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SOCIAL SECURITY What is Social Security Disability? This is actually several different programs. The two main ones are SSI and SSDI. SSI is generally for people who are both disabled and have limited resources. It is especially for disabled people who have not worked enough in the last 10 years to qualify for SSDI. SSDI (Social Security disability insurance) applies to people who have worked at least 20 quarters in a ten-year period. When it has been over five years from the last date worked to the onset date of the disability the claimant generally can only apply for SSI. What benefits can I get under Social Security disability? With SSDI, you can get a monthly check based on the amount you earned when you were working. You can also receive Medicare, and a check for dependant children. With SSI you can get a minimum monthly check which may be reduced based on other resources. If you qualify for SSI you will also receive a Medicaid card through the KY Medical Assistance Program. How do I know which program to apply for? The people at your local Social Security office will help you to apply for the right programs. Frequently people apply for both programs and some people receive benefits from both programs. The SSI benefits may be reduced when you also receive SSDI. However, as long as he receive 1 dollar of SSI you will also get a medical card. The medical card is valuable because it covers prescription medicine. How does Social Security determine if I am disabled? Social Security defines disability as the inability to engage in substantial gainful activity. (S. G. A.) Social Security considers the nature of a person's disability, how it affects their ability to engage in basic work activities, the requirements of a person's past relevant employment, as well as vocational factors. Vocational factors include age, education, and job skills. Social Security Administration has listings of impairments which are severe enough to be considered disabling without consideration of vocational factors. These listings only cover the very most severe forms of disability. In other cases the claimant must show that he is unable to engage in his past relevant work activity and Social Security must be unable to show that there is other work the claimant can do. The other work must actually exist in the form of a significant number of jobs in the National or local economy. Additionally, being able to engage in substantial gainful activity means being able to do so on a sustained full-time basis. The ability to do an activity for a few hours a week or only occasionally is not enough to keep the person from being disabled. How do I apply for disability? Applying is easy. All you have to do is call or visit your local Social Security district office. They will take your application and process it. The questions are straightforward and Social Security employees will assist you in answering them. You'll have to sign the appropriate forms allowing Social Security to obtain information about you. You may be required to attend one or more examinations by Social Security doctors. You may need to supply medical records. You'll have to tell Social Security all about your disability, past employment, education, and other relevant information. If you are applying for SSI you will also have to tell Social Security about your financial situation. This is because they have to determine your resources for eligibility purposes. Do I have to have a lawyer? You do not need a lawyer to put in your initial application. In fact, a lawyer cannot charge for assisting you with this initial application process. However, if you are turned down you should see a lawyer right away. You have important appeal rights and a lawyer can be very valuable in processing the appeal. If I'm turned down, is it worthwhile to appeal? Definitely, yes. Many cases are turned down simply because the file has not been fully developed or the best legal argument has not been made. Additionally, the claimant has not had an opportunity to appear before the decision maker and give testimony on his own behalf. This does not occur until the hearing phase, actually the third step in the process. How can a lawyer help with the appeal? A lawyer will sit down with the client and go over his entire medical, educational, and work history. He will also talk to the client in detail not only about the disability complained of, but any other potential disabling medical condition. Once he has this information, a lawyer can supplement the record with additional medical information, make referrals, and assist the client in developing the file more completely. The lawyer will help the client to fill out the proper paperwork for the appeal, and also get the client to appoint him as Representative. There after for everything that happens in the case he should receive a copy. This why he can also assist in keeping up with deadlines. He may also copy the file from the Social Security office. He may have the client get medical assessments filled out by treating doctors. This is important because in many cases Social Security has to give more weight to treating doctors opinions. The lawyer will write letters to Social Security explaining the legal reasons why the client should be found disabled. This will assist Social Security Administration in understanding the claimant's case. The lawyer will attend the hearing with the claimant. He can ask questions of the claimant and other witnesses. He can make arguments based on law to the administrative law judge. If there are unresolved issues, he can ask to supplement the record. If the hearing results are unfavorable, the lawyer may be able to pursue further steps in the appeal process. How much can a lawyer charge? It's against the law to charge a client more than the fee approved by Social Security Administration. We typically charge 25 percent of past due benefits with a cap of $4000, plus expenses. Social Security Administration does not have to approve expenses and considers these a matter between lawyer and client. We never charge for initial phone calls, or initial visits to determine whether the client has a potential disability case. How long does it take? Usually, the initial application is processed in two or three months. Reconsideration takes about the same amount of time unless additional medical exams are required or there is delay in obtaining records. These things can drag this out. The hearing phase takes longer, and also typically requires Social Security Administration to gather more information. This phase takes anywhere from several months up to a year. It can take longer if the claimant has surgery during this time. However, all of these times are approximate and vary from case the case. What if I am working? Disqualifying work would be any work earning over $700 per month. Other work, a part-time basis, may be considered evidence of an individual's ability to engage in substantial gainful activity. In other words, if a person is working as a cashier 20 hours per week, it will be necessary to show that that person could not engage in such activity full-time. This may be very difficult depending on circumstances. THIS ARTICLE IS INTENDED TO DISCUSS GENERAL LEGAL PRINCIPLES. IT IS NOT INTENDED TO BE A SUBSTITUTE FOR SPECIFIC LEGAL ADVISE FROM AN EXPERIENCED ATTORNEY AS TO YOUR PARTICULAR SITUATION AND NEEDS.
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