You may qualify for early Social Security Retirement at age 62 but not Disability Insurance Benefits (DIB), which is also called Title II benefits or Social Security Disability Insurance benefits (SSDI). You generally need to have worked five out of the last ten years and have sufficient quarters of coverage. This analysis is affected by the date you allege that you became unable to work, as well as the salary you earned. Claimants 31 years old or younger have different earnings requirements.
If you are ineligible for DIB, you may still be eligible for Supplemental Security Income (SSI), also called Title XVI benefits. Because SSI is a needs based (welfare) program, you must undergo a financial analysis of your income, the income of your spouse, household resources, etc.
2. After I learn that my case is approved at the Initial or Reconsideration level by the GA Department of Labor, Disability Adjudication Services or by an Administrative Law Judge at a hearing, I will get a check in the mail in the next week.
When you are found disabled at the Initial or Reconsideration level by the GA Department of Labor, Disability Adjudication Services (DAS), you will not receive a decision. If you are eligible for SSI, you will receive a letter stating that a financial interview (PERK interview) has been scheduled with the Social Security District Office. During the interview, you will be asked questions about your living arrangement, income, and resources. The interviewer will have to calculate the amount of your monthly SSI payment based on this information. You need to ask the interviewer how long it will take before you will get a monthly SSI check, as well as your back pay.
If you are eligible for DIB (Title II), you will get a letter from a payment center from locations such as Baltimore, Birmingham or Philadelphia stating how much you will receive and when you will receive your benefits.
If you are told that you are disabled at a Hearing before an Administrative Law Judge at the Office of Disabililty Adjudication and Review (ODAR), you must wait for the decision to be written by an attorney-advisor or paralegal. The decision could be mailed to you anywhere from one month to a year depending on the Judge. You will then receive a financial interview (PERK interview) notice from the District Office and/or a letter from a payment center.
3. If I go to the hearing and tell the Judge what is wrong with me, he will believe me, because I am telling the truth.
Your testimony alone will not convince the Judge that you are disabled. You must have ongoing treatment for each of your mental and/or physical conditions for the GA Department of Labor, DAS, or the Administrative Law Judge to find your testimony credible. To make your case stronger, you should have a physician and/or a psychiatrist attest to your work-related limitations in forms provided by your attorney.You also need treatment records from these sources. The more physicians and/or psychiatrists who can verify your medical conditions and limitations, the better. Even in rare circumstances, if you should win based upon your testimony alone, without your having ongoing treatment, the Appeals Council could review the case and send it back to the Office of Disabililty Adjudication and Review (ODAR) for lack of evidence. This scenario happened to one of my clients, who said that he did not have any money for transportation to pursue treatment.
4. If I am not in medical treatment, it won’t matter, because SSA will have me evaluated by one of their psychologists, psychiatrists or physicians.
An Adjudicator at the Georgia Department of Labor, Disability Adjudication Services (DAS) or an Administrative Law Judge at the Office of Disability Adjudication and Review (ODAR) may schedule you for an evaluation with a psychologist or physician called a consultative examiner. However, some Adjudicators or Judges may deny an attorney’s request for a consultative evaluation with a psychologist, psychiatrist or physician. Because of the cost, SSA infrequently orders psychiatric or neuro- psychological evaluations.
Claimants often complain that these consultative psychologists or physicians do not spend much time evaluating them. Psychological testing may be performed by a student assistant and not the psychologist. Physical examinations could be as brief as five minutes. Therefore, the best way to develop your case is to pursue ongoing treatment with your own psychologist, psychiatrist or physician.
5. If I allege that I became disabled ten years ago and the GA Department of Labor, DAS, or the Judge rules in my favor, I will be paid retroactively back ten years.
The sooner you file an application for social security disability benefits, the better.The most benefits that the Social Security Administration can pay you is one year before the date you file an application for Disability Insurance Benefits (DIB), Disabled Widow’s or Widower’s benefits, Disabled Adult Child Benefits (DAC) or Child Insurance Benefits. The benefit amount may be reduced depending on the onset date found by the Adjudicator or Administrative Law Judge (ALJ).
You can only be paid benefits from the filing date of the Supplemental Security Income (SSI) application but no sooner.
If you establish that you have new and material evidence and meet certain date requirements based upon how much time has elapsed between the initial denial on an old application and the filing date of a new application, you could have a prior application reopened. This is within the discretion of the Adjudicator or the Administrative Law Judge. Then, your benefits could go back further. Reopenings of new applications filed within one year of the initial denial on the previous claim, have to be reopened automatically.
6. I know someone who receives social security disability benefits, but there is nothing wrong with him.
You are not a physician or a psychiatrist, so you do not have the expertise to determine whether there is something medically wrong with a person. Someone could be awarded benefits based upon a low IQ score, a mental condition without overt symptoms, or a physical condition such as multiple sclerosis or Chron’s Disease with periods of remission. Also, looks can be deceiving. For example, someone with a mental or physical condition could expend a great deal of effort making himself/herself presentable to the public.
7. My friend and I have the same illness. Because my friend gets social security disability benefits, I will too.
Your friend may have one or more physicians, psychiatrists or psychologists who found that he/she has disabling physical or mental limitations.In addition, your friend may have better documented impairments, medical signs, and symptoms in the medical records.Finally, a friend, who is diagnosed with the same illness or disease, may receive a different outcome, because Adjudicators and Adminstrative Law Judges (ALJs), who review each file separately, have different mindsets and make independent decisions.
8. If I get a statement from my physician, psychologist or psychiatrist that I cannot work OR I have a VA rating of 100 percent disability, then I will automatically be found disabled by the Social Security Administration.
An Adjudicator or an Administrative Law Judge (ALJ), who will determine whether you are disabled based upon the complete record, may decide that your psychiatrist’s/physician’s opinion or another agency’s opinion such as the Veteran’s Administration’s or Long or Short Term Disability Carrier’s that you are disabled is not entitled to any weight. For example, an Adjudicator or an Administrative Law Judge (ALJ) could find that your psychiatrist’s/physician’s opinion is inconsistent with findings in the medical records. The judge must have good cause for discounting your psychiatrist’s/physician’s opinion, as well as a finding of disability by another agency. When the judge does not have good cause, the case will remanded, ie sent back, for a new hearing.
Each judge has his/her own style. At the hearing, some Judges like to ask questions before the attorney does. Other judges have the attorney ask most of the questions. Each judge also has his/her own approach as far as announcing a decision on the day of the hearing. Some judges never announce the decision on the day of the hearing. Other judges will tell you if they are finding you disabled depending upon the facts of your case.
Lastly, some judges might ask you to change the date that you said that you became disabled. If a judge does not think that there is sufficient evidence to grant you benefits back to the alleged onset date, you will be asked to amend to a later date. Usually, when a judge asks you to amend your onset date, he/she will find you disabled from the date of the amended onset. You should not agree to amend your onset date unless the judge states, on the record, that he will find you disabled based on the amended onset date.
Some adjudicators/judges are impressed with a claimant who has an extensive work history and may give you the benefit of the doubt when assessing your credibility about symptoms and limitations. Yet, how many years you have worked will not automatically qualify you for social security disability benefits. You must have well documented mental or physical conditions that result in disabling limitations found by your treating physician/psychiatrist and/or consultative examiners from the Social Security Administration.
11. The GA Department of Labor, DAS, or the administrative law judge does not like to grant social security disability benefits to children or young adults.
We are one of the few Atlanta firms who represent children under 18 years old, as other attorneys feel that there is too much work involved in developing these cases and think that DAS or a judge has a bias against children or young adults receiving social security disability benefits. For children’s cases, in addition to medical records, there needs to be documentation from schools, as well as teacher’s questionnaires. Both children and young adults must have ongoing treatment and forms completed by treating physicians or psychiatrists addressing limitations.
As far as young adult cases (not children’s cases under 18 years old which are analyzed differently), age is more significant if you have physical impairments versus mental impairments. For physical impairments, the adjudicator or judge must consider the Medical-Vocational Profiles based upon age, education, and skills acquired from all jobs performed in the past 15 years. The Medical-Vocational Profiles favor those over 50 years of age.
12. I cannot get Social Security disability benefits, while I am receiving worker’s compensation, long-term disability benefits from my company or VA benefits.
You can get Social Security disability benefits at the same time that you are receiving worker’s compensation, long-term disability benefits or VA benefits. However, you may not be eligible for SSI if the worker’s compensation benefits, long-term disability benefits or VA benefits exceed the monthly SSI amount.
There is no offset, ie reduction, of the DIB (SSDI or Title II) monthly benefit amount for receiving long-term disability benefits. However, your company may expect you to reimburse them with the backpay you receive from the DIB claim.
The monthly worker’s compensation benefits you receive will result in an offset. Your DIB (SSDI or Title II) benefits will be reduced so that the combined amount of the DIB (SSDI or Title II) benefit you and your family receive plus your workers’ compensation payment does not exceed 80 percent of your average current earnings.
For service connected VA benefits, there will not be any offset of the monthly DIB amount. As for non-service connected VA benefits, you will be paid the higher of the VA benefits or DIB benefits. However, if you are eligible for DIB benefits, you could be eligible for Medicare. Some veterans want Medicare to provide additional coverage to the care they receive at the Veterans Administration hospitals.
The first step of a five step sequential evaluation of your claim is the question of whether you are working and how much you receive in gross pay per month. (the earnings of self-employed individuals are evaluated differently. See Social Security Ruling 83-35).
In 2010, you will be adjudicated “not disabled” if you earn $1,000 or more per month in gross pay and your job lasted more than three months. If you earned over $1,000 per month in gross pay, you could still be eligible for SSI or DIB if your job lasted three months or less, and you had to discontinue the work for medical reasons. This would be an unsuccessful work attempt.
If you have not worked for 12 consecutive months and then earn over $1,000 a month in gross pay, you can request a closed period of disability. If you resumed work for nine months and stopped because of medical reasons, you can ask for a trial work period.
It is important to note that even if you are earning less than $1,000 a month, a judge may still conclude that you are “not disabled.” Some judges may consider those earning less than $1,000 a month in gross pay to be underemployed or to have no limitations that would interfere with the ability to perform simple full-time work. The strongest case is when a claimant is not actively working while pursuing SSI or DIB.
14. I used alcohol and drugs in the past but don’t use them now. I should still be found disabled, as I am ill.
Some claimants downplay their usage of alcohol and drugs when medical records reveal that they have a history of usage or are, currently, abusing alcohol and/or drugs. In the Eleventh Circuit, which includes the Atlanta area, the burden is on the claimant to prove that his disabilities exist separate and apart from any alcohol or drug abuse. Thus, these types of cases can be difficult to win if a mental or physical condition, such as depression or congestive heart failure, is linked by a treating psychiatrist/ physician to alcohol or drugs. However, if your attorney can establish that you would be disabled even when the alcohol/drug usage is discontinued, then you could be found disabled.
15. I cannot afford to pay an attorney to handle either my SSI (Title XVI) , DIB (SSDI, Title II) claim or my child’s SSI or child insurance benefits claim. Besides, I heard that I can represent myself just as well.
You do not have to pay an attorney until your case is won. The fee set for all attorneys handling these types of cases is 25 percent of your total back benefits or $6,000, whichever is less. You do not pay the attorney out of any future monthly benefits.
An attorney who specializes in social security disability cases has the expertise to present your case to the Social Security Administration by submitting the appropriate medical evidence and physician/ psychiatric forms to the adjudicator or judge. It is not recommended that you appear at a hearing without an attorney. An attorney knows which questions to ask you to skillfully present your case and preserve the record for appeal. Also, an attorney knows how to cross-examine vocational experts and medical experts who may be present at your hearing.
Despite what an attorney tells you, he/she cannot control how fast the government moves your case through the bureaucratic process. In certain instances, your case should automatically be adjudicated faster if a category below applies to you pursuant to Hallex I-2-1-40
Your case is categorized as a compassionate allowance. www.ssa.gov/compassionateallowances/
If you are homeless, your case will be sent to a homeless unit at the GA Department of Labor disability adjudication services and will automatically be moved along faster at the initial and reconsideration levels.
If you are terminally ill, your case should be flagged as a Terri case and automatically adjudicated faster.
If you are suicidal or homicidal your case should be flagged to be adjudicated faster. Hallex I-2-1-3
Beginning in 2014, any Veteran with a 100 percent disability compensation rating will have expedited processing of his/her social security disability benefits claim. The Social Security Administration (SSA) worked with the Veterans Administration (VA) to set up a data exchange to identify the veterans with a 100 percent disability rating when they first apply for Supplemental Security Income (SSI) or Social Security Disability Insurance benefits (SSDI). If a veteran receives the 100 percent disability compensation after applying for social security disability, a letter should be sent to SSA to update.
If you are military service personnel injured October 1, 2001 or later, while on active duty when the injury occurred, your case should automatically be adjudicated faster.
If you are in dire need, because you cannot get food, clothing, medical care or shelter, ie your home is in foreclosure or you are about to be evicted, an attorney can write a letter to the Social Security Administration asking that the case be evaluated as soon as possible. Unfortunately, since many people applying for Social Security Disability Insurance benefits (SSDI, DIB, Title II) or Supplemental Security Income (SSI, Title XVI) have no income or are homeless, the letter does not always guarantee that the case will be moved along faster.
Another option is to contact a Congress member’s office, who in turn will contact someone at the Georgia Department of Labor’s Disability Adjudication Services (DAS) or the hearing office called the Office of Disability Adjudication and Review (ODAR). Not all congressional inquiries result in your case being moved faster, but congressional assistance is worth exploring.
A lot of people applying for social security disability benefits suffer from depression and/or anxiety, because they can no longer work as a result of disabling medical conditions, have no money, have unstable living situations and are dealing with an insensitive governmental process. Others have bipolar, schizophrenic or have personality disorders. Unfortunately, some people feel that seeking mental health treatment is stigmatizing, because they will be branded “crazy” for life.
The Social Security Administration evaluates the effect of a combination of your physical or mental conditions on your ability to work. Therefore, if you have a mental condition, you absolutely should seek mental health treatment. You are not alone, as millions of Americans suffer from mental illnesses each year.
Never stop pursuing your claim, as long as you are receiving medical treatment and do not have earnings at the substantial gainful activity level. www.socialsecurity.gov/OACT/COLA/sga.html. In a lot of cases, those who are persistent in appealing their cases will eventually prevail. Furthermore, if you have been denied by a judge at a hearing, you can file a new application and appeal your hearing denial to the Appeals Council at the same time.
If the Social Security Administration (SSA)knows that you are receiving SSI benefits during any months that you have been confined in a jail, prison, a correctional facility or certain public institutions for committing a crime, your SSI checks will stop until SSA determines how long you will remain there. You will also be ineligible for SSI even if you are on a work release program or attending school as long as you are under a sentence of confinement and are not released due to parole or pardon. These types of incarceration are considered state funded food/shelter, which will preclude you from getting SSI, which is a needs based (welfare) program.
SSI benefits are prorated during the period of confinement. If you are confined for less than 1 full calendar month, your SSI (Title XVI) benefits will not be suspended. For example, if you are confined on March 2 and released on April 2, the SSI benefits will only be prorated. If you are confined on March 2 and are released on June 1, SSI benefits are suspended for April and May and prorated for March and June.
If you are released before 12 months have passed, you can ask SSA to reinstate the SSI (Title XVI) benefits without your having to file a new application. In both cases, you will need to show SSA documentation of the date you entered and were discharged. If you are in a jail, prison, a correctional facility or certain public institutions for committing a crime for more than 12 continuous months, SSA will terminate your SSI, and you must file a new application.
If you receive a DIB (SSDI or Title II) check when you enter a jail, prison, a correctional facility or certain public institutions, you are still eligible to receive your DIB check until you have been convicted of a criminal offense and confined to a penal institution for more than 30 continuous days. If you are residing outside of the correctional institution such as in home confinement, home tethering, etc., throughout any month, at no expense (other than the cost of monitoring), your DIB (SSDI or Title II) benefits will be reinstated.
Although your monthly DIB benefits may be suspended, your spouse or children can be paid benefits on your record if they are eligible. Upon release, you can ask SSA to reinstate your monthly DIB benefits without your having to file a new application provided you are not in violation of parole or probation. You must call your local Social Security District Office and provide documentation of date of entry and discharge. If you do not have to file new applications for SSI or DIB, SSA may still need to do a medical reevaluation of your case.