SOCIAL SECURITY DISABILITY
Social Security Disability benefits consist of monthly payments and/or Medicare benefits
which provide compensation to those who cannot perform substantial gainful work of any
kind because of total disability stemming from physical or mental impairments. These
benefits are provided under one of two programs operated by the Social Security Administration:
(1) Social Security Disability Insurance (SSDI) or (2) Supplemental Security Income (SSI).
The medical requirements for eligibility are the same for both SSDI and SSI. The differences
between the two programs are in the consideration of past work history and the consideration
of household income.
WHAT IS TOTAL DISABILITY?
Total disability for the purpose of Social Security has two requirements: (1) the claimant
must be unable to do any kind of work for which he is suited due to a disability and
(2) the disability must have lasted or be expected to last at least one year or result
in death. The disability can be due to a physical or mental condition, or a combination
of mental and/or physical conditions. If the claimant is found to be totally disabled,
Social Security benefits will continue as long as the claimant remains disabled.
WHO IS ENTITLED TO RECEIVE SOCIAL SECURITY BENEFITS?
Adults: There is no age requirement for the receipt of Social Security disability benefits.
If the claimant is receiving Social Security disability benefits at age 65, the disability
benefits are automatically converted to retirement benefits.
Members of the claimant’s family: Certain members of a claimant’s family
may be entitled to also receive Social Security Disability benefits upon a claimant’s
approval to receive benefits including: (1) unmarried children under the age of 18; (2)
unmarried children between the age of 18 and 19 who are still attending high school,
(3) unmarried children 18 or older who were disabled prior to the age of 22 and (4) a
spouse age 62 or older.
Children: Children are eligible for Social Security Disability benefits under SSI and
are considered disabled when they have a physical or mental condition which is so severe
that it results in marked and severe functional limitation. As with an adult, the child’s
disability must be expected to last at least one year, or be expected to result in the
SOCIAL SECURITY DISABILITY INSURANCE
Eligibility for Social Security Disability Insurance, or SSDI, is determined by the
amount of credits a claimant has received for past work in the ten years prior to the
claimant’s total disability. The Social Security Administration keeps a record
of all amounts reported by employers on each worker’s Social Security number or
account over the course of each worker’s work life. A credit is earned for each
quarter in which a person works. The person does not have to work for the entire quarter
to earn the credit but must make a certain amount in reported earnings for that quarter
in order to earn the credit. For example, in 2011 a worker must make at least $1,120
in reported earnings in a quarter to receive a credit for that quarter. A worker is eligible
to receive up to 4 credits in a year. The earnings amount required to receive a credit
increases each year.
To qualify for SSDI, a claimant must have earned a total of 20 credits out of 40 possible
credits (or worked a total of 5 years out of last 10 years) prior to claiming disability.
For SSDI, there is a date beyond which a person will not be considered insured by the
Social Security Administration and therefore will no longer be eligible for SSDI. In
other words, when a person has stopped working because of a disability, there is a date
after which the person will no longer have the required 20 credits out of the possible
40 credits to be eligible for SSDI. A claimant must be determined to be totally disabled
prior to the running of this date, even if they do not apply for SSDI prior to this date.
THE APPLICATION PROCESS
To apply for Social Security Disability benefits, you may apply in person at your local
Social Security office, by phone, by mail or through their online system. The initial
processing of a claim takes between 60 and 90 days. At this stage of the claim, the Social
Security Administration will often request that the claimant and the claimant’s
family complete forms, provide medical records and that the claimant attend appointments
with Social Security doctors. At this level of the process, there is no hearing held
and the case is processed by an adjudicator within the Social Security Administration.
Denial of the Initial Application is very common given the difficulties presented by
making a decision solely based on a paper record and the number of errors that are frequently
made at this level.
After the initial denial, a Request for Reconsideration is made to the Social Security
Administration. The Social Security Administration, at this stage of the process, may
request more medical records and may even send the claimant for more doctors’ appointments.
This stage if the claim process typically lasts between 60 and 90 days as well. As with
the Initial Application, the Request for Consideration will most often result in a denial
as there is no hearing and the decision is again based solely on paperwork.
Following the second denial, a Request for Hearing is made to the Social Security Administration.
The Social Security Administration, at this stage of the process, will request more of
the claimant’s medical records and will refer the claim to an Administrative Law
Judge to be processed for a hearing. At a hearing, the claimant can present medical evidence
and witnesses to support their claim of total disability. Given the right assistance
and preparation, a hearing before an Administrative Law Judge is more likely to lead
to an award of benefits than a decision at either of the two previous levels.
Once a decision is made, the claimant will receive written notice of that decision.
If approved, the claimant will receive a Notice of Award which shows the amount of benefits
to which the claimant is entitled. If the benefits are awarded under SSDI, the claimant
will be paid starting from the beginning of the 6th full month after the date the claimant
was determined to be totally disabled. This is known as the “five month waiting
period.” If the benefits are awarded under SSI, the claimant will be paid only
going back to the date of the application. There is, however, no five month waiting period
for SSI benefits.
WHY A SOCIAL SECURITY DISABILITY ATTORNEY?
The process of applying for Social Security Disability benefits can be time consuming,
confusing and stressful for a claimant. Hiring a Social Security Disability attorney
to assist in the preparation of your Social Security Disability case is one of the best
ways to insure that your case stays on the proper course. In the initial stages of your
claim, a Social Security attorney can assist in the gathering of vital medical records
and other evidence that will help to prepare a more persuasive case before the Social
Security Administration. During the process of denials and appeals, a Social Security
Attorney can keep track of your case to insure that your case stays on course. At the
hearing, a Social Security attorney can assist in the preparation of a case strategy
that will be persuasive to an Administrative Law Judge and insure that the ALJ has all
the necessary evidence to make an informed decision on your case. Finally, if your claim
is denied by the Administrative Law Judge, a Social Security attorney, unlike a non-attorney
representative, can appeal your case to the Appeals Council and even file an appeal with
the United States District Court in order to preserve your claim for benefits.
In short, hiring a Social Security attorney insures that neither you nor your claim
gets lost in the process of applying for Social Security Disability benefits.
Lober, Dobson & Desai’s attorneys handle a large volume of Social Security
Disability cases each year all over the state of Georgia. They’re experienced and
focused on serving your interests before the Social Security Administration. You may
contact our office by email or by phone at (478)
745-7700 and one of our Social Security
attorneys would be glad to discuss your claim with you.