The Basics

While there are multiple benefit programs under the Social Security Administration, our office deals with the two programs involving disability benefits. These programs are known as:1) Disability Insurance (“DI”); and 2) Supplemental Security Income, often called “SSI.” These 2 programs are described below.

What is a “disability?”

Social Security has countless regulations that govern the entire disability process. It is important for your attorney or representative to be familiar with these Federal Regulations. The person who is not familiar with the Federal Regulations will be at a severe disadvantage in handling your disability claim. No matter which of the two disability programs you apply for (i.e., DI or SSI), you will still have to prove that you are “disabled” as that term is defined by the Regulations. You do that by establishing that you are unable to engage in “substantial gainful activity.” This test applies to both child and adult claims. Though stating this basic definition is easy, establishing that you meet this definition is considerably more challenging. Hence, the Regulations are clear in requiring competent medical evidence as a primary way to establish your disability. How that evidence is gathered and presented, however, can make the difference between winning and losing your claim.

Two types of claims

As noted above, there are two basic disability programs: 1) Disability Insurance (“DI”), and 2) Supplemental Security Income, also called “SSI.” These are discussed here.

1. Disability Insurance (“DI”) This disability program is designed for people who have worked and paid into the Social Security system. In theory then, if the person becomes disabled later on, if they have met certain criteria establishing eligibility based on their payments into the system, they would then be able to receive Social Security Disability Benefits. Their payments over time into the system are, thus, a type of “insurance” as the name of the program implies.

2. Supplemental Security Income (“SSI”) Unlike the Disability Insurance benefits program, the Supplemental Security Income or “SSI” program is a needs-based program. If you can show that you are disabled and if you also have very little income or assets, you may qualify for benefits. This program is for disabled children as well as for adults who are basically needy and without resources. Specific income tests apply to determine if you are eligible for this SSI program.

Procedure

No matter which disability program you apply for, the procedures are virtually identical. If you intend to seek disability benefits, you must file an application with the Social Security Administration. Applications are generally filed by going to your local Social Security office. For DI claims, you may also apply on-line by going to the Social Security Administration’s web site:www.socialsecurity.gov/applyforbenefits. At this time, you cannot apply for SSI benefits on-line, though this may change in the future. You should also call your local office to determine whether you may apply over the phone if you are unable to go to the local Social Security office in person. After the application is filed, your case will normally take on a life of its own and may take 1-2 years to see to completion, on average. Multiple appeal levels are generally involved as well. Typically, the case goes to a hearing after several appeals. At this recorded hearing, you will be given the opportunity to testify, and present any witnesses and evidence you may have. A vocational expert will also appear at your hearing, at the request of the Social Security Administration, to give testimony as to what jobs you are able to work, if any, based on the evidence. More often than not, the vocational expert will testify that you can work and, thus, are not disabled. It is critical that you secure representation as early as possible and, in any event, well before the hearing. A good lawyer will help you prepare both your case and the file before you ever step into the hearing room. The attorney will also prepare you for testifying so you can concentrate on that rather than all the other things going on around you. At Trinity Law, our Disability Attorneys for York, Lancaster, Dauphin and Adams Counties will prepare the file by working with your physicians to acquire, if possible, the type of statements that will put your case in the best position possible. While many attorneys prefer to meet their client a few minutes before the hearing, our attorneys will normally prepare you days in advance for your hearing. You will know what to expect at the hearing as well as the theory of your case.