1. What are Social Security Disability benefits?

These are monthly cash benefits paid to individuals who suffer a severe physical or mental impairment that prevents them from being able to work full-time. Generally, Medicare or Medicaid is available for those found disabled. There are two main types of disability programs available from the federal government: SSDI and SSI. Both require that the applicant prove he or she is disabled. But SSDI requires the applicant show, in general, 1) he or she worked five of the last ten years before becoming disabled, and 2) worked a total of 6-10 years in his or her lifetime (depending on the age disability began). SSI, on the other hand, is the federal disability program for those who do not have a significant recent work history, but can show they are disabled and have very limited income and assets. Generally, their assets must be no more than $2,000.00 and their income must be under $1200 per month. SSI benefits are also available to children with severe physical or mental functional limitations and whose family can meet the same income and asset requirements.

2. What is considered a severe physical or mental impairment?

Of course, the most important aspect of your physical or mental impairment is that it prevents you from being able to maintain a job eight hours per day, day after day, week after week. But I always remind my clients that it’s the symptoms from the illness that must be made clear to the Social Security Administration, and how those symptoms keep you from working. Only in very rare circumstances does a specific diagnosis itself from your doctor suffice to qualify you for disability. Evidence you were diagnosed with congestive heart failure, or lupus, or breast cancer, or you had a hip transplant, or liver transplant, will not by itself qualify you as having a severe physical or mental impairment. The question is what symptoms do those impairments create in you that prevent you from working. For applicants under age 50, you will have to show the Social Security Administration there is no work at all you can do. For those over 50, you basically have to show there is no work you can do where you would have to be on your feet most of the day. Being able to prove a severe physical or mental impairment is crucial to getting approved for disability. When you apply, the Social Security Administration will have you complete a Disability Report. It is very important that you provide in this report a complete list of your doctors, hospitals, chiropractors, and physical therapists, so the Social Security Administration can obtain these records, which will provide the medical evidence of your disabilities.

3. How do I apply?

You may be able to apply online at HTTPS://WWW.SSA.GOV/BENEFITS/DISABILITY/. Be sure to read the requirements to see if you are eligible to apply online. You can also apply over the phone by calling 1-800-772-1213. A Social Security representative will take your information over the phone, then mail you a completed application to sign. You may also apply in person at your local Social Security office.  I am always willing to help a client apply. The initial application can sometimes require gathering a lot of information and documentation about your medical history, medical condition, assets and income, and personal records such as your birth certificate.

 4. How long does the application process take? What if I am denied? Do I have to go in front of a judge?

Not all states use the exact same application process. Here in Michigan, the first step is to file an initial application explaining why you are disabled (see topic 3). It will then take about 3-4 months before you get a decision. About one-third of all applicants nationally are awarded benefits at this initial stage. If denied, you have the right to file a Request for Reconsideration. You can expect to get this decision in 4-5 months. If you are denied at Reconsideration, you then have the right to file another appeal to ask that an Administrative Law Judge hear your case. Throughout this whole process, it is vitally important that you be alert to the filing deadlines given by the Social Security Administration. It is not uncommon for many Social Security Disability claimants here in Michigan to wait up to two years from the time they initially applied before finally receiving their first disability check. Even if you are denied by the Administrative Law Judge, you still have the right to appeal that denial to the Social Security Administration’s Appeals Council in Virginia. You will not have to attend any hearing in Virginia. The Appeals Council will make its decision based solely on what has been submitted to your file. If denied by the Appeals Council, you may still further appeal your case for benefits to the United States federal court system.

5. Do I need a lawyer? How do I pay my lawyer?

About one-third of all applicants nationally are awarded benefits at the initial application stage. Most of those people did not have a lawyer. For those not awarded benefits at this initial stage and need to request a hearing, I have no doubt they need a lawyer to help prepare for a hearing in front of an administrative law judge. But whether you need a lawyer to help you apply initially is a much harder to question to answer, except on a case-by-case basis. If you have the time and the resources to gather the medical evidence and complete the Social Security Administration’s voluminous paperwork without a lawyer to help, you may well be one of those 1/3 that are approved at the initial stage, and you won’t have to pay a lawyer anything. From the lawyer’s perspective it is much easier to know the likelihood of someone being awarded benefits if they have been denied at the initial and reconsideration stage, because by then the medical records have been obtained and can be quickly reviewed. But this will not be so for someone looking for a lawyer’s help with the initial application. With that said, I am always happy to talk with someone who is thinking about filing an initial application, and see how I may be able to help them. You should also understand that a lawyer generally gets paid by a portion of the back benefits you are due from the time you became disabled to the time you are awarded benefits. When a lawyer represents you at the hearing (often a year or more after you applied) you will likely be entitled to that year or more of back benefits. Your lawyer who helped you win your case will be paid directly by the Social Security Administration by a percentage of that back pay.

About one-third of all applicants nationally are awarded benefits at the initial application stage. Most of those people did not have a lawyer. For those not awarded benefits at this initial stage and need to request a hearing, I have no doubt they need a lawyer to help prepare for a hearing in front of an administrative law judge. But whether you need a lawyer to help you apply initially is a much harder to question to answer, except on a case-by-case basis. If you have the time and the resources to gather the medical evidence and complete the Social Security Administration’s voluminous paperwork without a lawyer to help, you may well be one of those 1/3 that are approved at the initial stage, and you won’t have to pay a lawyer anything. From the lawyer’s perspective it is much easier to know the likelihood of someone being awarded benefits if they have been denied at the initial and reconsideration stage, because by then the medical records have been obtained and can be quickly reviewed. But this will not be so for someone looking for a lawyer’s help with the initial application. With that said, I am always happy to talk with someone who is thinking about filing an initial application, and see how I may be able to help them. You should also understand that a lawyer generally gets paid by a portion of the back benefits you are due from the time you became disabled to the time you are awarded benefits. When a lawyer represents you at the hearing (often a year or more after you applied) you will likely be entitled to that year or more of back benefits. Your lawyer who helped you win your case will be paid directly by the Social Security Administration by a percentage of that back pay.

About one-third of all applicants nationally are awarded benefits at the initial application stage. Most of those people did not have a lawyer. For those not awarded benefits at this initial stage and need to request a hearing, I have no doubt they need a lawyer to help prepare for a hearing in front of an administrative law judge. But whether you need a lawyer to help you apply initially is a much harder to question to answer, except on a case-by-case basis. If you have the time and the resources to gather the medical evidence and complete the Social Security Administration’s voluminous paperwork without a lawyer to help, you may well be one of those 1/3 that are approved at the initial stage, and you won’t have to pay a lawyer anything. From the lawyer’s perspective it is much easier to know the likelihood of someone being awarded benefits if they have been denied at the initial and reconsideration stage, because by then the medical records have been obtained and can be quickly reviewed. But this will not be so for someone looking for a lawyer’s help with the initial application. With that said, I am always happy to talk with someone who is thinking about filing an initial application, and see how I may be able to help them. You should also understand that a lawyer generally gets paid by a portion of the back benefits you are due from the time you became disabled to the time you are awarded benefits. When a lawyer represents you at the hearing (often a year or more after you applied) you will likely be entitled to that year or more of back benefits. Your lawyer who helped you win your case will be paid directly by the Social Security Administration by a percentage of that back pay.

6. Can I work while applying for SSDI or SSI?

If you have worked recently, or even if you are working now, you may still be eligible for Social Security Disability benefits. Keep in mind the general rule that these disability benefits are available to someone who cannot maintain full-time work, consistently, over a long period of time. The Social Security Administration calls this “Substantial Gainful Activity”, or SGA. That’s all you need to show. The amount for SGA changes each year. But for 2020, the SGA amount is $1260 per month in gross earnings. So, if you are working, but below SGA, you should still be eligible. Plus, even if you earned above SGA recently, you may still qualify if it was for less than six months, and you had to stop due to your disabilities. If you plan to apply for SSI, you must always meet the asset and income requirements. You must have no more than $2,000.00 in assets as an individual. Unfortunately, it doesn’t take a lot of income to disqualify you for SSI. The maximum 2020 monthly benefit amount for an individual is $783; for a married couple, where both are eligible, it is $1,175.00.  But any income you get, earned or unearned, will reduce your benefit amount, but not necessarily disqualify you. For a child to receive SSI, the child’s household must generally meet these same SSI requirements.

On a related question, people have asked me if they should quit their job to help them qualify for disability. As explained above, if you are not making SGA, you don’t need to quit your job. But if you are making SGA, my advice is to not quit. It’s a bad idea. No one, including myself, can ever guarantee you will win your case. And even if you do, the wait can be a year or more, and you are going to need an income to live on. With the average SSDI benefit amount being about $1260 per month, it may well not be much more than what you are earning.

7. Do disability recipients get medical insurance?

Generally, if you are receiving SSI, you qualify for Medicaid. If you are receiving SSDI, you qualify for Medicare. But those Medicare benefits may not kick in until as much as 2 ½ years after your disability began. But this may not be as bad as it sounds, depending on when your disability began. Keep in mind, this 2 ½ years begins to run from when the Social Security Administration determines your disability began, not from when you applied. Because the application process itself can take a year to a year-and-a-half, you may not have to wait that long after being approved by an administrative judge before you begin receiving Medicare benefits.

8. What is the average disability benefit amount?

The average monthly benefit amount for someone receiving SSDI is $1260. Those receiving SSI can receive a maximum benefit of $783 per month, which the Social Security Administration may reduce if you receive other earned or unearned income that they consider countable.

9. What are auxiliary benefits?

Auxiliary benefits are Social Security benefits payable to family members of a qualified disabled, retired, or deceased person receiving (or if deceased, received) Social Security benefits. Generally, the total amount of auxiliary benefits will be about 50% to 80% of the qualified person’s benefit. Minor children, disabled adult children, and a spouse are the most common auxiliary beneficiaries. You will not have to go through anything close to the same application process described above for your family to receive these auxiliary benefits. But if you receive Social Security benefits, be sure to contact the Social Security Administration to ask about possible auxiliary benefits for your spouse, minor child, or adult disabled child; or if a spouse or parent of yours passed away and that person received Social Security benefits, you should do the same.

10. Do you help with regular Social Security retirement issues?

Yes. If you have questions about your retirement benefits, including early retirement, or how your benefits may be affected by a retired or deceased spouse of yours, give me a call.