interferes with work to an extent that you are unable to earn more than $1310 a month. The impairment must have lasted or be expected to last at least twelve months. The decision on whether to grant or deny benefits will be based on your medical records so it is important to have records of ongoing medical care that substantiates the impairment and indicate that it is a long-term condition.
You may apply for disability benefits at the time you become disabled. Applications for benefits may be made at your local SSA office or by completing the online application at http://www.ssa.gov/applyfordisability/.
You will be notified by mail whether your claim has been approved or denied. If approved, benefits can begin six months after the date the disability began. If denied, you have 60 days to appeal. Approximately 60% of all claims are initially denied.
The Appeals Process
The stated policy of the Social Security Administration is to ensure that everyone who is entitled to receive Social Security Disability (SSD) or Supplemental Security Income (SSI) does in fact receive it. They are required to carefully examine all the facts before they decide whether someone should receive SSD or SSI.
If they decide you should not receive benefits, or if you disagree with their decision because it is only partly favorable to you, you can appeal the decision. When you ask for an appeal, they will reexamine the entire decision, including those parts that were favorable to you. If their decision was wrong, they are required to change it. There are four levels of appeal. If you are not satisfied with the decision at one level, you may appeal to the next. The levels are (1) reconsideration, (2) hearing, (3) review by the Appeals Council, and (4) federal court review.
When we send you a letter about a decision on your claim, we will tell you how to appeal the decision.
When and How to Appeal
The most important thing to remember about appeals is the limited time you have to notify Social Security that you wish to appeal a decision. Generally, you have 60 days from the date you get the letter about the decision in your case to request an appeal.
Your appeal of an adverse decision must be in writing. You can get the appeal form from your local Social Security Administration Office or you can send them a signed note with your Social Security number and claim number stating you wish to appeal the decision in your case.
Your Right to Representation
Often, people file their appeals by themselves without assistance from anyone else other than the staff at the local Social Security office, other people get someone to help them or to “represent” them when they appeal a claim. We recommend that this representative be a lawyer who is familiar with the complex field of Social Security Disability Law.
Your attorney or other representative cannot charge or collect a fee from you without first getting written approval from Social Security. If we decide to take your case, we will not charge an attorney fee unless we are successful in obtaining an award of benefits. If you want more information about having one of our attorneys evaluate your case at no charge, please call us. There is no obligation on your part.
In a reconsideration, a person who did not take part in the first decision looks at your case to see if the decision is correct. If it is not correct, they are required to change it. It has been our experience that the Social Security Administration rarely changes their decision at this step of the process.
If you are appealing a decision about your medical condition, your reconsideration will be handled by a process they call case review. If you are appealing any other decision, you can choose either a case review or an informal conference. They are explained below.
Case review – In this kind of reconsideration, they look at your case without meeting with you. But you have the right to see what is in your file before they look at your case. You also can give them more information about your case.
Informal conference – Just like a case review, you can look at your file and give them more information. You may also attend the conference and tell the person who will be looking at your case why you disagree with their first decision. You can bring witnesses to talk about your case. You may also bring your representative, if you have one, to the conference. When the reconsideration is done, we will send you a letter explaining the decision.
If you disagree with the reconsideration decision, you may ask for a hearing before a person who has not seen your case before. That person is an Adjudication Officer or an Administrative Law Judge. The hearing is usually held within 75 miles of your home. The ALJ will notify you of the time and place of the hearing.
Before the hearing you may be asked to provide more evidence, clarification, or information about your claim. You should relay this information as soon as possible. You and your representative may come to the hearing and explain your case in person. You may look at the information in your file and give new information.
The ALJ will question you and any witnesses you bring to the hearing. You or your representative may also question the witnesses.
It is usually to your advantage to attend the hearing. If you do not wish to do so, you present your reason for not attending in writing. If you are unable to attend the hearing because of your health, you should advise them and they may be able to make other arrangements for the hearing.
When the ALJ makes his/her decision, they will send you a letter with a copy of the decision.
Review by the Appeals Counsel
If the decision is unfavorable, and you wish to pursue the appeal, you may ask for a review of the ALJ decision by Social Security’s Appeal Council.
The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your case, it will either decide your case itself or issue an order returning it to an ALJ for further review.
If the Appeals Council denies your request for review, they will send you a letter explaining the denial. If the Appeals Council decides your case itself, they will send you a copy of the decision. If the Appeals Council returns your case to an ALJ, they will send you a letter and a copy of the order.
Federal Court Review
If you disagree with the Appeals Council’s decision or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court.
For More Information
If you have any questions about the decision made on your claim or any other Social Security matter, please call us at 269-673-2105. We will be happy to help you.