If you or a loved one has suffered a serious illness or injury that lasted for a prolonged period of time, you may have wondered if you are eligible to receive Social Security Disability benefits. As attorneys specializing in Social Security Disability cases, we have seen common questions that arise in evaluating potential Social Security Disability claims. In this blog post we hope to provide you with some understanding of the claim process, the potential benefits available to you through the Social Security Administration and how an attorney can assist you in the process.
HOW DOES SOCIAL SECURITY DECIDE IF I AM DISABLED?
Social Security considers a person disabled if he or she has a severe impairment that is expected to last at least one year, or results in death and prevents them from engaging in substantial gainful activity. The Social Security Administration (SSA) uses a multi-step process to evaluate each claim. The very first question is whether or not the person is still working. The SSA will then acquire the claimant’s medical records from the treating doctors and all other treatment providers such as hospitals, physical therapists and counselors. The initial determination by SSA is based entirely on the application and the medical records.
HOW LONG DOES THE PROCESS TAKE?
From the time the initial application is led at the local Social Security office. it takes approximately four to five months for the SSA to issue a decision letter. If the claim is denied, the claimant has 60 days to file an appeal and request a hearing by an Administrative Law Judge. Once you decide to appeal, it is time to obtain an attorney to assist you in preparing for your hearing. It takes approximately one year from the time the appeal is filed until the actual hearing with the Social Security judge.
DOES SSA PROVIDE ANY BENEFITS FOR THE CHILDREN OF DISABLED INDIVIDUALS?
Yes, there are benefits available for children of disabled individuals up to the age of 18. There are multiple factors that the SSA takes into consideration but frequently families are able to obtain additional payments for dependent children.
HOW IS THE AMOUNT OF THE DISABILITY BENEFIT DETERMINED?
The Social Security Disability monthly payment is based on your earnings history in a way that is very similar to the way Social Security Retirement is calculated. If you review the earnings statement that the SSA sends you annually just prior to your birthday, you will find a section on the second page that will provide you with an estimate of your monthly benefit. (This is the letter that SSA sends you with the green stripe across the top of the page.)
HOW DO I APPLY FOR SOCIAL SECURITY DISABILITY?
There are two ways to apply for Social Security Disability benefits. The SSA is strongly encouraging claimants to file the initial application online. The SSA website, www.socialsecurity.gov is very user friendly and will guide you through the entire process. It is critical that you utilize a private computer since you will be disclosing personal identification information. You must also have access to a working printer. If you take the time to use the checklist SSA provides you to assist you in gathering all of the necessary information, the somewhat tedious process will go much more smoothly. It is acceptable to have someone assist you in filling out the forms and you may stop if you wish and return the application at another time. This is where the computer printer is vital because you must keep a copy of your re-entry number in order to pick up where you left off. As in all legal matters, you will want to keep a copy of your application and anything else that you submit to the SSA.
If you prefer, you may contact the local Social Security office and make an appointment to file your claim there in person. You will find the SSA personnel to be knowledgeable, courteous and helpful.
DOES SSA PROVIDE ANY ASSISTANCE FOR MEDICAL INSURANCE ONCE A CLAIM IS APPROVED?
Yes. After a waiting period that is roughly 30 months after the onset of your disability, the claimant is offered the opportunity to enroll in Medicare. Disabled persons then have the same health care benefits that retired persons receive from Medicare. While there is a charge for Medicare participation, it provides comprehensive medical insurance for disabled persons.
WHY DO I NEED AN ATTORNEY FOR MY DISABILITY APPEAL HEARING?
The SSA disability claim process is very heavily dependent on the medical records submitted to the SSA. In many instances, an experienced attorney can gather the medical evidence and present it to the SSA in a manner most favorable to your case. While the SSA performs the work of acquiring the medical evidence at the initial application stage, the responsibility to provide updated medical records switches over to the claimant or their representative at the appeal level. An attorney may be more successful in obtaining records from a hesitant or uncooperative medical provider as well. As was mentioned previously, it typically takes about twelve months after the filing of the appeal until you have your hearing. An experienced Social Security Disability attorney can help identify any areas of weakness in your case and make suggestions on how to resolve them. So, the time you are waiting becomes a time to actively develop your case more fully. When the time comes for the hearing, it is critical to have the assistance of an attorney who understands the SSA rules and regulations. Although all of the SSA judges are bound by the same rules, each is a unique individual with specific procedures and preferences. It is our belief that when your hearing day arrives and you have your approximately one hour in front of the judge, you have the best chance at a full favorable decision if you are represented by an experienced disability attorney who is familiar not only with the law and the facts of your claim, but also with the preferences of the Social Security Administration judge handling the hearing.
HOW DOES THE ATTORNEY GET PAID IN A SOCIAL SECURITY DISABILITY CLAIM?
By the time your case gets to the appeal hearing, you will be asking not only for the monthly benefit checks to start, but also for the past due benefits for all those months that your claim was being processed. The attorney fee is 25% of the past due benefits only but can never be more than $6,000.00 and is paid by the SSA from your past due benefits. In Social Security Disability, a claimant’s attorney does not get any portion of future benefits.
IS THERE A FEE FOR THE INITIAL CONSULTATION WITH THE ATTORNEY TO DISCUSS A POTENTIAL SOCIAL SECURITY DISABILITY CLAIM?
At KBG Injury Law, we offer a free consultation to discuss your case. We suggest that you contact us by phone or email. If you have to leave a message, the attorney or the paralegal will get back to you over the phone usually within one day to gather some basic information. Typically, some additional records or medical evidence is needed in order to fully figure out if we can successfully represent your claim. There is no charge to you for the initial evaluation.
The personal injury attorneys at KBG Injury Law are all experienced litigators. Almost all of them represented insurance companies prior to becoming advocates for injured people, which provides them with a unique perspective and insight into how these companies operate. They also offer extensive courtroom experience if going to trial is the best legal alternative for the client.