Social Security Disability Benefits

Unfortunately, the Social Security Administration tends to deny applications for disability benefits because they are always on the lookout for fraud. There are several things that applicants should know when they are applying for disability.

1. Applicants should have a healthy skepticism for the “system” and should know that they will likely face an uphill battle to appeal a denial; this is unfortunate but the SSA must protect themselves against those who abuse the system; also, applicants and their advocates (usually a lawyer) need to check and double check that everything is filed properly – don’t count on the SSA contacting to remind you of all the deadline dates and requirements

2. Examiners do not have an emotional investment in your claim; to make yours stand out, you must include detailed medical records that illustrate your physical limitations, prognosis, and especially your limitations due to the disability

3. You will probably need much more than just one doctor’s opinion that you have a disability; be prepared to submit to additional exams and provide more supporting documents than one doctor’s notes

4. Time is crucial and you can apply for disability as soon as you become disabled; there will be waiting periods but it is possible to eventually receive back pay; do not procrastinate!

5. You should definitely find a disability lawyer; many are willing to work out payment plans to make their services affordable.

When applying for Social Security Disability Income, work history is an important factor in determining your eligibility for benefits.

The Social Security Administration approves and denies claims based on whether or not a claimant is able to work. Social Security Disability is awarded to persons with an ongoing medical condition that hinders job performance. When making disability decisions, examiners look at medical records and what that information says about one’s ability to work. Examiners review the records to help determine what can and can’t be performed because of the impairment (residual functional capacity). Social Security examiners will analyze if a claimant can return to their past work, which could be any job they have performed within the last 15 years and whether or not a claimant can perform some type of other employment for which they are suited based on age, education, skills, and mental or physical limitations. They then examine vocational guidelines to determine if the person can earn a living wage. If a claimant is found by a disability examiner to be capable of working, the claim will be denied.

For example, a person has filed for disability who has worked for 15 years in a very physical job where he is living heavy items all day during the workweek. A physical disability limits him to only light work. His condition is expected to last at least 12 months or longer. Social Security examiners will deem this claimant as unable to return to past work. Remember that receiving Social Security benefits does not mean a person can’t work. In actuality, it means that a disabled person can’t have the ability to work and earn more than a certain threshold of income.

Claimants can improve their chances of receiving benefits by having a solid work history they can report to the examiner. It also helps to provide contact information for former supervisors and to detail all the duties one has performed previously on the job. Former supervisors should discuss all the demands placed from the job as well as skill sets one has acquired.

What happens if you have applied for Social Security income because of your disability and you were denied by the Social Security Administration? What you may not be aware of is that the letter you received in the mail is not the final word. You can move through the appeals process and there is a possibility you will be approved.

You have 60 days to file an appeal after you receive your letter which is called the initial denial. Reconsideration is the next level of appeal. You can pick up forms at your local Social Security office, request them by mail or check online. The Reconsideration request is reviewed by a different set of employees and not the ones who first reviewed your request.

Many people give up after they are denied a second time. However, you have 60 days to request a hearing before an Administrative Law Judge. The judge will hear from the claimant and any witnesses. The judge does not work for the Social Security Administration and decides based on the evidence presented.

If the judge denies the claim, you can appeal to the Appeals Council. A claimant can appear before the council if the council agrees to review the case. If the council will not review the case or if the case is denied, you can file in the U.S. District Court. If the court sides with the claimant, the case is sent back to the Administrative Law Judge.

The appeals process can take more than a year and involves several complicated steps. If you don’t meet the deadlines your claim can be denied and you will have to file your claim again. Many people hire an advocate or attorney to help them with their appeal.

One of the biggest questions that SSDI applicants have is “How much will I be paid in disability benefits?” The answer is specific to each applicant, but in general, SSDI will pay monthly benefits, backpay, and Medicare (provided there is not a waiting list for this healthcare service). The monthly benefit amount is calculated using a complicated matrix based upon the length of time that the applicant has paid into the Social Security system, called “covered earnings.” (It is not simply a percentage of current income or any other simple calculation, and there is a benefit limitation.) The average covered earnings over a period of years is called the average indexed monthly earnings (AIME). In general, benefits can range from $300 to $2200 per month.

Benefit payments can also be affected by other types of public disability payments. Payments from worker’s compensation or temporary state disability payments can lower the amount of SSDI received. However, SSI or VA benefits will not affect SSDI payments.

Most SSDI recipients will also receive a lump sum payment of past due benefits to cover the time between the initial application and the approval. Some applicants may also receive additional backpay from the time they actually became disabled (as much as 12 months prior to the application). These payments can be significant and amount to thousands of dollars.

Finally, Medicare is awarded to recipients two years after the time they are deemed eligible for SSDI. This is not the date of application, but rather the date of entitlement, which is the disability onset date plus 5 months.

Mental disorders are a major category for Social Security Disability Impairments. This can be a somewhat difficult category to navigate, since mental disorders can be somewhat subjective compared to other ailments such as cancer or ALS. Organic mental disorders refers to psychological or behavioral abnormalities that are caused by a dysfunction of the brain. Even with treatment, these disorders make it impossible for the subject to adhere to a regular work life, therefore necessitating the need for disability insurance.

To prove a mental disorder, applicants must meet two requirements:

1. The demonstration of the loss of specific cognitive abilities with the presence of at least one of the following:
a. Disorientation to time or place
b. Short term or long term memory loss or impairment
c. Thinking disturbances such as hallucinations or delusions
d. Noticeable change in personality
e. Emotional liability (such as temper or anger) or impairment of impulse control

2. As a result of #1, restriction in one of these aspects:
a. Activities of daily living
b. Maintenance of social functioning
c. Maintenance of concentration.

Examples of an organic mental disorder include:

• Schizophrenia
• Affective disorders (depression)
• Mental retardation
• Anxiety related disorders (severe OCD, post traumatic stress disorder)
• Somatoform disorders (speech, vision or hearing disorders)
• Personality disorders (bi-polarism)
• Substance abuse disorders
• Autism and developmental disorders.

Many people who suffer from mental illness will need the help of family and an attorney to win disability benefits.

Social Security Disability Insurance remains a vital lifeline for citizens who once held full-time jobs but have become too ill or injured to work. It is a time-honored expression of our nation’s commitment to help care for those who must stop working due to illness or injury.

While any large government program will have problems — and Social Security is no exception — we should work on fixing the problems and not join the current rush to condemn an entire system because of rare instances of abuse or mounting political pressures to cut federal spending.

Getting disability approval is harder than ever. Undocumented pain, alcoholism and drug abuse have been disqualified. Mental retardation and HIV standards are tougher. Diabetes and obesity are no longer distinct disabilities. Illegal immigrants are now disqualified. Applicants must now present objective medical evidence of disability. This is no rubber-stamp process.

Moreover, it is a misrepresentation to claim that there is a surge in unemployed applicants looking to get on the public dole. Applications have increased due to social, medical and economic mega-trends (such as more insured women and aged workers).

Yes, today’s Social Security Disability Insurance system is huge, complex, costly and certainly imperfect. But it deserves to be improved, not scorned. Claimants’ representatives play an important role by discouraging frivolous applications and assisting those who can prove disability navigate a daunting and often confusing bureaucracy.

The road to restoring Social Security to full health is not to conduct a witch hunt for the rare but inevitable undeserving claimants or deficient judges, but through sensible measures such as giving more help to people with disabilities who want to work, giving employers incentives to hire them, and upgrading the gathering and delivery of medical treatment and information.

Tough times can bring out the best in people. Let’s not let our frustration over a lousy economy cause us to turn on those who are most in need. Let’s improve a system that reflects the true spirit of American compassion.

SOURCE:
USA Today

In some cases, applicants can file for expedited disability benefits. Most applicants have precarious financial situations and do not have the ability to wait for their benefits to be approved and begin receiving money, especially if they have no other household income or financial resources. (Tip: for financial help while waiting for your disability to be approved, apply for food stamps, energy assistance, rent assistance, and Medicaid in addition to disability benefits; you will likely meet the requirements.)

• Presumptive SSI Disability Benefits – this means that the applicant has a high likelihood of winning disability if they have one of these impairments; conditions that meet the eligibility requirements for this type of benefit include: total deafness or blindness, cerebral palsy, Down syndrome, amputation, or mental retardation

• Compassionate Allowances – this is a delicate subject, but the SSA recognizes that some conditions will likely be fatal to the applicant and will likely expedite the application of those with malignant cancers, muscular dystrophy, acute leukemia, and others; a complete list of conditions can be found here: http://www.ssa.gov/compassionateallowances/conditions.htm

• Quick Disability Determination – this process uses a predictive computer modeling program to analyze the possibility that the applicant will be found disabled; the application is then sent to a Quick Disability Determination group for review.

If you filed for SSDI and your claim was denied, do not give up hope. You can fight back! There is a detailed appeals process that you can go through to ultimately have your claim approved. The SSA receives so many applications for disability insurance per year, and unfortunately not every claim is genuine. This is why they are very cautious when approving a claim and have a high rate of denying first time applications.

The first step to an appeal is to make a request that you want to appeal the decision, in writing, within 60 days. This is extremely important: DO NOT DELAY! There are four steps to an appeal:

1. Reconsideration – a complete review of the claim by an impartial party who did not take place in the original investigation
2. Hearing by an administrative law judge – the applicant may be asked to provide more details to support their case; the hearing will take place in person or via video
3. Appeals council – you may request a review by the Social Security Appeals Council; however, this request can be denied
4. Federal Court – you may take your case to a federal district court.

The appeals process can be very complicated and most applicants benefit from the help of an attorney, especially if their case is repeatedly denied and must finally be taken to court. There are several key steps to filing that must be accurately completed, which is much easier to do if a lawyer is handling the case. The legal help is referred to as your “representation,” who is then allowed to work directly with the SSA on your behalf.

The Social Security Administration (SSA) appoints a special office called the Disability Determination Services to review claims for Social Security Disability Insurance (SSDI) benefits. Applications will go to the office in the state where the applicant lives. The office uses a five step process to determine if benefits will be granted. These five steps are as follows:

1. If the applicant is currently working and earning an income over a certain amount, the office generally does not consider them disabled. If they are working but earning less than the average amount for their geographic area, the office will closely consider at their application. The average earnings dollar amounts change every year with the SSA based upon actual reported incomes.

2. The office will determine if the applicant’s medical condition is severe enough to prevent them from working for at least one year by limiting common work activities such as walking, sitting, lifting, or using memory skills; this is how the SSA defines a disability.

3. The agency will consult the SSA’s official List of Impairments to see if the applicant’s medical condition is listed. Examples of impairments can fall within major categories including musculoskeletal impairments, respiratory problems, mental disorders, immune system disorders, skin diseases, or cardiovascular problems. If the applicant’s condition is not on the list, this is not an automatic disqualification for the applicant; instead, the agency will decide if the condition is as severe as those listed.

4. The state office will look at the type of work the applicant was doing before the alleged disability and whether it can be performed again, even with the medical condition.

5. If the applicant cannot do the type of work they did before, the agency will determine if there are other types of work available based upon the applicant’s age, education, other skills, and work experience that would allow the applicant to earn a reasonable living wage.

If the application makes it through all five steps, the state agency will generally find that the applicant is disabled and eligible for SSDI benefits if there are no types of work they can do.

Parkinson’s disease is recognized by the SSA as a medical condition that can be considered a disability and possibly eligible for SSI benefits (depending upon other circumstances of the application). Parkinson’s is a disorder of the brain that causes tremors and difficultly with basic coordination, walking, and movement. It can affect both men and women and generally develops after the age of 50, although younger people can have Parkinson’s. It is thought to be a genetic disease, although there has not been enough scientific research to fully support that theory.

Parkinson’s disease occurs when the nerve cells in the brain that make the chemical dopamine become damaged. Dopamine is responsible for controlling muscle movement and is crucial to proper muscle functioning. Scientists do not know why the nerve cells that produce dopamine waste away.

Symptoms of Parkinson’s include: stiff muscles; tremors; slowed speech; and slowed movements. Those who suffer from Parkinson’s find it difficult to work because of their physical limitations. There is no cure for Parkinson’s, the goal of treatment is to control the symptoms as much as possible. This is achieved through medications that increase the levels of dopamine in the brain. Doctors must carefully monitor their patients because of the many side effects of these medications, including hallucinations or nausea. Lifestyle changes that incorporate proper nutrition and exercise can alleviate some of the symptoms of the disease. Stem cell research is currently being conducted to develop a cure for Parkinson’s.