AM I DISABLED?

Under Social Security Disability Law, a person can be considered disabled if they have medically determinable physical or mental impairment which prevents them from performing substantial gainful AND if such condition will last for a period of twelve (12) consecutive months, or result in death.

WHAT SHOULD I DO IF I AM DISABLED?

You should apply for Social Security Disability as soon as possible. You may do this online at www.ssa.gov or at your local Social Security Office. The process can be very long and exhaustive. Most likely, your initial application will be denied and you my apply for reconsideration and then appeal if that too is denied. Your case when appealed will be decided by a Social Security Judge (Administrative Law Judge).

HOW IMPORTANT IS IT TO FILE FOR SOCIAL SECURITY DISABILITY BENEFITS SOON AFTER I BECOME DISABLED?

If you have been employed, paid taxes, and are eligible for Social Security Disability Insurance (SSDI), which is monthly benefits based on your work history, it is very important that you file as soon as possible. Your eligibility can expire. If you have not paid in taxes on a regular and continual basis. In other words, if you become disabled and do not apply for disability and wait for a period in excess of five (5) years from the date you last worked, your eligibility for Social Security Disability may expire. In that situation, you would have to prove that you became disabled prior to the expiration of your eligibility.

Yes. It is very important that you hire a competent and experienced representative to handle your case. The Social Security Disability process can be quite exhaustive and lengthy. Once your initial application has been denied, it is your duty and responsibility to provide any and all medical and mental health documentation to prove your case. It is very important to have a representative that can communicate with your medical providers and acquire the necessary information to prove your case. It is important that the representative be able to present the evidence to the Social Security Judge (Administrative Law Judge) when your case is schedule for a court hearing. The best chance of winning your case is at the hearing before the Social Security Judge.

DOES MY REPRESENTATIVE HAVE TO BE A LAWYER?

No. Lawyers are experienced in developing a case and presenting a theory to a court and/or Judge. It is important that your representative be experienced in acquiring any and all medical records, developing a plan or theory to prove the case and being knowledgeable of the Social Security rules and regulations

which could be crucial to your case. Many times it is only one small fact such as a medical report or procedure that has been lost in hundreds of pages of medical records that could prove your case. This type of information may be overlooked if you do not have an experienced and competent representative.

HOW IS MY REPRESENTATIVE PAID?

In most instances, your attorney/representative charges a fee of 25% of any back pay to which you may be entitled once your case is approved. In other words, as these cases normally take upwards of two (2) years or more before your approved, the amount of benefits that you may be entitled to from the date the Administration decides you became disabled until your first benefits are paid, your attorney/representative would be entitled to 25%, not to exceed $5,300. Your attorney/representative is not entitle to any portion of your future benefits. However, any out of pocket expenses paid by the attorney/representative, to acquire medical records or other evidence in your case, are paid by them in advance and those amounts are your responsibility once your case is settled.

Yes. If you can prove that you were out of work for at least twelve (12) consecutive months for rehabilitation and/or treatment, you may have a case for back pay, even though you return to work. Many times, the Social Security Judge will give latitude for those individuals who are attempting to work and allow a back pay case, even though they are employed at the time of the hearing.

CAN I RECEIVE BOTH WORKER'S COMPENSATION AND SOCIAL SECURITY DISABILITY?

Yes. There may be a set off provision that would reduce the amount of Social Security Disability benefits you may receive on a monthly basis, depending on how your worker's compensation benefits are structured. This is designated as "the 80% rule", in other words, combining both worker's compensation and Social Security disability, you can only receive a total of 80% of your average earnings that you were receiving at the time you became disabled.

ARE THERE OTHER DISABILITY PLANS THAT BENEFIT FAMILY MEMBERS?

Yes. There are benefits that may go to minor children, if you are awarded Social Security Disability. There are also disabled widow and widower benefits that may be paid under certain situations. The representative that you meet with when applying for disability, should submit your application for any and all benefits to which you may be entitled.

The first month that you are entitled to benefits is the sixth (6th) month after you became disabled. That means, if the Social Security Judge finds you to be disabled on a certain date, the first month of eligibility is the 6th month after that date. Also, these benefits cannot be paid for more than one year prior to the month you filed your claim. SSI back pay benefits are handled differently. Since SSI recipients normally do not have a work history or their eligibility for Social Security Disability has expired, then their benefits cannot be paid before the month after they first filed their claim.

WILL I BE ELIGIBLE FOR ANY MEDICAL COVERAGE IF I WIN MY CASE?

Yes. If you are awarded Social Security Disability Insurance benefits ( commonly known as Social Security Disability), you are eligible for Medicare coverage twenty-four (24) months from the date in which your eligibility of benefits begins. In many cases, since it has taken twenty-four (24) months or longer to get the case approved, you may be eligible once your case is decided. In SSI cases, you are eligible immediately for Medicaid once your case is approved. In certain situations, you may be eligible for both Medicare and Medicaid, if you are an individual who may be eligible for both SSDI and SSI.

AFTER I HAVE WON MY SOCIAL SECURITY DISABILITY CASE, CAN I RETURN TO WORK AND STILL RECEIVE BENEFITS?

Yes. Social Security has work incentive programs that allow you to return to work and continue drawing your disability benefits. Of course, if you continue to work and perform substantial gainful activity and make over a certain sum of income, eventually, your benefits will cease.

OF ALL THE CONSIDERATIONS IN DECIDING WHETHER TO FILE FOR SOCIAL SECURITY DISABILITY , WHICH IS THE MOST IMPORTANT?

DO NOT DELAY OR HESITATE IN APPLYING FOR BENEFITS. IF YOU HAVE WORKED, PAID TAXES TO THE NUMEROUS GOVERNMENT ENTITIES THROUGHOUT YOUR WORK HISTORY AND YOU NOW ARE UNABLE TO PERFORM THESE ACTIVITIES ANYMORE, THEN YOU SHOULD NOT DELAY!

The purpose of the Social Security Disability program is to assist those individuals that are now unable to perform work activities at an age before they are entitled to Social Security retirement. In other words, if you believe you have become disabled and can no longer perform work activities and you have not reached retirement age, then you need to immediately file for Social Security Disability. You have paid for those benefits as a working individual. The most important decision to be made is to apply as soon as possible after you have become disabled.