10 Key Things To Know About SSD
Most people rely exclusively on the social security system to provide the safety net they need. We help disabled persons get social security disability benefits (both SSDIB and SSI) and Medicare coverage. We represent both children and adults. Depending on the person’s needs, we may start with the application process itself. Sometimes persons choose to contact us after they have been denied benefits. If necessary, we may take the claim to federal court, as well. We are ready to help.
Our office does not charge for an initial consultation, and in social security disability cases, legal fees are not payable, unless disability benefits are obtained.
There is a lot to know. Among the things important to know are the following:
1. If a person is medically disabled, there are two types of social security disability benefits available:
A) SSDib (Title II) stands for Social Security Disability Insurance benefits. These benefits are based on the individual’s work history and past payment of social security taxes. Whether the benefits are payable and the amount of benefits payable depend on the amount of social security taxes paid. Under this disability benefit, Medicare coverage becomes available two years after the date SSDib disability benefits are first payable, not necessarily two years after the date of the application. Consequently, it is more important than ever, to identify the earliest onset date of disability.
B) SSI (Title XVI) stands for Social Security Supplemental Income benefits. This is a federal welfare program for persons who meet the definition of disability under the Social Security Act, but who have not worked enough to qualify for SSDib. Medicare coverage is not available, but persons may apply for Medicaid coverage through the state where they reside.
2. Disability is not necessarily visible. That is one reason why the disability application process is difficult, and it takes a long time. Severe pain or severe fatigue, for example, cannot be seen on an X-ray. Note that a person who has just been diagnosed with a terminal cancer will not necessarily “look” or act disabled…at least not yet. For some people, the disability is episodic, such as in cases of asthma or seizure disorders.
3. It is important to get medical treatment and other evidence to prove disability. The burden to get the necessary medical evidence is on you, the applicant. People often do not know what type of evidence is needed. For example, Social Security does not always accept medical diagnoses from certain providers, such as nurse practitioners, physicians assistants, therapists or chiropractors. Sometimes people have been afraid to see doctors, or to go to the emergency room. Some have not been able to afford medical care. Many are often unjustly denied benefits because of a lack of proof. We can help the applicant get medical evidence and other evidence that the Social Security Administration needs.
4. Persons with physical or mental health impairments are often overwhelmed by the process. Sometimes they are simply not well enough to do it on their own. They may not follow through with the effort and “give up” even though they may qualify for benefits.
5. To qualify for benefits, the person has to have one or more physical and/or mental impairments that prevents him/her from sustaining gainful employment for at least one year. The person does not have to be disabled for one year before he/she applies for benefits. If a person’s medical condition(s) is severe enough that treatment is expected to last at least a year or more, the individual may apply for social security disability benefits immediately.
6. Because of work incentive rules, some individuals may work and still collect social security disability and Medicare benefits. A person does not need to be completely out of work to qualify. We encourage our clients with disabilities to work as long as possible. Continued employment, even if is part-time, allows the individual to stay connected to the community, improves their outlook, and often speeds up medical recovery. Disability does not need to be permanent.
7. Mental conditions (including learning disability) are equally important as physical conditions, when seeking disability benefits. Some persons with mental health impairments are embarrassed by their difficulties and will not disclose mental health impairments at all.
8. After an initial denial, the appeal process takes more than a year. If the claim has to go to federal court, it may take another year longer. Applicants for social security disability benefits should therefore obtain legal representation as early in the process as possible, to obtain benefits as quickly as possible.
9. The Social Security disability regulations have been toughened in the past few years. Many changes are happening. We are keeping track of those changes to help individuals get favorable awards more quickly. It is more important than ever to make your strongest application as early as possible.
10. Terminal Illness Cases (Terri Cases): When a person applies for social security disability, they get their place in line and wait their turn for processing. The SSA has rules and guidelines allow for expedited processing of claims when the individual has a terminal illness. The claim needs to be identified as a “TERRI case” referring to terminal illness. There are many reasons why terminal illness cases often do not get expedited treatment.