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Many workers who apply for Social Security Disability Insurance (SSDI) will be denied. The SSA receives an overwhelming number of applications and must sometimes make hasty decisions. The applicant has the right to appeal the denial through a serious of processes designed to reverse the denial from the SSA if the applicant truly has a disability preventing them from working and can prove it. The SSA is very strict about their decision making process to prevent people from fraudulently receiving disability benefits that they truly do not need or deserve.
The initial step in the appeals process is called a reconsideration. The applicant will complete the reconsideration forms and then the SSA will send them to the State Disability Determination Services office where the applicant lives. This office will review the applicant’s medical records and other evidence and then make a decision or determination about their application. The applicant is allowed to submit additional information in addition to the documents from the first application. If the application is denied, the second step is called a hearing.
The applicant will complete a request for hearing by an administrative law judge and an appeal disability report. These forms will be sent to the Office of Disability Adjudication and Review. The office might request further information from the applicant to clarify their claim of disability. The applicant can also request a face to face meeting with a judge. If the claim is again denied, the next step is a review with an appeals council.
The Appeals Council Review will appoint someone in their office to review the applicant’s medical records and make a determination about benefits. It is the right of the Appeals Council to deny the request for a review if they believe that the previous hearing resulted in a proper and legal ruling.
The final step to the appeals process, if necessary, is filing a case against the SSA in federal district court. The applicant must be represented by an attorney for this action. A district court judge will hear the case and make a ruling about SSDI for the applicant.
Those who file any type of appeal must be meticulous with their recordkeeping and be able to provide medical documentation of their disability. They must also be patient, as the appeals process can be lengthy and frustrating.
SSDI can provide regular monthly payments to eligible recipients. This can be beneficial for those who must live on a fixed income as they will know how much money to expect every month for budgeting purposes. The SSA is also able to provide annual cost of living increases that may be tax free under some circumstances.
SSDI beneficiaries are eligible to receive Medicare Part A (hospital), Part B (medical benefits), and Part D (drug benefits) after 24 consecutive months of receiving SSDI. The age of the recipient is not a consideration. Paying for private healthcare coverage can be nearly impossible for disabled workers, so this is a much needed benefit. Beneficiaries should also look into other types of aid to help pay for housing, food, and education. For those who want to work in some capacity while still receiving benefits, the SSA provides job opportunities and training programs. In addition, money earned while on disability will not adversely affect the person’s retirement benefits.
Dependents of a disabled worker such as a spouse or minor child may be eligible for benefits as well since their head of household is unable to provide a living wage for the family. In special cases, this benefit can possibly be extended to stepchildren or grandchildren.
Workers applying for SSDI should understand the concept of “substantial gainful activity.” If the SSA determines that a worker can indeed support himself despite his disability, he will likely be denied benefits. Substantial gainful activity is work that involves productive and significant duties that pay more than the SSA’s predetermined monthly income limit, which is $1000 as of 2011 and usually increases slightly every year.
Types of income that can be applied to substantial gainful activity include wages from a company, earnings from self-employment, or income from things that are in kind such as room and board. Only net income is counted. Income from bonuses or reimbursements is usually not included in the total.
Countable income is the figure used by the SSA to determine whether the applicant meets the eligibility requirements for SSDI. Countable income includes: pensions, annuities, child support, alimony, and regular cash gifts. Countable income does not include the earned income tax credit, fringe benefits paid by an employer, foster care payments, or one time insurance payments.
The Social Security Administration (SSA) has two insurance programs in place to help workers in financial distress: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). These two programs are very different. SSDI is for workers who have become disabled and can no longer make their previous income. In some cases, workers who receive SSDI are able to retrain for other work. To qualify for SSDI, workers must have a minimum work history based upon their age and must have paid into the Social Security system. There are no income minimums to apply for SSDI. SSI is for elderly, blind or disabled workers who have no other source of income.
To receive SSDI, workers must show that they have a medical disability or impairment that makes it impossible for them to perform work duties. The SSA has a vast list of impairments that is regularly expanded. Examples of impairments include: gland disorders (endocrine); inflammatory bowel disease (digestive); chronic anemia (hematological); mental retardation (mental); and some types of fatal cancers. If the applicant’s medical impairment is not on the SSA’s official list, it does not necessarily mean that the applicant will be denied SSDI, but it might be more difficult to be approved.
The SSA is aware that unscrupulous individuals might try to cheat the system and therefore must be very particular about who is approved for SSDI. Applicants have many opportunities to appeal a denial. The first step is the reconsideration level, where the applicant may submit new supporting material and have their case reviewed again.
The next step is a hearing before an Administrative Law Judge. This is a chance for the applicant to personally appeal their case and give examples and provide medical evidence of their disability. This judge will issue a written decision. If SSDI is still denied, the applicant can appeal to the Appeals Council, and then the Federal Court as a last resort.
Applicants who need help appealing a denial of benefits should contact an attorney who specializes in disability law.
When a work injury occurs, the most common form of help is through worker’s compensation insurance. This type of payment usually provides money and benefits to a worker who has been injured through no fault of their own while on the job. Other types of financial help can include Social Security disability insurance if the worker is unable to continue in their job. If an employer does not have worker’s compensation insurance, the worker is responsible for making sure their rights are covered and may need to investigate legal steps if they are injured.
Many workers are unaware that they may have the right to sue their employer or other defendants for compensation in addition to worker’s comp if certain conditions apply that fall under personal injury laws. These can include the following situations:
1. The worker is injured by a defective product – this may entitle the worker to sue the manufacturer under a product liability action; examples of a defective product include defective equipment that is inherently dangerous or failed to work properly
2. The worker is harmed by a toxic substance that causes acute injuries (quickly apparent health problems) or latent injuries (health problems that may take many years to appear); examples of toxic substances include asbestos, radium, and benzene
3. The worker is harmed by inappropriate conduct by the employer, such as an act of violence or if the worker is put in harmful situations on purpose
4. The worker is harmed by a third party – in this case, the worker may be able to sue the responsible party directly.
It is important for workers to investigate how much help they can receive for pain and suffering and mounting medical bills if they are injured at work. In addition to personal lawsuits, workers should consider taking action with the Department of Labor’s Occupational Health and Safety Administration (OSHA) to prevent their employer from continuing unsafe practices and harming any more people. In most cases, the worker should contact an attorney immediately if they are harmed at their place of employment.
The Social Security Administration (SSA) provides more than just retirement benefits. The SSA offers two types of disability insurance to those who cannot work. They are Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). SSDI is a monthly insurance payment made to those who can no longer work due to a disability. To qualify for SSDI, the worker must have a job history that includes payments into the SSA system for a specific period of time, depending upon their age.
Workers must prove that they have a disability that prevents them from working and earning a wage. SSA defines a disability as an impairment that limits or prohibits the individual’s ability to work at their former level. Impairments are usually medical in nature, either physically or mentally, and must be supported by medical records or other evidence. The SSA has an actual Listing of Impairments that thoroughly documents accepted disabilities; the list is updated frequently. Examples of impairments include: chronic heart failure (cardiovascular); asthma or cystic fibrosis (respiratory); epilepsy (neurological); and schizophrenia (mental). An applicant for disability insurance does not necessarily have to have one of the official impairments to qualify for SSDI but it might make it easier to qualify.
The process can take several months for an application to be approved or denied. If an application is denied, the applicant can appeal the decision. The appeals process begins at the initial level through the Disability Determination Services (DDS). The next level is called Reconsideration, when the applicant can request a hearing. The next level is a hearing before an Administrative Law Judge where the judge will issue a written decision. If the application is still denied, the next two steps are the Appeals Council and then finally Federal Court.
Applying for SSDI or appealing a denial can be very complicated, and it is helpful to have the help of an attorney who specializes in disability law.
Non-citizens of the United States who are legal aliens may be eligible to receive SSDI benefits. They must have a valid Social Security number and they must have worked at jobs that allowed them to pay taxes into the Social Security system. They must also have a medical condition that is ruled a disability. The SSA website has a complete list of disabilities called the Listing of Impairments. If your condition is not listed, that does not automatically disqualify you from receiving SSDI, but it might make it more difficult.
Non-citizens who are over the age of 18 should apply for an immigrant visa with the U.S. Department of State and a social security number at the same time. Types of situations that will likely be approved for immigration status include: student, teacher, farmworker, businessperson, refugee, or a temporary resident of the United States. The U.S. has agreements with several countries to provide asylum to displaced citizens with ties to the United States. Immigrants who believe they are disabled and would qualify for SSDI should contact the SSA for help with their application. If the English language is a barrier, translaters are available from the SSA who speak a variety of different languages.
Applying for SSDI can be a lengthy process. Applicants must be very organized and prepared with all of their paperwork and documentation. The first step is to apply online at http://www.socialsecurity.gov/disability. The applicant can also apply over the phone or make an appointment at a local Social Security office to apply in person. No matter how you apply, this is the application date. Requests for SSDI generally take 90 days after the application date to be processed and approved or denied. If the claim is denied, the applicant should investigate how to appeal a denial.
Once approved, SSDI benefits will continue as long as you are disabled and meet all of the other eligibility requirements. The SSA has the right to review your case at any time to make sure you are not committing any type of benefits fraud. The timing of your review depends upon your disability. In general, if you medical condition is “expected” to improve, a review will take place within 6 months of the initial SSDI payment. If you medical condition will “possibly” improve, a review will happen within 3 years. If your medical condition is “not expected” to improve, you can expect a review within 7 years.
You may be considered disabled by the Social Security Administration (SSA) if you meet the following criteria:
1. You cannot do the work you did previously because of your disability
2. You cannot reasonably sit at a desk or perform any type of manual labor
3. You cannot adjust to other work because of your medical condition or disability
4. Your disability is expected to last at least one year or may result in death.
The SSA has an official Listing of Impairments that is updated frequently. Your disability does not necessarily have to be on the published list, but it will help your case. Here is an overview of some of the major categories:
1. Musculoskeletal System – disorders of the spine, amputation, burns
2. Respiratory System – asthma, cystic fibrosis, pulmonary disease
3. Cardiovascular System – chronic heart failure, congenital heart disease, aneurysm of aorta, peripheral arterial disease
4. Neurological Disorders – epilepsy, brain tumors, Parkinson’s Disease, multiple sclerosis, muscular dystrophy, cerebral trauma
5. Mental Disorders – paranoid schizophrenia, personality disorders, substance addiction disorders.
To help prove their case, applicants should keep meticulous medical records and seek numerous medical opinions of professionals who will back up their claims. In addition to SSDI, disabled workers should seek help from the numerous non profit organizations that are geared specifically towards their disease or disability.
Nobody likes to think that they might need financial help from the government, but in reality, there are many different circumstances that may render you unable to work and earn a living. According to the Social Security Association (SSA), the average 20 year old worker has a 30% chance of becoming disabled at some point in their career before they reach retirement age. Of course people should plan for these disastrous events by having personal insurance, but this is an expensive option that is out of reach for most workers.
Luckily, the SSA provides several safety nets including SSDI benefits. Generally, only workers who have paid into the Social Security system through payroll taxes are eligible to apply. (Some different types of cases include minor children of disabled adults or adults who have been disabled since childhood and have not paid these taxes.) The SSA has guidelines to determine whether someone qualifies as disabled and cannot work for at least a year. Usually a disability is a medical condition such as a debilitating injury or chronic disease. If you are receiving SSDI and then reach retirement age, you will begin receiving regular retirement benefits in place of the SSDI in the same amount.
If you think you are disabled and could use SSDI benefits, do not delay and apply immediately since it can be a lengthy process that might involve rejection of claims and an appeals process.