Frequently Asked Questions
1. What is the difference between Social Security Disability benefits and Supplemental Security Income benefits?
Both programs are administered by the Social Security Administration. For most people, the medical requirements are the same and the person’s disability is determined by the same process. The major difference is that Supplemental Security Income benefit decisions are also made on the basis of financial need.
Social Security Disability (“SSD”) benefits come from a program financed with Social Security taxes paid by workers, employers and self-employed persons. Disability benefits are payable to disabled workers, disabled widow(er)’s or adults who have been disabled since childhood, who are otherwise eligible. Auxiliary benefits may be payable to an individual’s dependent children as well. The monthly disability payment is based on the Social Security earnings of the insured worker on whose Social Security number the disability claim is filed. Currently the most an individual can receive is $2185 per month. When you have been disabled for 24 full calendar months, you are entitled to Medicare at a nominal cost.
Supplemental Security Income (“SSI”) is a welfare type program financed through general tax revenues. SSI disability benefits are payable to adults or children who are disabled, meet the income, resource and living arrangement requirements, and are otherwise eligible. Currently, the asset limit is $2,000 for individuals and $3,000 for couples. No Auxiliary benefits are paid with SSI. The monthly amount of SSI payments are different in every state and can vary depending on the individual’s income and resources. In California the maximum amount is currently $870 per month for an individual and $1525 a month for a couple .You can be eligible for SSI even if you have never worked or paid taxes under FICA. Generally, to be eligible for SSI, you need to be a U.S. citizen or meet certain requirements for non-citizens. If you receive SSI you are entitled to Medicaid, which is free. In California this is referred to as Medi-Cal.
2. Can I receive both Social Security Disability benefits and Supplemental Security Income simultaneously?
Sometimes. It depends on how much you are entitled to receive through the Social Security Disability benefits program. If your disability amount represents the maximum allotted amount you are permitted to receive under the law, you will not be entitled to any additional resources through the Supplemental Security Income program.
3. What is the earliest age that a person can receive Social Security Disability benefits?
There is no minimum age. However, to qualify for Social Security Disability benefits, you must have worked long enough and recently enough under Social Security. You can earn up to a maximum of four (4) work credits per year. The amount of earnings required for to earn one credit increases each year. The number of work credits you need for Social Security Disability benefits depends on your age when you became disabled. Generally you need twenty (20) credits earned in the last ten (10) years ending with the year you became disabled. However, some younger workers, depending on their age, may qualify with fewer credits.
4. Do you have to be permanently disabled to get Social Security Disability benefits?
No. You have to have been disabled for at least a year, or be expected to be disabled for at least a year, or have a condition that can be expected to result in death.
5. What is the definition of disability used by Social Security?
Under the Social Security Act, "disability" means "[the] inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months."
6. What are examples of disabilities?
Anxiety Disorders • Asbestosis • Asthma • Back Pain • Bipolar Disorder • Blindness • Cancer • Carpal Tunnel • Chronic Fatigue • Chronic Pain Syndrome • Diabetes • Depression • Emphysema • Epilepsy • Fibromyalgia • Herniated Disc • Hip Replacement • HIV / AIDS • Heart Disease • Knee Replacement • Personality Disorder • Mental Retardation • Reflex Sympathetic Dystrophy • Leukemia • Arthritis • Multiple Sclerosis • Migraine Headaches • Neck Pain • Joint Pain • Schizophrenia • Seizures • Stroke • Lupus • Hepatitis C
7. How do I apply for Social Security Disability benefits?
You can fill out an application for Social Security Disability benefits at the local Social Security office nearest to your home, by telephone, or via the internet. The address and telephone number of your local Social Security office can be obtained by calling 1-800-772-1213. The website address is www.ssa.gov. When applying you should be prepared to give Social Security a list with the names, addresses and phone numbers of all the doctors, hospitals or clinics who have treated you for your condition. You should also bring a list of where you have worked in the past 15 years.
You will also need to provide Social Security with an original or certified copy of your birth certificate, your last earnings documents (W-2, last pay stub, statement of your employer, etc.) and copies (keep the originals) of any medical records you may be able to obtain.
Please note, however, that you should not delay filing for benefits if all documents are not immediately available.
8. How long do I have to wait after becoming disabled before I can file for Social Security Disability benefits?
Not even one day. You can file for Social Security Disability benefits on the very same day that you become disabled. Many individuals make the mistake of waiting months and even years after becoming disabled before filing a Social Security Disability claim. There is no reason to file a Social Security Disability claim if one has only a minor illness or one which is unlikely to last a year or more. However, an individual who suffers serious illness or injury and expects to be out of work for a year or more should not delay in filing a claim for Social Security Disability benefits.
9. Do I need an Attorney?
You have the right to have an attorney represent you in your Social Security Disability case. Statistics have shown that claimants represented by attorneys have been much more successful than people without representation. You should seriously consider the advantages of having an attorney represent you by examining all the different services that an attorney would perform in regards to your claim.
10. When should I contact an attorney?
As soon as possible, preferably as soon as your initial application is denied. An attorney will then be able to start assisting you in determining if you are disabled, as that term is defined by the Social Security Act. Your attorney can begin the appeals process for you and start developing ways to prove to the Social Security Administration that you are disabled.
Attorneys in Social Security Disability cases do much more than sit in at a hearing and ask a few questions. Diligent representation includes pre-hearing preparation, analysis and evidence gathering for your case. For this reason you should not wait until a week or two before your hearing to contact an attorney. The earlier an attorney is able to start working on your case, the better your chances of winning.
Please note that not all attorneys practice before the Social Security Administration. You will do best to find an attorney familiar with the complex Social Security Disability regulations and the somewhat unusual Social Security Disability procedures.
11. How does Social Security determine if I am disabled?
To receive benefits under the Social Security Disability program, you must have a physical or mental impairment (or a combination of impairments) severe enough to keep you from working fulltime in any regular paying job for at least one year or result in death. The test isn't whether or not you are able to go back to your old job, and the test isn't whether or not you have been able to find a job lately. Rather, the test is whether you are capable of doing any job available in the national economy (even if this job involves different skills or pays less than your previous work). By using an extensive set of regulations, the Social Security Administration takes into account your medical condition, your age, your abilities, your training and your work experience in deciding your case.
The Five Step Evaluation that Social Security uses to determine if you are disabled is as follows:
1. Are you working? If you are and you are earning more than the current Substantial Gainful Activity amount (currently $940 a month), you generally cannot be considered disabled;
2. Is your condition severe? Your impairment must be expected to last one year or result in death and interfered with basic work related activities;
3. Is your condition found in the list of disabling impairments? Social Security maintains a list of impairments for each of the major body systems that are so severe they automatically mean you are disabled. If your condition is not on this list, Social Security has to decide if it is of equal severity to an impairment on this list. If it is, your claim is approved. If it is not, Social Security goes on to the next step;
4. Can you do the work you did previously? Does you condition prevent you from doing any work that you did in the last fifteen (15) years. If it does not, your claim will be denied. If it does, your claim will proceed to the fifth and final step of the evaluation;
5. Can you do any other type of work available in the national economy? Social Security considers your age, education, past work experience, and transferable skills against the job demands of occupations as determined by the Department of Labor. If you cannot do any other kind of work, your claim will be approved. If you can, your claim will be denied.
12. Why does it take the Social Security Administration so long to decide my claim? The Social Security Administration processes hundreds of thousands of claims every year. Due to the volume of applicants and the current staffing issues throughout the Administration, your claim may not be resolved for several years. However, if you are granted, you will be entitled to benefits that accrued during this waiting period. Applicants often think that attorneys can speed up the process. However, we are subjected to the same timelines as everyone else. |
Under certain circumstances, applications will be processed more quickly if there is a dire need situation or a terminal illness is imminent. Please contact your attorney to see if this applies to you.
13. If I am approved for Social Security Disability benefits, how much will I get?
That depends on the type of benefit you have applied for. For Social Security Disability benefits, it depends upon how much the wage earner worked and earned in the past. For all types of SSI benefits, there is a base amount that an individual with no other income receives. Other income that an individual has reduces the amount of SSI which an individual can receive.
14. How far back will my retroactive benefits go?
It depends on what application you have filed. The Supplemental Security Income program allows benefits from your date of initial application. The Social Security Disability program allows you to obtain a maximum period of retroactive benefits one year before your application date.
15. Will I get health insurance from the Social Security Administration if I am granted?
Yes. The Supplemental Security Income program provides you with Medi-Cal in the state of California. The Social Security Disability benefit program entitles you to Medicare once your disability has been established for 24 months.
16. What do I do if I am denied benefits?
Appeal! Many disabled people become disheartened and frustrated after they receive a disability benefits denial notice and do not appeal. This is often a mistake. Nationally, about 75% of all applicants are denied initially and about 90% are denied at the first appeal stage -Reconsideration. But many of these people ultimately receive their benefits, nationally about 70%.
What may be most frustrating about applying for Social Security Disability benefits is the process itself. Those who apply are often made to feel like they are asking for something that they do not deserve, and nothing could be further from the truth. Social Security Disability is not a welfare program; these benefits are paid for by you and were intended to act as a financial buffer in case you or a family member became seriously ill or injured. Therefore if you are unable to work, but you have been denied benefits, you should appeal.
17. How long will I be able to receive Social Security Disability benefits?
You will receive Social Security Disability benefits as long as you remain disabled and unable to work. Your benefits will not run out because you did not contribute enough into the Social Security system.
18. I was disabled for seven months, but able to return to work after surgery. Am I able to get benefits for the 7 months I was unemployed?
No. In order to be eligible for Social Security Disability and Supplemental Security Income benefits your disability must have lasted or be expected to last for a continuous period of at least 12 months, or be expected to result in death. The Supreme Court has ruled that if your disability
lasts less than a full year, you are not entitled to receive benefits.
19. Can I work and still receive Social Security Disability and Supplemental Security Income benefits?
Sometimes. Of course, work does affect your Social Security Disability and Supplemental Security Income applications. After all, you are alleging that your disability prevents you from being able to work. In certain instances, you may be permitted to work at such a level that it does not jeopardize your claim for benefits. You must speak to your attorney immediately before returning to work. Based on your specific situation, your attorney will advise you as to what your options are and how your choices may affect your case.
20. If I get on Social Security Disability benefits and feel better and want to return to work, can I return to work?
Yes. Social Security wants individuals drawing disability benefits to return to work and gives them every encouragement to do so. Social Security permits a “Trial Work Period” in which individuals can test their ability to perform services without jeopardizing their benefits. Contact your attorney if this applies to you.
21. What is an onset date?
An onset date is the date that you stopped working on a fulltime basis as a result of your symptoms. It is not the date that your symptoms first began.
22. The Administration says that I am no longer insured for benefits, but I used to work. How can this be?
While there is no expiration date associated with a Supplemental Security Income claim, a Social Security Disability claim requires that you worked both long enough and recently enough to be insured to benefits. Often referred to as the 20/40 rule, you generally need at least 20 credits earned over the last 10 years to be technically eligible for Social Security Disability benefits.
23. I can’t afford to see a doctor. Will that affect my case?
Yes. These are medical claims. Benefits are not awarded without medical proof from treating doctors who provide medically documented support for a person’s inability to function. The clinical findings, test results, and the written opinions of the treating physicians are the key to any disability claim. No opinion regarding the severity of a medical problem will be given great weight without supportive medical findings.
If you are without insurance, we recommend that you seek out county facilities and/or free clinics for treatment.
24. What will take place the day of the hearing?
At the hearing, you will testify about your disability and how it prevents you from working. Both the administrative law judge and your attorney will ask you questions regarding your impairment, your work history and your daily activities. Each administrative law judge conducts the hearing differently. Your attorney will tell you what to expect with the particular judge assigned to hear your case. The administrative law judge may call either, or both, a vocational expert and a medical expert to testify at your hearing. These are people you have never met. The vocational expert will summarize your work history for the last 15 years. The medical expert will summarize the medical records and give his/her opinion as to your limitations. Each hearing takes approximately one hour to complete, but it can be shorter or longer depending on the judge assigned. Once the administrative law judge concludes the hearing, a formal written decision will be issued in about 90 days.
25. Will a judge deny me if I do not look sick?
No. These judges have handled many claims and recognize that not all disabilities have physical manifestations. Mental, neurological and even orthopedic problems do not always have physical signs. It is never a good idea to manufacture a physical symptom just because you think it will prove to the judge that you are sick. If you do not use a wheelchair to move around, do not bring one to the hearing. If you do not need a walker, do not bring this to the hearing. Exaggerating a symptom will only have adverse affects on your credibility.
26. Will my Workers' Compensation payments and other disability payments affect my Social Security Disability benefits?
Ordinarily, disability payments from other sources do not affect your Social Security Disability benefits. However, if the disability payment that you receive is Workers' Compensation or another public disability payment (such as some civil service disability benefits, some military disability benefits, some Federal, State or Local government retirement benefits which are based on disability) yours and your family's Social Security benefits may be reduced.
Your Social Security Disability benefit will be reduced so that the combined amount of the Social Security Disability benefit you and your family receive plus your Workers' Compensation payment and/or public disability payment does not exceed eighty percent (80%) of your average current earnings.
27. Can I collect unemployment benefits and still receive benefits from Social Security?
Yes, BUT proceed with caution. While there are no regulations, rulings or guidelines that prohibit the receipt of unemployment and Social Security benefits simultaneously, the two programs are facially inconsistent. When you apply for unemployment, you are alleging that you are physically and mentally able to work, but that you cannot find a job. When you apply for Social Security benefits, you are alleging that you cannot physically or mentally work, and therefore, you are not seeking employment. The judge may use evidence of your unemployment benefits to question your credibility.
28. My doctor says I am disabled, so why is Social Security denying my Social Security Disability claim?
Social Security's position is that it is not up to your doctor to determine whether or not you are disabled. It is up to them and they will make their own independent decision regardless of what your doctor thinks.
29. Veterans Affairs says I am disabled, so why is Social Security denying my Social Security Disability claim?
It is Social Security's position that Veterans Affairs (”VA”) decisions are not binding upon them. Social Security and the VA, while both government agencies, have very different standards for approving disability claims.
30. If I should die before my claim is resolved, will my family get my benefits?
Sometimes. Children, spouses, parents, and executors may be eligible under the Social Security Disability program to receive benefits on behalf of the deceased. More remote family members are not. Conversely, a Supplemental Security Income application normally ends once the applicant is deceased, but there may be a limited exception.
31. Do I have to pay income taxes on benefits?
Sometimes. We recommend that you consult a tax advisor to ensure proper filing. Generally speaking, less than one-third of current Social Security beneficiaries pay taxes on their benefits. You will have to pay federal taxes on your benefits if you file a federal tax return as an "individual" and your total income is more than $25,000. If you file a joint return, you will have to pay taxes if you and your spouse have a total income that is more than $32,000. For more information, call the Internal Revenue Service (IRS) toll-free at 1-800-829-3676 and ask for IRS Publication Number 915, Social Security and Equivalent Railroad Retirement Benefits.
To schedule a free consultation with an experienced attorney, please call our toll-free number at (800) 459-3017. There is never a fee for a consultation and there are no attorneys’ fees for representation in a Social Security matter unless we are successful in your quest for benefits.