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your rights This information is not intended to constitute legal advice or to substitute for consulting with, or seeking advice from, a lawyer. While we intend to keep this information up-to-date, the accuracy should always be verified with an appropriate professional. Frequently Asked Questions about Social Security Disability:
What is Social Security Disability? Social Security Disability (known as Title II) is a federal benefit program for disabled individuals. To qualify, a person must a) be found "disabled" under Social Security rules and b) have worked enough years to have "insured status" before the disability began. Disabled workers who do not meet the earnings requirement may qualify for SSI benefits. What is the advantage in receiving Social Security Disability? If you are unable to work at all types of jobs, Social Security Disability can provide an ongoing monthly benefit to you and your family. If you are on Social Security Disability for two years you will receive a Medicare card, entitling you to health care benefits. How does a person apply for Social Security Disability? You can apply by contacting your nearest Social Security office. We recommend applying in person if you are able to do so. Does it cost to apply for Social Security Disability? There is no cost to apply. You do not need a lawyer to apply. But you should talk to a lawyer if you receive a letter denying your application. If I apply do I have to provide Social Security all of my medical records? The more information you provide Social Security on your disability, the better. But you can apply even if you do not personally have all the medical reports and records. You will be asked to provide contact information on the doctors you have seen. In theory, Social Security will seek those records. In practice, they may not receive all of the records. Thus, if there are important documents which show your disability, be sure to do what you can to get them to Social Security. What is the criterion for being disabled under Social Security rules? Social Security will decide whether they think you are unable to do ALL work for a year or more. The issue is not just whether you are unable to do your last job. Thus, if Social Security determines you are able to do other work-even if the other work is at a lower pay grade-you may be found "not disabled". How does Social Security make its determination? After you apply, Social Security will assemble some of your medical records. You may or may not be sent to a doctor chosen by Social Security. Many of these examinations are very brief. The doctors conducting these examinations frequently do not have all the medical records and spend very little time examining the claimant. Can you explain more about how Social Security analyzes whether someone is "disabled" or "not disabled"? You must be disabled (or be likely to be disabled) for 12 months or more in a row. Generally, Social Security determines whether the claimant can return to their "past relevant work". Under their rules, that means they will determine whether you can return to any of the jobs you held over the last 15 years. Again, if you can do a job you did several years ago, you could be found "not disabled" even though you cannot do your most recent higher paying job. Social Security will then determine whether you "meet or equal the listings". The listings are a list of impairments that automatically entitle a person to be found "disabled". If you are unable to return to your past relevant work but your impairment does not "meet or equal the listings", Social Security will determine whether in their view you can do other types of work. In making this determination, they will look at your age, education, work skills as well as all physical and mental impairments. Social Security has a complex system for analyzing all of these factors. For this reason, it is important that you provide them with information on all your impairments. If I am collecting workers’ compensation, can I receive Social Security Disability benefits? Yes. But there is an offset. The general rule is that your combined monthly Social Security benefit and your monthly workers’ compensation benefit is not to exceed 80% of your base period monthly earnings. If the combined benefits exceed the 80% threshold, Social Security will be entitled to reduce their payment. Computing this can be complicated. If I apply and am denied, what is the appeal time? You have 60 days from the date of the denial notice (in most cases stamped on the denial notice) plus there is a five (5) day grace period. Filing after that date will be too late. Time limit problems often arise where claimants wait until the last minute to mail in a reconsideration appeal request. It is not uncommon to see many problems arise when a claimant filed an appeal, but Social Security had no record of receiving the appeal. In many instances this resulted in a claimant having to start the whole application process over. Is re-filing a new application the same thing as filing a reconsideration appeal? No. If you are denied you should make every effort to file for reconsideration. If you file a new application you may be losing valuable time in the appeals process. Also, filing for reconsideration allows you to claim retroactive benefits. If I file for reconsideration after the initial denial, what can I expect? Social Security may or may not send you to a medical examiner of their choice. They will consider additional medical evidence provided. This reconsideration process may take a number or months. Social Security will then send you a letter announcing that they have found you "disabled" or "not disabled". If the reconsideration denial notice says that I am not disabled, can I appeal? Yes. The appeal from a reconsideration denial is called a request for hearing. The time frame to request a hearing is 60 days (plus five (5) days for mailing) from the reconsideration denial notice. Time limit problems can result if you wait until the last minute to file the appeal. We have seen problems where a claimant’s paperwork does not appear to have been actually received by Social Security. In such cases the claimant may have to start the process all over, thus having to file a new application for benefits (losing valuable time and often losing eligibility for some of the retroactive benefits) Is it a good idea to communicate with Social Security by return receipt mail? Yes, particularly where you are filing appeals with time deadlines. How can Boxer & Gerson help with a Social Security claim? Our attorneys can help you with the paperwork if your initial application is denied. We will help you evaluate what evidence you need to win your claim. Depending on the circumstances, we may help you develop the evidence by seeking clarification from your doctor. We have had years of experience attending Social Security disability hearings. Because Social security law can be highly technical, we can help you understand your legal rights. If I am collecting workers’ compensation, are there some pitfalls I need to be concerned about? Yes. If you are on Social Security or seeking Social Security, you need to make sure the terms of your workers’ compensation settlement do not damage your Social Security entitlement. The settlement agreement in a workers’ compensation case can be worded in a way that will minimize offset by Social Security. What you want to avoid is receiving a lump sum workers’ compensation settlement only to find that it greatly reduces your entitlement to Social Security benefits. Also, if you are settling future medical treatment in a workers’ compensation settlement, there are complex requirements to "consider Medicare’s interest". Therefore, if you are seeking Social Security, special care needs to be taken in settling a workers’ compensation case. Boxer & Gerson attorneys can discuss this with you. What happens at a Social Security hearing? The hearing is held by a federal administrative law judge. The judge may arrange for a doctor to appear as an expert witness (called a "medical advisor"). Even though the doctor has never seen you, the doctor may testify about what the medical evidence shows. The judge may also arrange for a vocational expert to appear. The vocational expert may be asked to identify possible alternative jobs you can perform. Typically the judge will ask questions about your ability to work based on various hypothetical situations (for example, for how long you can stand, how much you can lift or carry, how much you interact with the public, ability to focus on tasks, etc.). Some judges may use various medical opinions to pose multiple hypothetical questions to the vocational expert. It is very important to have a lawyer present at your hearing. The vocational expert testimony could make or break your case. Can I seek a legal consultation on my Social Security claim? Yes. Lawyers at Boxer & Gerson are pleased to discuss your Social Security Disability Claim. CAUTION: keep in mind that there are important time limits in Social Security Disability claims! You may lose your right to appeal denials if appeals are not filed within 65 days of the denial. You can contact us at 510-835-8870 or by completing our form. How are lawyers paid in Social Security claims? Lawyers are paid on a contingency basis. If you do not win your claim, there is no fee.  |
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