J. Paige Frampton, P.C.

 

 


Social Security

 

answers...

How do I begin a claim for social security disability benefits?

A claim is initiated by filing an initial application. You may visit your local social security office or consult with an attorney to begin the filing process. If you have internet access, you may also file online.

How does Social Security determine whether or not I am disabled?

You must have a medical condition or combination of conditions that has kept you from working, or can be expected to keep you from working for a 12 month period. In many cases, Social Security must find you are unable to perform any full time work.

What is the difference between social security disability and supplemental security income?

Social Security Disability (SSD) is known as Title 2 Disability benefits.  One is eligible to submit an application for these benefits if s/he has paid into the social security system and has obtained sufficient quarters of coverage or credits.  You may confirm whether you qualify by checking your annual earnings statement from the Social Security Administration.  Supplemental Security Income (SSI) is known as Title 16 Disability benefits.  It is a need based disability program and certain income requirements apply.   A person may apply for both types of benefits at the same time provided they meet the eligibility requirements.

I heard that you have to apply three times before Social Security will approve your claim. Is this true?

Not quite. Many claimants apply for social security disability repeatedly after receiving an initial denial. You are better off appealing the decision rather than applying again in most cases. Statistically, you have a greater chance of losing on the initial application for benefits but a greater chance of obtaining benefits on the appeal level before an administrative law judge.  Statistics also show that claimants who are represented have a greater chance of obtaining benefits as well.

How are attorneys paid in a social security disability claim?

Most of the time attorneys work on a contingent fee structure. This means that unless you win your case, you owe nothing to your representative (except for the costs of any medical records, etc). Social Security has capped the fee amount an attorney or non attorney representative can collect at $5300. This amount is generally withheld by Social Security from your past due benefits.  If 25% of the total past due benefits is an amount less than $5300, that is the fee your attorney will receive. An attorney may also suggest a fee petition arrangement in which case no fee is withheld from past due benefits and you will be expected to pay the attorney for his or her services at the conclusion of the case. Please note, however, Social Security must approve any fee before an attorney may collect it from his or her client. 

Right now, I cannot work, but I would like to return to work in the future.  Will I be able to return to work if I am approved social security disability benefits?

Yes. There is no requirement that Social Security Disability is permanent.  You may return to work following a favorable decision. There is even a “Trial Work Period” program that allows a claimant to work and continue to receive his or her benefits for a period of time.

If I am deemed “disabled” by Social Security, are my children entitled to any benefits?

If you have dependent children under the age of 18 or 19 and attending high school or a disabled child over the age of 18 whose disability began prior to age 22, they may be entitled to disability benefits on your record.  This amount is generally half of what the adult claimant’s benefit is or the family maximum. If you are applying for Supplemental Security Income only, your children will not receive dependent benefits unless they are found disabled under the SSI guidelines.

I am collecting worker’s compensation and my attorney told me not to apply for social security disability benefits.  Why?

There is no law or regulation that says you cannot collect both worker’s compensation benefits and social security disability benefits simultaneously.  However, some claimants are offset if they are awarded social security disability benefits. This is because there is a rule that states a claimant may only receive 80% of his or her average current earnings between social security disability and worker’s compensation benefits. If you are collecting both, you may be receiving over 80% of your average current earnings.  If you are, your social security disability benefit is reduced so that your full entitlement equals out to 80% of your average current earnings. In some states, however, a claimant’s worker’s compensation benefit is reduced and the social security disability is not.

I have thought about applying for social security disability but I look “fine.”  Nobody is ever going to believe I have a condition that truly is disabling.  Will it be a waste of my time? 

While there is much truth to the rumor social security disability is difficult to get, you should not be dissuaded if you are in fact unable to work but your appearance does not suggest this. There are various medical impairments invisible to the human eye, but just as severe as physically obvious impairments. It is critical that you have objective tests or medical evidence documenting the impairment exists, but you do not necessarily have to “appear” disabled.

I am only 45 years old.  If I apply for social security disability, will it reduce my social security retirement benefits so that I won’t have anything when I am in my 60s?

No!  This is a common misconception. If you apply for and receive social security disability benefits, you are receiving the benefit of an earnings “freeze.” This means that for the years you remain out of work, Social Security will not add in zeroes for those years in which you are not receiving any work income. If you cannot work because of a disability, you are better off applying for social  security disability benefits, or else you will continue to accumulate zeroes on your earnings record, which will in fact deplete your retirement benefits over time.

I am receiving private long term disability benefits. The insurance company wants me to apply for social security disability. Should I?

You will want to refer to the contract you have with your long term disability carrier to see if this is mandatory.  Many long term disability carriers require their insureds to apply for social security disability benefits.  They do this in order to save money and will actually offset what they pay you once you begin receiving social security disability benefits.  There is really no negative in applying for social security disability benefits in a situation such as this, but just know that most of the time, any past due benefits you receive from Social Security Disability go back to reimburse the long term disability carrier.  Conversely, Social Security will not reduce what they pay to you because you receive long term disability.

How long does the process of applying for social security disability take? 

It depends. If you win benefits on the first try, you are looking at 3-6 months on average. Unfortunately, most claims are denied and once you appeal your claim there is normally a waiting period to receive a hearing date.  This waiting period can last anywhere between 9-24 months, depending on the state and the hearing office’s backlog of cases. Most states require a claimant to exhaust a Reconsideration appeal before they can request a hearing before an administrative law judge. This appeal takes about 2-4 months. Pennsylvania no longer uses the Reconsideration appeal.

Is there anything I can do to expedite my claim?

It is best to speak with a qualified attorney who specializes in social security disability if you’re wondering whether there is anything that you can do to speed the processing time on your claim. Most attorneys offer a free consultation and only receive a fee if you win your case. Even if there is nothing that can be done to have your case heard any sooner, it will certainly be a benefit to develop a case strategy and discuss the strengths and weaknesses of your case with a professional. Attorneys may be utilized to develop case theories at hearing, obtain medical evidence, submit written statements and prepare witnesses for hearing.

What will I receive in terms of benefits?

If you are applying for Supplemental Security Income (SSI) only you are entitled to receive $637 per month as an individual in 2008. This amount is subject to annual cost of living increases but may be reduced if your household income changes. Your benefits will begin the first month after the application for benefits or the first month after you were found disabled, whichever date is later.  If you are applying for social security disability benefits, your benefits will depend on how long you’ve worked and how much you’ve earned over a period of time. Everyone’s entitlement is different in a SSD case, so it is best to refer to your annual Earnings Statement for the most accurate estimate. In SSD cases, benefits may be paid five full months after the claimant is found disabled or one year prior to the application date, whichever date is later. 

How about health insurance? 

One of the reasons people apply for social security disability or supplemental security income is to obtain health insurance. In a SSI claim, a claimant is entitled to Medicaid as of the date of the application.  In a social security disability case, a claimant is eligible for Medicare after a 24 month waiting period from the date the claimant was entitled to receive a monetary benefit. There are few situations in which a person’s Medicare eligibility waiting period is waived. These include claimants who suffer from End Stage Renal Disease and Lou Gehrig’s disease.

 

 

 

 

Nothing contained herein shall be taken as professional legal advice and no attorney client relationship
exists until a written agreement is made. Please contact an attorney for legal advice

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