Things You Should Know Before You Apply for Social Security Disability Benefits
If you have suffered a bodily injury, or have been diagnosed with a debilitating physical or mental health related medical condition, and are unable to continue working, you may be eligible to apply for certain financial and medical benefits through the Social Security Administration. The application process to obtain benefits is quite complex and can be intimidating, especially for someone who is already struggling with a serious injury or medical condition. This article focuses on addressing some of the most common questions asked by clients when they are applying for Social Security Disability Benefits.
Speak to an Experienced Social Security Disability Benefits Lawyer Today
As you can see, the disability benefit application process is complex and there are many pitfalls that can delay an individual’s ability to obtain benefits. This is why it makes sense to have an experienced and knowledgeable attorney on your side who can help you navigate the process. As a former staff attorney with the Social Security Administration, Sara J. Frankel knows the law and how the system works from an inside perspective. Contact us today, we can help!
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You may be surprised to learn that there are a myriad of different disability benefit programs managed by the Social Security Administration. In fact, there are at least five major forms of benefits you could potentially access through Social Security. Here is an overview of the five major disability programs.
Disability Insurance Benefits (SSDI) – This is the type of benefits most commonly applied for by individuals through the Social Security Administration. To be eligible, or be “insured”, you must have a record of working five out of the last ten years and are now disabled.
Disabled Widow’s and Widower’s Benefits – These benefits are available to individuals who have become disabled after losing their insured spouse and they are at least 50 years of age or older.
Disabled Adult Child Benefits – These benefits are available to a disabled adult child who is (i) over the age of 18; (ii) unmarried; (iii) became disabled before the age of 22; and (iv) one of the child’s parents receives Social Security benefits or is deceased.
Supplemental Security Income Disability Benefits (SSI) – These benefits are available to disabled individuals who are struggling financially. The big distinction between supplemental security income benefits and other disability benefits is that it does not matter whether an individual has worked in the past or not.
Supplemental Security Income-Child’s Disability Benefits – These benefits are available to minors under the age of 18. To be eligible, the children must have a severely limiting physical and mental condition, or conditions. Additionally, there are restrictions for an applicant’s household income. Basically, if the child’s parents or guardians make over a certain amount, the child would be ineligible for benefits.
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To be eligible for Social Security disability benefits, there needs to be documented evidence that you are suffering from a permanent or long-term (i.e. 12 months or longer) illness or injury that prevents you from working.
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If your doctor told you that you should not work, but your disability benefits application is denied, do not give up hope. This is quite common. Many applicants encounter this situation, where they have a letter from their doctor stating they should not return to work, but are nonetheless denied benefits by Social Security.
The issue that often arises is the content of the letter supplied by the doctor. For example, the letter may advise the patient not to go back to their current work, but it makes no mention of whether the patient is unable to perform any other type of work. This is extremely important in the context of a disability benefits application. Why? Because even if you are unable to go back to your previous employment, Social Security may not approve your benefits application if it is possible you could perform other work duties that may be less physically and or mentally demanding.
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When deciding whether an applicant is disabled, the Social Security Administration utilizes a multi-step process addressing five key questions.
Are you working?
Is your condition “severe”?
Is your condition found in, and as described in, their list of disabling conditions?
Can you do the work you did previously?
Can you do any other type of work?
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The time frame for Social Security to make a decision in your case can vary, depending on the backlog at the agency at that point in time. However, we are able to give clients with ongoing cases time estimates for their particular level of application and or appeal.
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The Social Security Administration will send your disability benefits application to a state agency that is empowered to review and make decisions regarding benefit applications. A vocational-disability examiner and a medical expert or experts will be assigned to your case, and they will send you a packet of detailed questionnaires to complete regarding your daily activities, symptoms and treatment of specific health conditions, and your work history. They will contact your doctors to obtain medical records and completed disability questionnaires, and at times information from your former employers, all of which they will then review. There are also instances where the state agency will request that you undergo a medical examination performed by a specialist that they hire (You will not have to pay for this examination, and transportation will be provided if you need it). These examinations are often ordered because you have insufficient treatment of your own in which to document your conditions, or your doctors are not providing information to the agency in a timely or complete manner.
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If you are deemed disabled, the types of benefits you may receive include monthly cash payments and insurance to cover your medical expenses.
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The Social Security Administration utilizes a formula when calculating your available benefits. For Social Security Disability Insurance benefits (SSDI), the agency will likely use your Average Indexed Monthly Earnings (AIME) and Primary Insurance Amount (PIA) to calculate your disability benefits. For example, in 2020, the average benefit amount through the Social Security Disability Insurance program is $1,258 per month. For Supplemental Security Income (SSI), the benefit amounts vary by state of residence and household composition, income and assets.
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Yes, it is possible for your loved ones to be eligible for disability benefits if you are awarded SSDI (there are no family benefits available through SSI), if they rely on your income (i.e. dependent minors). For example, if your spouse becomes disabled and is approved for disability benefits, you may also be eligible to receive benefits if you are age 62 or older, or you are caring for a child who is under the age of 16 (or if your child is also disabled).
If you are the parent of a child and you are collecting disability benefits, your child may also be eligible for benefits if they are under the age of 18 and unmarried, or 19, unmarried and still attending high school.