Frequently Asked Questions from Individuals

There are three types of Social Security Disability (SSD) benefits:

• Disability Insurance Benefits are paid to individuals who have worked in recent years and are now disabled.
• Disabled Widows and Widowers Benefits are paid to spouses who are at least 50 and are disabled within seven years of the wage earner's death or termination of surviving parents benefits. The deceased spouse must have worked enough to be Social Security insured.
• Disabled Adult Child Benefits are paid to children of persons who are deceased or receiving Social Security disability or retirement benefits. The child must be 18 or older and disabled before age 22.

Other disability income payments available through Social Security include:

• Supplemental Security Income (SSI) - paid to individuals who are disabled and who have financial need. Past employment is not required for SSI.
• SSI for children - paid to children under the age of 18 who are disabled and have financial need.

If you have a medical condition (physical or mental) that interferes with your ability to work full time, you should apply for SSD. Your impairment must be expected to last 12 months or result in death.

Your SSDC representative will:

• Explain the disability claim process
• Appeal your claim at each level
• Assist you with all government forms
• Work with doctors to obtain medical evidence
• Conduct legal and medical research
• Represent you at hearings
• Serve your best interest at every step of the process

If your claim has been denied, an appeal or new claim can be filed. If you’ve been denied within the last 60 days, an immediate appeal should be filed.

Many of our awarded clients were denied in the past. If you are unable to work because of a medical condition (physical or mental), your claim should be evaluated by an experienced advocate who can determine if you are eligible for benefits.

• Application (4-6 months)
• Reconsideration (2-4 months)*
• Hearing with Administrative Law Judge (12 to 18 months)
• Appeals Council (1-2 years)
• Federal Court (2-3 years)

If your claim is denied at any of the above levels, you have 60 days in which to appeal to the next step. Processing time varies from state to state, and the above estimates are based on the current Social Security Administration backlog. Rarely will processing times be less than stated above, and in some cases they may be longer.

* The Reconsideration step has been eliminated in the following 10 states: Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New Hampshire, Pennsylvania, parts of California and parts of New York. Social Security has eliminated the Reconsideration step in an effort to make the decision process better. In these states, if your claim is denied at Application, you would skip the Reconsideration step and go directly to the Hearing level. The application denial notice tells you what the next appeal step will be.

Every paycheck you earn has FICA taxes deducted. Those taxes pay the premiums for Social Security Disability benefits. You are insured for these benefits while you are working, and for about five years after you stop working.

Social Security will gather your medical records and will consider all of your health problems, as well as your age, education, and work experience. In general, Social Security decides whether you are able to do your past work or any other work.

Social Security will consider the effect your medical problems have on your ability to perform basic work activity. This includes an evaluation of your ability to sit, stand, walk, lift, and think at a job, 8 hours a day, five days a week, on a sustained basis.

No. If you expect to be off work at least one year due to a disability, you may be entitled to benefits.

Be sure to give Social Security information about all of your medical problems, including those that you do not consider to be disabling. You should tell them about physical problems as well as any other problems you may have, such as:

• Depression,
• Anxiety,
• Chronic pain,
• Severe fatigue,
• Memory loss, or
• Difficulty concentrating

If your claim is denied, it is important to appeal. Most claims are denied at the initial level, but are approved at higher levels of review. An experienced advocate understands the way Social Security works. Statistically, claimants who have an advocate to represent them on their appeal are much more likely to win than those who are unrepresented.

This can be a very important part of your Social Security disability claim. If you go to one of Social Security's doctors unprepared, the resulting report may be used against you to deny your claim. Ask Social Security's disability claim processor to explain the reason for the exam. You may be able to avoid the need for an exam if your doctor provides thorough information about your medical condition. Talk to your doctor about all of your medical problems so that this information is in your medical records. This is a key area where an advocate can make a difference in your claim.

It is possible to collect both Social Security Disability benefits and Workers' Compensation benefits. However, in some cases, your Social Security Disability benefits may be reduced because you are receiving Workers' Compensation benefits.

Yes. If you are under full retirement age and are unable to work full-time or unable to perform the work you are trained to do, you may be eligible. Collecting other retirement benefits is not a factor for receiving Social Security Disability benefits. Being unable to work because of health problems is the test. Many early retirees who develop medical problems become eligible for Social Security Disability benefits.

Your Social Security Disability benefit is based upon how much money you earned and paid into the Social Security system. When you apply for Social Security Disability benefits, the Social Security Administration will provide you with an estimate of your monthly benefit. The current national average is $876.30 per month.

When you become entitled to Social Security Disability benefits, your dependents become entitled to monthly benefits. Your dependents are not eligible for health insurance through Social Security unless they qualify for disability benefits of their own.

Dependents are:

• spouses with children in their care under age 16,
• children under age 18 (under age 19 if in high school), or
• children over 18 with disabilities

Yes. Twenty four months after you become entitled to Social Security Disability benefits, you will be automatically enrolled in Medicare Parts A and B. Medicare Part A covers inpatient hospital services and is provided to you for free. Medicare Part B, which covers doctor's office visits and outpatient tests and services, costs approximately $115.40 per month and is deducted from your Social Security check. Medicare Part B is optional and you may decline this coverage. We encourage most people to keep Medicare Part B because:

• Even if you have other insurance through a former employer, whether traditional or HMO, that insurance company may require you to purchase the Medicare Part B.
• If you decide you want Medicare Part B at a later time, the government may penalize you an additional cost of 10% per year from the time you were offered the Part B, but did not take it. This penalty will continue thereafter.

Please note that, currently, Medicare does not cover prescriptions, dental or eye care services. You should contact your current insurance carrier and/or your (or your spouse's) employer to carefully assess your insurance coverage and how it coordinates with Medicare before you decide to decline Part B Medicare or reduce any other insurance you may have.

Social Security has special rules regarding work activity. In general, if you are working part time and making less than $1000 per month (before deductions), you may be eligible for Social Security Disability benefits if you cannot work full time due to a disability. The amount you can earn may be higher if you have out-of-pocket medical expenses that allow you to continue working. Social Security will evaluate your work activity and medical expenses when you file your claim.

There is no charge for your initial consultation. When we win your claim, you pay our fee out of your retroactive award of Social Security Disability benefits. All representative fees are regulated and approved by the Social Security Administration and are contingent upon winning your claim. If we don’t win your claim, we won’t charge a service fee.

At SSDC, we understand your financial situation. That’s why we work with you and your doctor to minimize out-of-pocket expenses for medical information needed to support your claim. Clients are responsible for expenses, which are usually under $100.

When it comes to disability, looks can be deceiving. There are many people who look healthy but who are quite disabled. For instance, individuals who suffer from severe psychiatric illness are physically healthy and able to do things such as mow their lawns.

You may be eligible for Social Security Disability benefits if you are age 50 or older and became disabled within seven years of:

• your spouse's death, or
• your last entitlement to surviving mother's or father's benefits

Any physical or mental impairment that prevents you from working full time can be the basis for an award of benefits. Your age, education, and past work experience also play a role in determining if you are eligible.

Social Security has a list of impairments and specific criteria used for evaluating each impairment. A relatively small number of people meet these criteria exactly. A larger number of people who are awarded Social Security Disability benefits do not exactly meet the criteria or have a medical problem that is not on Social Security’s list.

The bottom line is this: If medical problems (physical or mental) prevent you from working on a full time, sustained basis, you may qualify for Social Security Disability benefits. An experienced SSDC advocate can help you determine if you qualify.