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Disability is defined as the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.”
There are several benefits available under Social Security, but the most familiar are Title II and Title XVI benefits. Title II is called Social Security disability and is based upon a person’s earning history. Title XVI is called Supplemental Security Income (SSI), and it does not matter how much a person has earned if any at all.
A person can go to his/her local Social Security office, call an (800) number for an interview, or even apply on the internet. An attorney may also assist you applying on the internet.
There is no waiting period to apply. In fact, you can lose rights to benefits if you wait too long. You have to have a condition that has kept you off from work for a year, or is expected to keep you from work for a year.
Yes, in fact, most disability benefit programs will require you to apply for Social Security as well.
Yes, you do not have to choose one or the other. However, there are intricate laws involved in determining how much you can receive from both benefit packages. Social Security will most likely have an “offset” for some of the money paid by workers’ compensation.
There really is no set formula to determine this. A person may be determined disabled due to multiple ailments or one single impairment. You must determine on your own if you believe that you will be off from work for a year and can prove that to the court.
A person does not have to be found permanently disabled in order to qualify for Social Security. For example, you could obtain benefits for a couple of years, then return to work. Once you return to work, your Social Security benefits will cease.
Social Security determines your disability based upon your age, education, work experience and health issues. Older individuals have fewer thresholds to meet to be found disabled.
There are basically three stages that a typical person will undergo in a disability process. You first apply for benefits. At this stage, there are disability examiners at the local office that will review your records and make a decision. You will be notified of the decision usually within a couple of months. Statistically, more than 60-70% of these people are denied benefits. At that point, you have 60 days to appeal the decision on what is called Reconsideration. The Reconsideration is sent to the same local office but reviewed by another individual. The denial rate at this stage is nearly the same as the first state, and usually takes 2-4 months. Once again, you have 60 days to appeal, but this time it is called Request for Hearing. The Request for Hearing is sent to a different office for review, and also set for a hearing before a judge. Typically, it takes more than one year before you will receive a trial date. The Social Security process is extremely busy, and a typical case will take well over a year to complete. In fact, the national average in 2008 was 541 days before you received a hearing.
This is somewhat difficult to answer. Social Security has laws that they follow called Listings. If you meet the qualifications for certain medical conditions, then you could be found disabled without having to prove your physical or mental limitations.
A person with mental or psychological issues can qualify under Social Security. The same standards are applied as to a person with a physical impairment.
No, you can obtain benefits on your own, but it will be very difficult if you have been turned down at the application stage. You must know what forms and information to submit to Social Security and you must turn them in within the time frames designated.
All attorney fees are set by federal law at 25% of past due benefits. Past due benefits are the checks you should have been receiving while you are going through your appeal. If it takes a year to win your case, then your past due benefits would be for that year. If an attorney does not win your case, then you would owe no fee.
Yes, Title II recipients do not receive benefits for the first 5 months they are determined disabled.
Yes, a child could qualify under Title XVI. The same standards are applied to children but not compared to work. The disability is evaluated against what a child of that same age would typically be able to do.
There are two types of health insurance through Social Security. Medicaid is a welfare benefit and Medicare is not. Once you receive Title XVI (SSI) you would be able to get Medicaid. Medicaid virtually requires you to prove poverty. Medicare is not dependent upon whether you have money or assets. A very wealthy person could actually obtain Medicare benefits. Medicare does not pay for prescription costs and you must be on Social Security benefits for 2 years before you are eligible. Medicare pays doctors at higher rates than Medicaid.
Oddly enough, the answer is no. Social Security has taken the position that VA decisions are not binding upon them.
If the question related to Social Security Law you can e-mail me with the question, or call me at (918) 872-8800.