Here are answers to the most common questions we receive about applying for, appealing, and receiving Social Security Disability benefits.
- What is the difference between Disability Insurance Benefits (“DIB”) and Supplemental Security Income (“SSI”)?
- What types of income will the Social Security Administration look at when determining my eligibility?
- Will my spouse’s job affect my social security disability claim?
- How does the Social Security Administration define “disability?”
- Am I disabled if I cannot do my past job, even though I might be able to do another job?
- What will the Social Security Administration use to determine whether I am “disabled” or not?
- Can I be disabled and still work part time?
- How long does the social security disability application and decision process take?
- What is the Social Security Disability decision and appeal process?
- How do I file a claim for Social Security Disability benefits?
- Can I collect unemployment compensation benefits and still file a claim for Social Security Disability benefits?
- How long must I be disabled to get benefits?
- What benefits are provided under the Social Security benefits program?
- How is my Social Security Disability attorney paid?
Guide to Social Security Disability Law:
1. What is the difference between Disability Insurance (DI) and Supplemental Security Income (SSI)?
- 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.
- Supplemental Security Income (SSI) – Unlike the Disability Insurance benefits program, the Supplemental Security Income (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.
2. What will the Social Security Administration count as income or assets in determining my eligibility for Supplemental Security Income (“SSI”) benefits?
There are two categories of income that the Social Security Administration looks at when determining eligibility for SSI benefits: earned income and unearned income. Earned income is income received from sources such as wages from a job (whether in cash or another form); revenue from a business; royalties from publications; and/or monies received from other activities such as workshops or work activities centers. When considering unearned income, the Social Security Administration will look at the value of food or shelter that someone gives to you, or the amount of money they give to help pay for food and shelter; proceeds from life insurance policies, rental income, union benefits, and support and alimony payments; and benefits received from retirement plans, annuities, pensions, worker’s compensation, unemployment, the Department of Veterans, just to list a few.
3. Will my spouse’s job affect my Social Security Disability claim?
Your spouse’s income should have no affect on your claim for benefits for Disability Insurance (DI) benefits. However, your spouse’s income will be a consideration and may, in fact, prevent you from receiving benefits under the Supplemental Security Income (SSI) benefits program.
4. How does the Social Security Administration define “disability?”
The Social Security Administration has a large set of regulations governing all aspects of a claim, including how the word “disability” is defined? Generally speaking, “disability” means that you are unable to engage in what the Social Security Administration refers to as “substantial gainful activity” (“SGA”). In essence, while this may be an oversimplification, if you are unable to work a full time job, week-in and week-out, for an extended period of time (ie. 12 months or longer) you will be determined disabled.
5. Am I disabled if I cannot do my past job, even though I might be able to do another job?
If you are unable to do your past job or jobs, the Social Security Administration will then look at whether you are able to do other jobs. If the Social Security Administration determines that you are able to do virtually any other job on a full time basis, week in and week-out, you will likely not be found disabled. Note, many doctors, when telling their patients that they are “disabled” often only mean that their patient is unable to perform their last job, while leaving open the possibility that they can perform some other job on a full time basis. It is important to know how the Social Security Administration defines “disability” as it is a more difficult standard to meet than simply whether you can work your last job or not.
6. What will the Social Security Administration use to determine whether I am “disabled” or not?
In determining whether you are disabled, the Social Security Administration will look at a variety of pieces of evidence to determine your physical condition. The most important types of evidence, however, are: A) the testimony you provide, and B) the evidence and opinions your physicians provide. It is not a stretch to say that between what you think about your physical and/or mental conditions and what your physician’s think about them is different and your physician’s opinions are more significant. You or your social security lawyer must be sure to obtain the best medical records and opinions from the important treating physician’s to put your case in the best light before the Social Security Administration. The Social Security Regulations are very clear, however, that you need more than a simple statement from your doctor saying you are “disabled.” Such statements must be adequately and thoroughly supported.
7. Can I be disabled and still work part time?
If you have not yet been approved for social security disability benefits, the Social Security Administration will, in determining whether you meet their definition of “disability,” look at all of your activity. This includes your hobbies, household chores and duties, social activities, etc. They will also look at your work activity. If you are working part time, the Social Security Administration will have to determine whether they believe that such work activity reflects your actual ability to work on a full time basis. In this way, while simply doing some part time work will not alone render you not disabled, it is one factor of many the Social Security Administration will look at. Generally speaking, if you make more than $1000 a month, the Social Security Administration will say that you are engaging in substantial gainful activity and, thus, are not disabled. However, if you are only able to generate $1,000 a month for a limited time, usually 6 months or less, then this may not be a bar to your disability claim as this may be viewed as an unsuccessful work attempt. Therefore, it is possible to work part time and be found disabled. After a person is approved for benefits, the Social Security Administration has a program whereby you can attempt to return to full time work and still get the benefits for a limited time.
8. How long does the social security disability application and decision process take?
The answer to this question depends on many factors; however, from the time a person first applies until they have their first hearing can be anywhere from 12-24 months. This time may be considerably less or considerably longer, again, depending on many factors, not least of which is the type of case you have, the area of the country in which you live and file, the number of appeals that result, etc.
9. What is the Social Security Disability decision and appeal process?
The process varies slightly based on where you file your claim in the U.S. However, a claim for disability benefits begins when you file an application with the Social Security Administration. After you file your application, an initial determination of your condition is made, usually months later.
If you are denied benefits (as a majority of people are at this stage) you have the right to file an appeal — typically within 60 days of the denial. The appeal is generally made with a request for a hearing before an Administrative Law Judge. You have the right to appear at the hearing to present evidence. This hearing is like a mini-trial at which time you will be sworn in, have the opportunity to testify, enter evidence, make certain objections, etc. The Judge may have witnesses at the hearing including a vocational expert and possibly a doctor to testify in person, by video, or by the speaker phone. These witnesses frequently testify in a way that suggests that you are not disabled. You must be prepared for this. After your hearing, often months later, you receive a written decision. If the decision if favorable, the Social Security Administration moves forward to process your benefits claim. If it is an unfavorable decision, you are allowed to appeal the Judge’s decision to the Appeals Council. After briefing the matter, the Appeals Council makes a decision which is also subject to an additional appeal to the Federal Circuit Court.
10. How do I file a claim for Social Security Disability benefits?
You can file a claim for social security disability benefits on-line at www.ssa.gov or by calling 1-800-772-1213
11. Can I collect unemployment compensation benefits and still file a claim for Social Security Disability benefits?
Yes. But be aware that in order to obtain unemployment compensation benefits you will likely have to represent to the unemployment compensation office that you are eligible and available for work. The Social Security Administration will likely ask you about this and, thus, you should be prepared to give an appropriate and accurate answer.
12. How long must I be disabled to get benefits?
You must be disabled or expected to be disabled for a period of 12 months or longer in order to obtain social security disability benefits.
13. What benefits are provided under the Social Security benefits program?
If approved for benefits under the Disability Insurance (SSDI) and Supplemental Insurance (SSI) programs, you are eligible to receive monthly cash benefits, typically direct deposited into your bank account. The amount you receive for SSDI benefits mainly depends on your prior work history and the amount you have paid into the system over the years. The amount of SSI benefits are regulated by the Administration with certain monthly, maximum limits. In addition, after 24 months on the SSDI program, you are eligible for Medicare health care benefits. SSI recipients may receive Medicare benefits as well. Please also note that the rules governing the provision of health insurance benefits changes from time to time, therefore, you should consult the Social Security Administration as to the latest policies for health care coverage.
14. How is my Social Security Disability attorney paid?
The fees paid to an attorney in a social security disability case are frequently called “contingent fees.” What this means is that your attorney will only get paid if he helps you to win your social security disability benefits case. Generally speaking, if he wins the case, you will owe him a percentage. In most situations, the Social Security Administration will have to approve the fee and, in fact, there are certain maximum amounts that an attorney can charge you for his work. Normally, the fee your attorney earns is paid to him directly by the Social Security Administration. If you are unsuccessful in your case for disability benefits, while you do not owe your attorney for any of his fees, there may be certain expenses that are due, such as costs for medical records, etc. To be sure, you want to make certain that any such fee or charge is clearly spelled out in writing before you hire any lawyer.