Social Security Claims FAQs
SSD is another name for Social Security Disability, and is the type of disability benefits most “disabled” individuals seek. The Social Security Administration pays monthly benefits to disabled individuals who have paid into the Social Security system.
SSI is another name for Supplemental Security Income. It is very similar to SSD but the main difference is that you can only have a certain amount of income and assets in order to qualify for SSI. It can be applied for at the same time you apply for SSD benefits.
The questions and answers below outline some of your basic rights and responsibilities if you are seeking Social Security Disability (SSD) or Supplementary Security Income (SSI) benefits under the Social Security System.
Remember that each individual claim is different, and this information should not be considered as a complete explanation.
Q. What is SSD?
A. SSD is another name for Social Security Disability, and is the type of disability benefits most “disabled” individuals seek. These benefits are paid out of the Social Security Administration.
Q. Where does the money come from?
A. SSD benefits are paid out of the funds you pay into Social Security during the years that you work.
Q. How do I qualify for SSD?
A. The first requirement is that you must have paid into the Social Security Administration for a long enough period and in large enough amounts to be considered “Insured.” Next, you must not be “gainfully” employed. You must next be under a “disability” which has lasted or is expected to last 12 months. You must have a “disability” that is severe enough to keep you from doing your past Job, or any other jobs in the local or national economy. All of the words in quotations are legal terms that need to be explained by an attorney familiar with Social Security Regulations.
Q. How long do I have to apply?
A. There is no set time limit in which to apply for benefits. However, the longer you wait, the more benefits you may lose. Also, since your insured status usually ends five years from the last date that you worked, if you wait longer than five years to apply for benefits, it may become extremely difficult or impossible to obtain benefits.
Q. When should I apply?
A. As soon as a doctor tells you that you will be unable to work for 12 months or more, or if you have already been unable to work for at least 12 months due to a medical disability.
Q. What is a “disability”?
A. This is a legal term used by the Social Security Administration. A disability could be any medically documented condition that keeps you from holding a full-time job for at least 12 months.
Q. Can I still be working and apply?
A. Yes. As long as your wages do not exceed those set by the Social Security Administration. Most people can still work and make up to $500.00 per month and still be eligible for SSD benefits.
Q. How long will I remain insured?
A. Normally, you keep your insured status for about five years from the date you last worked.
Q. How do I apply for SSD?
A. The road to benefits is a long one. You must first contact your local social security office and make an application for benefits. Information will be taken and you will be informed of a decision by mail in approximately 30-90 days.
Q. What do I do if I am denied?
A. Almost everyone that applies for SSD benefits is denied at this first stage. You should contact an attorney to make a “Request for Reconsideration” within 60 days from the date of your denial letter.
Q. What if the 60 days pass?
A. If you do not appeal within the 60-day period, you will have to most likely start all over, and could lose benefits.
Q. Do I need an attorney yet?
A. Yes. An experienced attorney will assure that your rights are protected.
Q. What if I am denied again?
A. About 75% of those who apply are denied again. Your attorney will inform you of further action to be taken.
Q. What is the biggest mistake people make?
A. Failing to appeal within the time period. More than two thirds of the people who are denied at the first step fail to ask for reconsideration. Also, failing to keep in contact with your treating doctor and following his instructions can be damaging to your case.
Q. Do I have to go to court?
A. Yes. Once you are denied at the Reconsideration stage and you contact an attorney, your case will be appealed to an Administrative Law Judge and set for hearing. At this hearing, you will have to be present and testify regarding your medical problems. However, the trial process is very informal. It is only you, the Judge, a court reporter, your attorney and maybe a vocational specialist in the room. There is no jury, and the hearing is not open to the public.
Q. How long will it take to get my benefits?
A. From the time you first apply for benefits until you have your hearing will normally be about 1 year. It will then be another 2 to 4 months before the Judge decides if you will be granted benefits. It will then be another 60 days before you actually receive any money.
Q. How much can I draw if I win?
A. This question can only be answered once an attorney has seen your social security records. The amount is different for every individual depending on how much you have paid into the system.
Q. How often will I be paid?
A. Your first check will pay your past due benefits in one lump sum. You will receive a monthly check after that.
Q. Are my spouse and my children covered?
A. Usually your children and your spouse will also be entitled to receive monthly checks while you are disabled. This is in addition to the money you receive each month.
Q. How far back will I be paid?
A. If you are granted benefits, you can be paid past due benefits which go back a maximum of one year from the date you apply for benefits. Your payments would start 5 months after your disability began.
Q. How long will I draw SSD?
A. You will continue to draw disability benefits as long as you remain disabled.
Q. Will my case be reviewed?
A. Yes. Most SSD cases are reviewed every 3 years to determine if you are still disabled.
Q. Will I need an attorney for this review?
A. Normally, you will not require the assistance of an attorney when your case is reviewed, as long as you continue to follow-up with a doctor every so often.
Q. Will this affect my old age social security?
A. No. You will still be entitled to receive your old age Social Security Benefits. They may even be more.
Q. Does my disability have to be caused by an accident?
A. No. Your disability can be caused either by an accident, a birth defect, or a hereditary disease process such as Multiple Sclerosis, Cerebral Palsy, ALS, AIDs, or a number of other physical or mental conditions.
Q. Does alcoholism or drug addiction qualify?
A. No. In fact, if drug or alcohol addiction is considered a material contributing factor to your disability, you may be denied disability benefits.
Q. Can I draw both SSD and workers’ compensation?
A. Absolutely. You can draw SSD, SSI and Workers’ Compensation. Your SSD and/or SSI benefits will not affect your workers’ compensation benefits. The amount you receive from SSD or SSI may be reduced if you are receiving, have received or may be receiving workers’ compensation benefits. You should discuss this with an attorney who is experienced with Social Security.
Q. Can my disabled child qualify for SSD benefits?
A. Your disabled child can only qualify for SSD benefits once they reach the age of 18. This is a very complex issue and needs to be discussed with an attorney. However, see the discussion on SSI benefits
Q. Will I be entitled to Medicare or Medicaid?
A. Yes. If you are found disabled and awarded benefits, you will become eligible for Medicare and Medicaid approximately 24 months from the date your disability began. This is another reason to apply as soon as you think you are disabled.
Q. Where can I obtain additional information about Social Security Disability benefits?
If you wish to apply for Social Security Disability or need more information, call Rowland & Yauger at 910-722-9717 (toll free), or e-mail us. Let us use our knowledge, experience and resources to smooth your way through the maze of government regulations. There is no charge for the personal consultation.
Q. What is SSI?
A. SSI is another name for Supplemental Security Income. It can be applied for at the same time you apply for SSD benefits.
Q. How do I qualify for SSI?
A. There are several requirements for SSI, most of which are the same requirements for SSD. The main difference is that you can only have a certain amount of income and assets in order to qualify for SSI.
Q. How do I apply for SSI?
A. You apply for SSI in the same manner and usually at the same time that you apply for SSD benefits.
Q. Does it take as long as SSD?
A. Yes. The process is exactly the same.
Q. Will I still need to appeal the first denial?
A. Yes. If you applied for both SSD and SSI benefits, then you will need to make a “Request for Reconsideration” for both claims. The same holds true if you just applied for SSI.
Q. When will I need an attorney?
A. As soon as you receive your first letter of denial.
Q. Will I have to go to court?
A. Yes. Just like with SSD cases, you will have a hearing before an Administrative Law Judge. This is held in the same way as a SSD case.
Q. How long does it take to receive benefits?
A. Again, it is the same as SSD cases. They both take about 1 year from start to finish.
Q. How much will I receive?
A. Again, this is different in each case. However, it is normally less than what you would receive under SSD benefits.
Q. Why would I want SSI benefits?
A. If you have not paid enough money into Social Security for a long enough period to be considered “insured”, then SSI is the only route you can take to obtain benefits.
Q. Can I draw both SSI and SSD?
A. Yes. You can draw both, but only if the combined amount, along with other income and/or assets is less than the amounts set by the Social Security Administration as the maximum amount allowed. Also, you would draw SSI benefits during the 5-month waiting period required before you can draw SSD benefits.
Q. Can my disabled child draw SSI?
A. Yes. A child under the age of 18 can draw SSI benefits, but the same income and asset limitations apply. The income of the whole family and all assets will be taken into consideration.
Q. How far back will I be paid?
A. With SSI benefits, you are only paid back to the date of your application for benefits. However, there is no 5-month waiting period as there is for SSD, so your benefits will begin from the date you applied.
Q. Why do I need an attorney for either SSD or SSI benefits?
A. You are not required to have an attorney to represent you in your quest for SSD or SSI benefits. However, without a lawyer, you will have to deal on your own directly with the Administrative Law Judge, the Vocational Specialist and the Social Security Administration. The best way to be sure that you receive a full and fair hearing and all the benefits to which you are entitled, is to have the help of an attorney who understands Social Security Regulations and Law, and is interested in YOUR RIGHTS.
Q. How much does an attorney charge?
A. You pay a legal fee ONLY if you are awarded benefits. Under the Law set forth by Federal Statute, an attorney receives a 25% attorney fee on your past due benefits, and only once his Fee Agreement or Fee Petition is approved by the Social Security Administration. We further limit our fee to 25% of past due benefits or $5,300.00 whichever is LESS. If you do not receive past due benefits, then we do not receive a fee.
Q. Who pays the attorney?
A. If you are awarded SSD benefits, then the 25% of past due benefits, or $5,300.00, whichever is less, is automatically withheld by the Social Security Administration and paid to the attorney once the fee is approved. If you are awarded SSI benefits, then the 25% of past due benefits, or $5,300.00, whichever is less is paid directly by you to your attorney once the fee is approved.
Q. Are there any other charges for preparing my case?
A. Naturally there are times when your attorney will have to obtain medical records relating to your disability. In rare cases, your attorney may have to obtain a written report from a doctor outlining the nature and severity of your disabling condition. It is necessary to pay the doctors for this information. In addition, occasionally an attorney will incur other expenses in preparing your case.
Q. How are these charges paid?
A. Under the law, the client is responsible for the payment of these expenses. However, your attorney is to pay your costs at the beginning of your claim and then request payment from you.
Q. Where can I obtain additional information about Supplemental Security Income benefits?
A. If you wish to apply for Supplemental Security Income benefits or need more information, call Rowland & Yauger at 910-722-9717 (toll free), or e-mail us. Let us use our knowledge, experience and resources to smooth your way through the maze of government regulations. There is no charge for the personal consultation.