Do I have a Social Security Disability Case?
SSD or SSI
To receive SSD (Social Security Disability) your need to have:
Eligibility
You have to be both fully insured and currently insured.
a. Fully insured 40 quarters (10 years) of "work" in your lifetime or at least six quarters and one quarter per year for all years after age 21 and to your age now.
b. Currently insured 20 quarters out of the last 40 or, if less than 31 years old, then half of the quarters from age 21 to present.
Dependents? They too are eligible for benefits based on your work record (kids must be less than 18 or 19 or under and in high school or between 18 and 22 and disabled and dependent on the wage earner).
To receive SSI (Supplemental Security Income) or the federal version of welfare, you need not have an earnings record. But there is a resource test; if you have resources of $ 2,000.00 or more this may disqualify from receiving SSI, i.e. $ 5,000.00 in a bank account.
Disability Defined:
Both SSD and SSI require that you be "disabled". The test for both is the same, that is, inability to engage in substantial gainful employment because of a medically determinable impairment (physical or mental) which can be expected to result in death or which has lasted or can be expected to lat for a continuous period of not less than 12 months.
How does the Social Security Administration determine if I am in fact disabled?
Social Security uses a 5 step process as follows:
1. At the first step, SSA considers your work activity, if any. If you are doing substantial gainful activity, SSA will find that you are not disabled. That is if you are currently working you are not entitled to SSD. Makes sense!
2. At the second step, SSA considers the medical severity of your impairment(s). If you do not have a severe medical or mental impairment that meets the duration requirement in §404.1509, or a combination of impairments that is severe and meets the duration requirement, SSA will find that you are not disabled.
3. At the third step, SSA also considers the medical severity of your impairment(s). If you have an impairment(s) that meets or equals one of our listings and meets the duration requirement, SSA will find that you are disabled. http://www.ssa.gov/disability/professionals/bluebook/
4. ) At the fourth step, we consider our assessment of your residual functional capacity ( what you have left as far as your physical ability) and your past relevant work. If you can still do your past relevant work, we will find that you are not disabled.
5. At the fifth and last step, SSA considers their assessment of your residual functional capacity and your age, education, and work experience to see if you can make an adjustment to other work. If you can make an adjustment to other work, SSA will find that you are not disabled. If you cannot make an adjustment to other work, SSA will find that you are disabled.
How long does the process take?
This varies depending on where you live. Because of the backlog of 745,110 cases (reported in the USA Today Monday July30, 2007) it may take from 14 to 18 months or longer.
The initial determination on your application may take anywhere from four to six months. If your claim is approved at this point, you can probably expect payment to begin within 30 to 45 days. If your claim is denied you then have 60 days from the date you receive your initial denial to file a reconsideration. Once you file a reconsideration you should hear something from Social Security within two to four months.
If you are denied on reconsideration, you then must request a hearing before an administrative law judge within 60 days from the date that you receive your reconsideration. You can then expect a hearing, probably in the 14 to 18 months.
If your claim is denied by the administrative law judge you can ask the Appeals Council to review your case. Again, you must ask for this review within 60 days of receiving the decision from the administrative law judge.
If the Appeals Council denies your claim, you then have 60 days to file an action for review and the Federal District Court.
What about Attorney Fees?
First of all, there are no attorney fees if the attorney does not win your case. If you do receive a favorable decision on your case, the Social Security administration will withhold up to 25% of past due benefits or $5,300, whichever amount is less. They will pay that directly to your attorney.
Our office offers you a free consultation with regard to your Social Security case. Either John Jeren jj@jhsthlaw.com or Michael Tiberio mt@jhsthlaw.com can answer your questions. Don't hesitate to contact us; we can assist you in getting your claim allowed.