Frequently Asked Questions
Below is a list of Frequently Asked Questions compiled in large part by the National Organization of Social Security Claimant=s Representatives (NOSSCR), of which Mr. Peters is a member. Although this list may help to familiarize yourself with the Social Security Process, please be advised that it is for general informational purposes only. None of the information should be construed as legal advice as each case and situation is unique. Although the list may appear to answer some of your questions, you should still discuss your concerns with a qualified, licensed Attorney. Call a disability lawyer at Social Security Professionals 24/7 for a Free Consultation about your disability case. (248) 549-3485. Here are some questions and answers:
Under the Social Security Act, “disability” means “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.”
There are at least five major 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. 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. 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.
You can apply online at: https://secure.ssa.gov/iClaim/dib
You can call (800) 772-1213 and arrange to apply at a local office in person or over the phone;
You can appear in person at a local office. Find your local office using the SSA Office Locator: https://secure.ssa.gov/ICON/main.jsp
There may be some strategic advantages as to which method you use to apply. You should discuss this with an attorney.
No. You can apply for SSD and the money you have in the bank does not prevent you from filing and winning your claim. If you have worked in recent years or if you are applying for Disabled Widow’s or Widower’s benefits or Disabled Adult Child benefits, it does not matter how much money you have in the bank. There is no reason to wait to file the claim.
Possibly. If you have worked five out of the last 10 years before becoming disabled, you will have enough earnings in to potentially qualify for Social Security Disability benefits. For individuals 31 or less, the requirements are a little different, since such individuals have not had such a long time to work. Unless a person has been staying home and taking care of their children for quite a long time, however, it is very possible that they will qualify for Social Security disability benefits based upon their own earnings. Also a homemaker, if poor enough, can qualify for Supplemental Security Income (SSI) whether he or she has worked in the past or not.
Not even one day. You can file for Social Security Disability benefits on the very same day that you become disabled. Many individuals make the mistake of waiting months and even years after becoming disabled before filing a Social Security disability claim. There is no reason to file a Social Security disability claim if one has only a minor illness or one which is unlikely to last a year or more. However, an individual who suffers serious illness or injury and expects to be out of work for a year or more should not delay in filing a claim for Social Security Disability benefits. Also, once you win, you can receive back benefits for all the time you were disabled. However, they will only pay you back one year prior to the disability application. In an SSI case, Social Security will only pay you from the date of the application.
No, you do not have to wait until the sick leave is exhausted. You should file for Social Security Disability benefits now, if you believe that you will be out of work for a year or more.
You do not have to wait until the worker’s compensation ends and you should not wait that long. An individual can file a claim for Social Security Disability benefits while receiving worker’s compensation benefits. It is best to file the Social Security Disability claim as soon as possible because otherwise there may be a gap between the time the worker’s compensation ends and the Social Security Disability benefits begin.
Yes. There is an offset, which reduces Social Security Disability benefits because of worker’s compensation benefits paid, but in virtually all cases, there is still some Social Security Disability benefits to be paid. In a few states the offset works the other way – – worker’s compensation benefits are reduced because of Social Security Disability benefits.
Unless your disability is catastrophic (such as terminal cancer, a heart condition so bad that you are on a heart transplant waiting list, total paralysis of both legs, etc.), there is no easy way for you to tell whether you will be found disabled by Social Security. In the end, the decision of whether or not to apply for Social Security Disability benefits should not be based upon whether or not the person feels that Social Security will find them disabled. Attorneys familiar with Social Security Disability can make predictions about who will win and who will lose, but even they can seldom be sure. An individual should make the decision about whether or not to file for Social Security Disability based upon his/her own belief about his/her condition. If the individual feels that he or she is disabled and is not going to be able to return to work in the near future, the individual should file for Social Security Disability benefits.
Disabling conditions can be physical or mental or both. Social Security speaks in terms of a medically determinable condition. Any condition can result in a finding of disability if the condition is severe enough to preclude all work.
No. You have to have been disabled for at least a year or be expected to be disabled for at least a year or have a condition that can be expected to result in death within a year.
Social Security is supposed to consider the combination of impairments that an individual suffers in determining disability. Many, perhaps most claimants for Social Security disability benefits have more than one health problem and the combined effects of all of the health problems must be considered.
If you expect to be out of work for a year or more on account of illness or injury, you should file for Social Security disability benefits. Even if you expect to go back to work, this does not mean you are not entitled to benefits. If your disability ends such that you can go back to work, you may still be entitled to a closed period of benefits for the period that you could not work.
Social Security is supposed to gather your medical records and carefully consider all of your health problems, as well as your age, education, and work experience. In general, Social Security is supposed to decide whether you are able to do your past work. If Social Security decides that you are unable to do your past work, they are supposed to consider whether there is any other work which you can do considering your health problems and your age, education, and work experience.
After an individual files a Social Security disability claim, the case is sent to a disability examiner at the Disability Determination agency in your state. This individual, working with a doctor, makes the initial decision on the claim. In Michigan, if the claim is denied and the individual requests a hearing, the case is sent to an Administrative Law Judge who works for Social Security. The Administrative Law Judge makes an independent decision upon the claim. This is the only level at which the claimant and the decision maker get to see each other. This is also the level at which you have the best shot at winning your case. Consequently, you want to give it your best and you should be represented by an Attorney to make sure your case is properly presented to the Judge.
Social Security has to consider age, because that is what the Social Security Act requires. As people get older, they become less adaptable, less able to switch to different jobs to cope with health problems. A severe foot injury which might cause a 30- year- old to switch to a job in which he or she can sit down most of the time, might disable a 60- year- old person who could not make the adjustment to a different type of work.
There is a list of impairments. View a list of impairments here. Claimants who meet a specified listing will be found disabled. Claims that are not of listing level, must be judged against several other factors.
First, although some cases are won without Attorneys, your best shot is to contact an Attorney as soon as possible. Be honest and complete in giving information to Social Security about what is disabling you. Many claimants, for instance, fail to mention their psychiatric problems to Social Security because they are embarrassed about them. In almost all cases, individuals who were slow learners in school fail to mention this fact to Social Security, even though it can have a good deal to do with whether or not the Social Security Disability claim is approved. Beyond being honest and complete with Social Security, the most important thing that you can do is just keep appealing and hire an experienced person to represent you. It is important to appeal because most claims are denied at the initial level, but are approved at higher levels of review. It is important to hire an experienced person to represent you because you do not understand the way Social Security works. Statistically, claimants who employ an Attorney to represent them are much more likely to win than those who go unrepresented.
You can contact Social Security Professionals and speak with Attorney Donald H. Peters in Michigan for free at (248) 549-3485. He has the Highest A+ rating with the Better Business Bureau.
For disability insurance benefits, it all depends upon how much you have worked and earned in the past. For disabled widow’s or widower’s benefits, it depends upon how much the late husband or wife worked and earned. For disabled adult child benefits, it all depends upon how much the parent worked and earned. For all types of SSI benefits, there is a base amount that an individual with no other income receives. Other income that an individual has reduces the amount of SSI which an individual can receive.
For Disability Insurance Benefits and for Disabled Widow’s and Widower’s Benefits, the benefits cannot begin until five months have passed after the person becomes disabled. In addition, benefits cannot be paid more than one year prior to the date of the claim. For a Disabled Adult Child, there is no five-month waiting period before benefits begin, but benefits cannot be paid more than six months prior to the date of the claim. SSI benefits cannot be paid prior to the start of the month following the date of the claim.
First, do not be upset or surprised. Most Social Security Disability claims are denied at the initial level. If you are denied at the initial level, you should appeal. In Michigan, you would file a Request for Hearing. You should also consider employing an Attorney to represent you.
There is no simple answer to this question. One reason is that the file may be lacking in medical proofs. Many claims will not only need the requisite medical records to help prove a claim, but the claim may need expert opinions from treating physicians. Another reasons is that SSA is concerned with people filing fraudulent claims. If SSA is going to pay benefits on your claim, SSA will require that you prove your claim. An Attorney can help you do this.
Actually, when you file a Social Security Disability claim, you are not trying to just get “your own money” back. The money that an individual may have paid into Social Security over the years would not last very long if that was all that an individual could draw from Social Security.
When a claim for Social Security disability benefits is denied at the initial level, the claimant may then request “reconsideration” of that decision. The case is then sent to a different disability examiner for a new decision. Unfortunately, about 80% of the time the reconsideration decision is the same as the initial decision – a denial. Michigan did away with this step. Now, your next avenue of appeal in Michigan following an application denial is to Request a Hearing.
A disability examiner at the Disability Determination Section makes the reconsideration determination. Most of the time, the claimant does not see the disability examiner or even know his or her name. Michigan did away with this step.
Statistically, about 20% of the time a claimant wins at reconsideration but Michigan did away with this step.
Not in Michigan. In other jurisdictions, if you want to appeal a denial of Social Security disability benefits, you have to go through reconsideration.
There is much variation around the country. In a few areas of the country the wait is only three months. In a few areas of the country the wait is around 2 years. The wait in recent years seems to have been just over 12 months.
The hearings are fairly informal. The only people likely to be there are the Judge, a secretary operating a tape recorder, the claimant, the claimant’s Attorney, and anyone else the claimant has brought with him or her. There will be a Vocational Expert and In some cases, the Administrative Law Judge has a medical doctor testify by phone if necessary.
Statistically, over half of the claimants who have a Social Security Disability hearing win. Claimants who hire Social Security Professionals by calling Attorney Donald H. Peters for free at (248) 549-3485 stand a far greater chance than that. Although he does not have a 100% success rate, Mr. Peters is close and rarely loses a claim.
Yes. You can appeal to the Appeals Council. Social Security Professionals handles those appeals. Some disability firms will not handle appeals.
The Appeals Council exists to review Administrative Law Judge decisions. The Appeals Council is located in Falls Church, Virginia, and neither the claimant nor the Attorney sees the people at the Appeals Council who are working on the case.
Yes. After being denied by the Appeals Council, it is possible for a claimant to file a civil action in the United States District Court, requesting review of Social Security’s decision. A Social Security Disability claim can go all the way to the Supreme Court. Note that a non-attorney representative such as an “advocate” or “representative” cannot file or appear in U.S. District Court. Only licensed Attorneys may do this.
Certainly you can return to work. Social Security wants individuals drawing disability benefits to return to work and gives them every encouragement to do so. SSA allows trial work periods during which a Claimant may attempt to work for a certain amount of time and still receive benefits in the event his or her work attempt ultimately fails.
You can call Disability Attorney Donald H. Peters at Social Security Professionals at (248) 549-3485 for a Free Consultation regarding your disability case. You can also call a State Bar Association or NOSSCR for a referral to a Social Security Attorney.
No. However, statistically, claimants who are represented by an Attorney win a good deal more often than those who are not represented. Can you cross-examine a Vocational Expert who testifies against you?
In almost all cases, the Attorney receives 25% of the back benefits if the claimant wins and no fee if the claimant loses. The Government withholds 25% of your past benefits to pay your Attorney. After paying your attorney directly, the Government will then release the remainder of the funds to you. At Social Security Professionals, you need no money to hire an Attorney. Call Attorney Donald H. Peters to discuss your claim for free at (248) 549-3485.
Not by reason of alcoholism or drug addiction. However, alcoholics and drug addicts can suffer from other disabling addictions that can make them eligible for Social Security Disability and or SSI.
When it comes to disability, looks can be very deceiving. There are many people who look quite healthy but who are quite disabled by anyone’s standard. For instance, many individuals who suffer from very severe psychiatric illness are physically healthy and able to do things such as mow their yards. Some people function quite well at times especially around their own homes. At other times and under other circumstances or in different environments, they cannot function well enough to perform a job on a sustained basis. You simply may not see these individuals when they are at their worst.
If you are poor enough, you can qualify for Supplemental Security Income (SSI) if you are disabled, even if you have never worked in the past. It is also possible to qualify for Disabled Adult Child Benefits on the account of a parent if you became disabled before age 22 or for disabled widow’s or widower’s benefits on the account of a late husband or wife.
If you are over 50 and became disabled within seven years after your husband or wife died or within seven years after you last drew mother’s or father’s benefits from Social Security, you can get Disabled Widow’s or Widower’s Benefits. Perhaps more important, if you are poor, you can draw Supplemental Security Income benefits no matter what age you are or when you became disabled.
Very possibly. If the child is under 18 and you are poor enough, the child may be able to qualify for SSI child’s disability benefits. If the child is over 18, she may be able to qualify for SSI disability benefits without regard to the income of her parents. If her father or mother is drawing Social Security benefits of some type or is deceased, the child may be eligible for disabled adult child benefits.
Social Security is not supposed to cut off disability benefits for an individual unless his or her medical condition has improved. If you have this concern, you should consult an Attorney immediately. Your Attorney will know how to protect your right to continuing benefits.
You should appeal immediately. If you appeal within 10 days after being notified that your disability benefits are being ceased, you can ask that your disability benefits continue while you appeal the decision cutting off your benefits. You should also call an Attorney immediately but you must file the appeal immediately to protect your benefits.
Social Security takes the position that Social Security, not your doctor, will decide whether you are disabled. Further, Social Security will not accept a bald conclusion from a doctor, i.e., APatient is disabled@. Social Security will insist on test results and objective evidence.
It is Social Security’s position that VA decisions are not binding upon them. Social Security and VA have very different standards for approving disability claims.
No. Under Social Security rules, there are no percentages of disability. You are either disabled or not disabled.
Yes. In fact, mental illness can form one of the strongest basis for approving a Social Security Disability claim. Imagine a clinically documented case of Agoraphobia in which the patient is terrified of leaving his or her house. Or, imagine a case of bipolar disorder where the patient is so depressed that he or she does not get out of bed and doesn’t even eat for several days at a time.
It can. Many Social Security Disability claimants become frustrated with claim delays and eventually ask their U.S. Representative or Senator to help. The local Congressional office typically will have staffers who are experienced with Social Security procedures and personnel. A Congressional Inquiry, as it is called at Social Security, may help to get a stalled process moving again. Note that the inquiry will have no impact on how Social Security decides the outcome of the case.
In most cases Social Security makes the first decision within four months.
In Michigan, it can take a couple of years. SSA has been making efforts to help speed the process in Michigan by having Judges from other parts of the Country hear Michigan cases in an effort to decrease Michigan’s huge case-load. In recent years, cases go to hearing in just over a year from the appeal.
History dictates about a year, maybe longer.
Getting help with medical bills is usually tied up with getting cash benefits, that is, you don’t start getting help with medical bills until after you start getting the cash benefits, so you have to keep going with the Social Security disability claim in order to get the help with medical bills. In Michigan, you are encouraged to go to DHS and inquire as to what medical benefits may be available to you.
Medicaid is a poverty program and Medicare isn’t. Many disabled people who get Medicaid get it because they are on Supplemental Security Income (SSI). This is called categorical Medicaid eligibility. To get SSI and thereby get Medicaid you have to be poor and disabled. Medicaid pays doctors at very low rates. People who have only Medicaid 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. Note that it is possible to apply for Medicaid directly – through a local Medicaid office – without having a companion claim for SSI.
For Medicare it does not matter whether you are rich or poor. 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. The bad things about Medicare are that it does not begin until after a person has been on cash disability benefits for two years and that it generally does not pay for prescription medications.
If you are approved for any kind of Social Security Disability benefit other than SSI you will get Medicare after you have been entitled to Social Security Disability benefits for two years.
If you are approved for SSI you will get Medicaid. It is possible to get both Medicare and Medicaid if you are entitled to SSI and some other type of Social Security disability benefit.
This is one perfect example as to why you should have an Attorney. Under the Social Security Rules, if Social Security wants to send you off for a Consultive Evaluation with a doctor, the rules say that your own doctor is the preferred choice. Social Security must contact your doctors to seek medical information. If SSA does not receive the requested information from your doctors, the rules require SSA to re-contact your doctor and ask for the information unless to do so would be futile. After SSA has exhausted the above efforts, only then may SSA send you to a Social Security doctor. If SSA fails to comply with the above requirements, SSA is not allowed to ask you to visit an SSA doctor. SSA regularly violates these rules. However, if you fail to attend, you run the risk that SSA will claim you failed to cooperate in the development of your claim and may deny benefits on that basis. As to whether you attend or not is a strategic decision that you, as a Claimant, do not want to make. It is a decision that should be made only by a qualified Attorney. If you don=t have an Attorney and you receive such a notice of a medical exam, you should contact an attorney immediately to decide whether it would be strategically advantageous to not attend. In more recent years, Social Security has taken a stronger position and has looked very unfavorably upon those that do not attend their exams by an SSA doctor.
To reiterate, the above is for general informative purposes only. It is not intended to be legal advice and should not be construed as such. Even though the above list may appear to answer questions you may have, each case is unique and you should discuss your concerns with an Attorney.