Social Security Disability Faqs
You should apply for disability benefits as soon as you become disabled. It can take a long time to process an application for disability benefits (three to five months).
Twelve months in the short answer, but do not delay filing an application early if you believe your condition will prevent you from working that long. You can file for Social Security disability benefits on the very same day that you become disabled. Don’t make the mistake of waiting months and even years after becoming disabled before filing a Social Security disability claim. If you have suffered a serious illness or injury and expect to be out of work for a year or more, you should not delay in filing a claim for disability benefits.
There are two ways that you can apply for disability benefits.
- Apply with the Social Security Office.
- Hire an attorney
Yes, you have the right to be represented by an attorney of your choice when you do business with Social Security. Once you appoint a representative, he or she can act on your behalf before Social Security. The Law Offices of Walter F. Benenati would be honored to discuss the process and represent you in your claim. If you are not successful in obtaining benefits, there is no attorney fee charge.
- Help you complete your application;
- Get information from your Social Security file;
- Help you get medical records or information to support your claim;
- Come with you, or for you, to any interview, conference or hearing you have;
- Ensure you have provided all the necessary documentation to support your claim;
- Request a reconsideration, hearing or Appeals Council review; and
- Help you and your witnesses prepare for a hearing and questioning any witnesses.
No. You can go through all of the levels of review on your own, if you wish, but statistically claimants who are represented by an attorney win a good deal more often than those who are not represented.
The U.S. Social Security Administration will review your application to make sure you meet some basic requirements for disability benefits. They will check whether you worked enough years to qualify and evaluate any current work activities. If you meet these requirements, they will send your application to the Office of Disability Determinations in your state.
This state agency completes the disability decision for the Social Security Administration. They will use the medical evidence from your doctors and hospitals, clinics or institutions where you have been treated and other information you provide. They will ask your doctors about your medical condition and how it limits your activities. They will ask the doctors for information about your ability to do work-related activities, such as walking, sitting, lifting, carrying and remembering instructions.
The Office of Disability Determinations may need more medical information before they can decide if you are disabled. If more information is not available from your current medical sources, the state agency may ask you to go for a special examination. Social Security will pay for the exam and for some of the related travel costs.
When the state agency reaches a decision on your case, the Social Security Administration will send you a letter. If your application is approved, the letter will show the amount of your benefit and when your payments start. If your application is not approved, the letter will explain why and tell you how to appeal the decision if you do not agree with it.
It depends on whether you are denied or accepted in the early stages. If you are denied at the initial application and reconsideration stages and must seek a hearing with an administrative law judge, it can take from eighteen months to two years from the application submission to the hearing. The range would be 4 months for a quick acceptance to over two years if appeals are necessary.
If you wish to appeal, you must make your request in writing within 60 days from the date you receive the denial letter. The Social Security Administration will assume you received the letter five days after the date on the letter, unless you can show you received it later.
Generally, there are four levels of appeal:
- Request for Reconsideration of the initial denial;
- Request for a hearing by an administrative law judge if the reconsideration was denied;
- Review by the Appeals Council if the claim denied by the administrative law judge; and
- Federal Court review if the claim was denied by the Appeals Council.
The hearings are fairly informal. Typically, the only people there are the administrative law judge, his secretary operating a tape recorder, the claimant, the claimant’s attorney, and any witnesses the claimant has brought. In a few cases the administrative law judge has a vocational expert present to testify at the hearing. There is no jury nor are there any spectators at the hearing. Best of all, there is no attorney at the hearing representing Social Security trying to get the judge to deny the disability claim.
The Social Security Administration will send you a letter telling you that your application is approved, the amount of your monthly benefit and the effective date. Your monthly disability benefit is based on your average lifetime earnings.
Your first Social Security disability benefits will be paid for the sixth full month after the date your disability began. If your are found disabled more than six months prior, your first monthly check should arrive within 60 days of your favorable decision.
If the Office of Disability Determinations decides your disability began on January 15, your first disability benefit will be paid for the month of July. Social Security benefits are paid in the month following the month for which they are due, so you will receive your July benefit in August.
This is just part of the Social Security Law. Everyone found disabled on a certain date must wait full five (5) calendar months from the date of disability before disability payments begin. Your monthly disability benefit is based on your average lifetime earnings.
Past-due benefits will be paid back for up to a year from your initial application date.
You will get Medicare coverage automatically after you have received disability benefits for two years.
Certain members of your family may qualify for benefits based on your work.
- Your spouse, if he or she is age 62 or older;
- Your spouse, at any age if he or she is caring for a child of yours who is younger than age 16 or disabled;
- Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be younger than age 18 or younger than 19 if in elementary or secondary school full time; and
- Your unmarried child, age 18 or older, if he or she has a disability that started before age 22. (The child’s disability also must meet the definition of disability for adults.)
- In some situations, a divorced spouse may qualify for benefits based on your earnings if he or she was married to you for at least 10 years, is not currently married and is at least age 62. The money paid to a divorced spouse does not reduce your benefit or any benefits due to your current spouse or children.
Yes. You can contact the Social Security Administration and request a trial work period (“TWP”).
Trial work period – The trial work period allows you to test your ability to work for at least nine months. During your trial work period, you will receive your full Social Security benefits regardless of how much you are earning as long as you report your work activity and you continue to have a disabling impairment. In 2012, a trial work month is any month in which your total earnings are over $720, or if you are self-employed, you earn more than $720 (after expenses) or work more than 80 hours in your own business. The trial work period continues until you have worked nine months within a 60-month period.
Extended period of eligibility – After your trial work period, you have 36 months during which you can work and still receive benefits for any month your earnings are not “substantial.” In 2012, the Social Security Administration generally considers earnings over $1,010 ($1,690 if you are blind) to be substantial. No new application or disability decision is needed for you to receive a Social Security disability benefit during this period.
Expedited reinstatement – After your benefits stop because your earnings are substantial, you have five years during which you may ask the Social Security Administration to start your benefits immediately if you find yourself unable to continue working because of your condition. You will not have to file a new disability application and you will not have to wait for your benefits to start while your medical condition is being reviewed to make sure you are still disabled.
Continuation of Medicare – If your Social Security disability benefits stop because of your earnings, but you are still disabled, your free Medicare Part A coverage will continue for at least 93 months after the nine-month trial work period. After that, you can buy Medicare Part A coverage by paying a monthly premium. If you have Medicare Part B coverage, you must continue to pay the premium. If you want to end your Part B coverage, you must request it in writing.
Work expenses related to your disability – If you work, you may have to pay for certain items and services that people without disabilities do not pay for. For example, because of your medical condition, you may need to take a taxi to work, instead of public transportation, or pay for counseling services. The Social Security Administration may be able to deduct these expenses from your monthly earnings before it determines if you are still eligible for benefits.
There are a number of different types of Social Security disability benefits.
- Disability Insurance Benefits is the most important type of Social Security disability benefits. It goes to individuals who have worked in recent years (five out of the last 10 years in most cases) who are now disabled.
- Disabled Widow’s and Widower’s Benefits are paid to individuals who are at least 50 and become disabled within a certain amount of time after the death of their husband or wife. The late husband or wife must have worked enough under Social Security to be insured.
- Disabled Adult Child Benefits go to the children of persons who are deceased or who are drawing Social Security disability or retirement benefits. The child must have become disabled before age 22.
- Supplemental Security Income benefits, however, are paid to individuals who are poor and who are disabled. It does not matter for SSI whether an individual has worked in the past or not.
- SSI child’s disability benefits are a variety of SSI benefits paid to children under the age of 18 who are disabled. The way in which disability is determined is a bit different for children.
For Disability Insurance Benefits, Disabled Widow’s or Widower’s Benefits and Disabled Adult Child benefits, it does not matter whether the disabled individual is rich or poor. Benefits are paid based upon a Social Security earnings record.
Yes. Depending upon the state you live in, either workers’ compensation or social security will get to take an offset, which may reduce that payment, but in most cases, you will continue to receive both.
Medicaid is for disabled people who are on Supplemental Security Income (SSI). To get SSI and thereby get Medicaid you have to be poor and disabled. Medicaid pays doctors at very low rates. Medicaid recipients can have a hard time finding doctors willing to take them on as patients. Medicaid does pay for prescription medications. Medicaid can go back up to three months prior to the date of a Medicaid claim. It is possible to apply for Medicaid directly – through a local Medicaid office – without having a companion claim for SSI.
Medicare does not take into account your finances. If you have been on Disability Insurance Benefits, Disabled Widows or Widowers Benefits or Disabled Adult Child Benefits for 24 months you qualify for Medicare. The good thing about Medicare is that it pays doctors at a higher rate than Medicaid. Almost all doctors are happy to take Medicare patients. It generally does not pay for prescription medications.
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