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What factors determine whether someone qualifies for social security disability benefits?

For adults, social security seeks to determine whether a person can work given their age, education, past relevant work, and medical limitations. Most people assume that because they cannot do their past relevant work they will qualify. However, it is not that simple. If SSA thinks there is other work you can do in light of the above factors, they will likely deny your claim. Also, even if you are unable to work at all, you must prove that your disability lasted, or is expected to last, at least 12 months. At the hearing level, judges will often rely on the testimony of a vocational expert to help them decide whether there is any work a person can do if they cannot return to their past job. A skilled attorney can cross examine such job experts and get them to admit that a truly disabled person cannot work.

What are the requirements for child disability benefits (SSI)?

Social security will look at whether your child has a listed condition, a severe impairment, or two "marked" impairments. Proving a listed condition is very difficult and the requirements tend to be very demanding. However, your child is considered disabled if he or she has either one severe, or two "marked" limitations in the domains of 1) acquiring and using information; 2) attending and completing tasks; 3) interacting and relating with others; 4) moving and manipulating objects; 5) caring for him or herself; and 5) health and well being.

What is the difference between SSI and SSD?

Social Security has two disability programs: SSI and SSD. These are also known as "title 16" and "title 2" respectively. Both programs look at the factors discussed above to determine if a person is capable of working. But SSI differs from SSD in two important ways: 1) it is a "means based" program, meaning it is intended for individuals with financial need who have not earned enough quarters of coverage to qualify for SSD; and 2) the monthly award is determined by federal and state guidelines and is generally lower than SSD award amounts. To qualify for SSD, a person has to have 20 quarters of coverage in the 10 years preceding their application for disability; and award amounts are based on a person's earnings record. Because SSD is not "means based" a person will not lose eligibility based on having too much money in the bank.

I just received a letter from social security denying my SSI or SSD disability application. What do I do?

Make sure you request an appeal in writing within 60 days of receiving your denial letter. Requesting an appeal verbally, on the phone with a social security representative, does not count. I have heard from many disabled individuals who thought they had filed an appeal simply because they told a social security representative over the phone that they wanted to appeal a decision. Social security will often mislead such persons into thinking that an appeal is filed once a person has told a representative on the phone that they would like to appeal. However, it does not work like that. You must inform social security by completing an online appeal, if your case was based on an SSD claim; or by filing form SSA HA-501 U5. Of course, you can retain an attorney and have them file the appeal on your behalf, which is actually your best option. Just be sure to act soon after receiving your letter. How do I prepare for a Social Security Disability Appeal hearing?First of all, make sure you have an attorney. Social Security laws and regulations can be complex and confusing, and it is important that you understand the rules governing the hearing process. For example, all medical evidence must be submitted to SSA no fewer than five business days before a hearing. Likewise, medical and vocational experts typically testify at hearings. If you are unable to effectively cross examine these individuals, there is a good chance that their testimony will provide the basis for a denial. Lastly, make sure you have plenty of current medical evidence. By the time a case gets before a judge, it has typically been 1.5 to 2 years. During that time, social security has not ordered any medical records. It is your obligation to get medical records for that period of time to prove your case. Judges will deny a case if they cannot point to medical evidence which proves the disability that a person is trying to establish.

Can I get my own medical records?

Yes! In fact, under newly enacted legislation in New York State, medical providers are obligated to provide records free of charge if: 1) a patient asks for them directly; 2) for the purposes of a social security disability application or hearing; and 3) the facility has records in "electronic format." Since it is the 21st century, virtually every office in existence will have records in "electronic" format. This means that if you have an SSI or SSD application, or hearing, your doctors must turn over your records to you free of charge when you ask for them directly. If you have someone else ask for the records, your doctors can charge $.75 per page as a printing/copying fee. I have received invoices as high as $1800 for medical records prior to enactment of the new law.

Can I collect early retirement and SSD at the same time?

If you retired early because of a disability, you can apply for SSD benefits and, if successful, get the difference between you early retirement and full retirement benefits retroactively. Once you have won your case, your monthly benefit will turn into a full retirement benefit.

How much are the legal fees in social security cases?

My office will only charge a fee if we win your case. And that fee is 25% of any back-pay social security owes you up to a limit of $6,000. The social security administration periodically increases the cap on legal fees; but it is currently set at $6,000.

* This is attorney advertising and past results do not guarantee future outcomes. *

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