|
DAVIS ELDER & DISABILITY LAW SERVICES
PO Box 754 Lewisville, NC 27023 (336) 499-0672 |
|
More Information: Social Security Disability Benefits Supplemental Security Income Medicaid Planning Guardianships Special Needs Trusts Veterans Benefits
|
SOCIAL SECURITY DISABILITY BENEFITS Frequently Asked Questions
What does Social Security mean by “disability”?
“Disability” is defined by the Social Security Act as the inability to perform substantial gainful activity for at least 12 continuous months by reason of physical and/or mental impairments.
Who can receive Disability benefits?
There are two different disability programs that may provide benefits.
Social Security Disability Insurance Benefits (DIB) are for disabled workers and certain dependants who have worked enough (generally 5 out of the last 10 years) to obtain the number of credits required to be eligible for benefits. In addition to the length of time spent working, you must also have earned a certain amount of money each year and have had FICA taxes withheld from your pay in order to receive credits.
Supplemental Security Income (SSI) is a program for the aged, blind or disabled. Children whose parents have low income and limited resources may also receive SSI benefits. In addition to proving that you are disabled under Social Security law, you must also demonstrate financial need by meeting strict limits on your income and resources (such as cars, bank accounts, etc.)
Many disabled people are entitled to benefits under both DIB and SSI at the same time ("concurrent eligibility").
The financial eligibility rules for SSI benefits are very strict. You should carefully review your assets to ensure that you do not own assets that will jeopardize your eligibility for SSI. Some common examples of assets that may prevent you from being eligible for SSI include: 1) cash or investments of more than $2,000 in value, 2) land other than your residence, 3) life insurance of more than $1,500 in value. For a complete list, refer to SSA's "Spotlight on SSI" at www.ssa.gov.
Do I get health care benefits if I qualify for disability benefits?
Yes! If you qualify for DIB then you will be eligible to receive Medicare two years after your disability benefits begin. If you are awarded SSI benefits in the State of North Carolina, then you will automatically receive Medicaid benefits.
I applied for Medicaid, but my application was denied since Social Security has not approved my disability claim. What can I do?
Appeal! As a general rule, your application for Medicaid will be denied at the first level. When you appeal your Medicaid decision, ask for a Medicaid hearing before a State Hearing Officer.
Many people successfully win Medicaid benefits before their disability case is ever even heard by Social Security. In many cases, you will need to have medical evidence that you can only develop if you have Medicaid and can thereby afford to visit the doctor.
If you have tried to apply for Medicaid at the local Department of Social Services and were told that you cannot submit an application until Social Security finds you disabled, go back and demand that a worker take your application. The law requires DSS to evaluate your claim for Medicaid independently from the Social Security Administration’s processing of your disability claim.
Unlike many law firms, Davis Elder & Disability Law Services will represent you at your State Medicaid Hearing in appropriate circumstances. Do you handle cases for disabled children?
Yes, we handle claims for disabled children. Keep in mind that the regulations for children's disability programs differ in significant ways from those covering adults. Many attorneys are either inexperienced in children's disability or hesitate to take such cases because the fees are generally lower. If you have been seeking representation for a disabled child, we would be happy to try to help you.
How do I file a claim for disability benefits?
The first step is to complete an application for benefits. You can obtain the application by visiting your local Social Security office and they can help you fill it out if necessary. You should always apply for disability as soon as possible after you become disabled.
What should I do if my application is denied?
Most applications (approximately 75%) are denied at the first level. Once you have been turned down, you should file a Request for Reconsideration. If you haven't already done so, this is also the good time to contact an attorney experienced in disability claims since an attorney can help you file your Request for Reconsideration. Usually within three to six months after your Request for Reconsideration is filed, the Social Security Administration will issue a new decision. Statistically, you will likely be turned down again unless your condition has significantly worsened. Nationally, about 90% of claims are denied upon reconsideration.
What should I do if my claim is denied after Reconsideration?
Appeal! Again, most claims are denied at the Reconsideration level. Upon receiving the denial, you should file a Request for a Hearing before an Administrative Law Judge. Although the Judges work with the Social Security Administration, they are independent and they are not bound by the earlier decisions in your case. At the hearing, the judges hear testimony from witnesses under oath, examine evidence from doctors, consider any legal arguments regarding your claim and ask questions about your situation.
What happens if I qualify for Social Security disability benefits?
If you are found disabled and awarded benefits, you will get paid retroactive benefits.
If you qualify for DIB, the will get paid retroactively for benefits beginning either five full months after the date that you became disabled OR for a maximum of twelve months back from the date that you applied for benefits. Social Security will use whichever date is the later. For example, suppose you became disabled on January 15, 2000 but didn’t apply for disability until January 15, 2001. In this case, you would be entitled to benefits beginning on July 1, 2000 since that date would be five full months after you became disabled. If, instead of applying for benefits on January 15, 2001, you had waited and applied for disability on November 1, 2001, then you would only be entitled to benefits from November 1, 2000 since that date would be a maximum of twelve months back from the date that you applied for disability. Again, you should always apply for benefits as soon after becoming disabled as possible.
If you qualify for SSI, then you will get paid retroactively for benefits beginning in the month that you applied for disability benefits. If you became disabled on January 15, 2000 and you did not apply for benefits until January 15, 2001, then you could only receive benefits beginning in January 2001.
How much money will I receive if I qualify for disability benefits?
If you qualify for DIB benefits, then you will get paid the same monthly amount you would receive if you had retired at full retirement age (generally 65 years old). Although Social Security often provides an estimate in your Annual Earning Report, the exact amount depends on your work history, how much you earned and how long you worked.
If you have received unemployment compensation or worker’s compensation, then your disability benefits may be reduced or even eliminated. Since each of these programs is designed to replace lost income that would have been earned if you could work, you are not permitted to double benefits under the programs. In the case of unemployment benefits, you are only entitled to receive payment if you were able to work but unable to find a job. By receiving such benefits, you are stating that you were not disabled from working. If you received worker’s compensation, at least some of the income lost from disability will have been provided under the worker’s compensation plan and your disability benefits must be reduced. It is often very important to have an attorney analyze your situation if you received worker’s compensation to avoid completely losing disability benefits.
For SSI, the maximum amount you receive is set each year by the government.
How much does it cost to hire an attorney?
Social Security has strict rules governing what an attorney can charge. We take disability cases on a contingency fee basis, which means that there is no attorney fee if you lose. If we win your case, then we charge 25% of your past-due benefits OR $5,300, whichever is less. Although there is no attorney fee if your case is unsuccessful, you are obligated to repay us for any expenses that we advance in the course of representing you. Such expenses usually involve paying doctors and hospitals for copies of your records, charges for photocopying Social Security records, postage/certified mail expenses and other similar costs. The total cost in most cases is less than $225.00.
Do I really need an attorney?
Statistics compiled by Social Security consistently show that individuals represented by an attorney are awarded disability benefits far more often than those who do not have an attorney representing them. Your right to an attorney is important and there are several advantages that you should consider before declining such assistance.
In choosing an attorney, we recommend that you seek a law firm that is experienced in Social Security disability law. We have handled hundreds of disability cases, regularly attend many hours of professional training directly related to disability law and we have detailed knowledge of Social Security rules and regulations. As you might expect, there are literally hundreds of complex laws relating to disability and these rules change frequently. By focusing our practice on disability law, we are able to devote the time needed to keep up with changes and understand this complicated area of law. If you are considering walking into your disability hearing without an attorney, ask yourself how many Social Security regulations you have read and how well you understand what Social Security law requires before you can be declared "disabled."
Some of the things that we do for our Social Security disability clients:
When should I contact an attorney?
As soon as possible! Contacting us early allows us to examine your situation and evaluate if you are disabled under the strict rules established by Social Security. You will then be able to decide whether or not you want to pursue an appeal of the decision. By deciding to talk with us early in the process, we can start developing ways to prove that you are disabled. Waiting until a week or two before your hearing to contact an attorney puts you at a significant disadvantage. The earlier an attorney starts working on your case, the better your chances of winning.
|
Serving: Alleghany Ashe Carrabus Davidson Davie Forsyth Iredell Rowan Stokes Surry Watauga Wilkes Yadkin Counties
|
|
|