1. What is the difference between SSDI and SSI?
Social Security Disability (SSDI) is best thought of as an insurance program. A recipient has to have worked a certain amount in his or her lifetime to qualify for benefits. Supplemental Security Income (SSI) on the other hand is considered to be a form of welfare and is needs based, meaning that a person must be very low income with very few assets in order to qualify. Both programs pay benefits to disabled persons who qualify under the physical and mental impairment guidelines set by Federal regulations
2. I have a denial. What happens now?
If the decision is the initial denial, you must file a Request for Reconsideration with the Social Security Administration. If it is the second denial (after the review based on your Request for Reconsideration), then you must file a Request for Hearing. You have 60 days from the date of a Social Security determination to request a review of that decision. Failure to timely file the appropriate paperwork with the Social Security Administration will end the application for benefits.
3. My denial says I do not qualify as of my last insured date and am no longer insured. What does that mean?
As indicated above, Social Security Disability is an insurance program, which requires a recipient be insured in order to collect benefits. Insured status requires two things: 1) 40 credits or quarters (10 years) worked during your lifetime; and 2) working five out of the last ten years. Social Security has special guidelines for people under thirty-one years of age who have worked, but have become disabled. You should contact your local Social Security office to determine when you were last insured. If your disability began after your last insured date, then you will not qualify for disability benefits from Social Security. You may still qualify for retirement benefits after age 62, however.
4. Do I need an attorney?
It is always beneficial to have a qualified attorney represent you if you are denied Social Security disability benefits after your initial application. A qualified attorney can review your complete medical history with you and prepare the necessary paperwork to file for a reconsideration of denial, stressing your disabling conditions. If your reconsideration is denied, as is often the case, your attorney will prepare and present your case to an Administrative Law Judge. Your attorney will be present with you at the time of the hearing to make certain that all appropriate information is presented to the hearing judge.
5. How long does it take?
The average time involved to handle a claim through the entire application process is as follows (times are approximate):
- Initial Application-90-120 days
- Reconsideration-90-120 days
- Hearing Request-20-24 months
- Appeals Council-12-30 months
- Federal Court-12-24 month
6. What if I return to work prior to a hearing?
You are entitled to Social Security disability benefits if your disability is either expected to result in death or expected to last or has lasted for a continuous period of 12 months. If you have been off of work for at least 12 months as a result of disabling condition or conditions and then you return to work, you may still be entitled to receive what is called a "closed period of disability" from Social Security.
7. How much money will I get?
Your Social Security benefit amount is based on your earnings over your lifetime. The longer you worked and the higher your average earnings over your lifetime, the higher your monthly benefit will be. Your benefit amount will be negatively impacted if there are years in which you did not work or your earnings were very low. The benefit amount is impacted by your age at the time of application, the amount of your earnings, and the number of years that you worked during your lifetime.
Social Security mails an annual earnings history and benefits summary to workers each year. They also provide an online calculator which can be used to provide an estimate of monthly disability and retirement benefits. You can find the calculator at the following link: http://www.ssa.gov/retire2/AnypiaApplet.html. You will need your detailed earnings history in order to use this estimated benefits calculator.
8. If I am receiving Workers' Compensation benefits, how will receiving Social Security benefits affect my L&I benefits?
Between Social Security and the Department of Labor & Industries benefits, you are entitled to receive 80% of your highest year's earnings. The highest year's earnings must be within the five years of your disability date or the average of your highest five consecutive years of earnings. Either Social Security or the Department of Labor & Industries will reduce or "offset" your benefits.
9. Will my spouse and/or dependant children get benefits?
Social Security Disability Insurance pays benefits to you and certain members of your family if you are "insured," meaning that you worked long enough and paid Social Security taxes. When you start receiving disability benefits, members of your immediate family including your wife and dependent children may also qualify for benefits. Each qualified child may receive a monthly payment up to one-half of your full disability amount, but there is a limit to the amount that can be paid to the family as a whole.
10. What about entitlement to Medicare?
If your application for disability benefits is approved by Social Security, your monthly benefit payment will begin the sixth full month after the date Social Security determines your disability began. You will be eligible for Medicare benefits 24 months after your first month benefits are paid. For example, if you are determined to be disabled as of January 1, 2005, you will be eligible for Medicare benefits June 1, 2007 (24 plus 5 months).
11. Is this benefit for the rest of my life?
The Social Security Administration will review a person's eligibility for benefits periodically. During the review process, Social Security will send a questionnaire for you to complete, outlining your current medical sources as well as providing information about your current condition. You will continue to receive benefits as your medical records are obtained and a final determination is made. If you receive a disability cessation notice from Social Security, that notice must be protested within 10 days to continue receiving ongoing benefits pending the outcome of the appeal.
You may lose your benefits if you return to work after you begin receiving Social Security disability benefits. You may continue to receive your Social Security disability benefits for a period of nine months (during a rolling 60-month period), which is considered a trial return to work period.
12. Are Social Security benefits taxable?
They can be, depending on the amount of other taxable income you have, and if you are married, income that you and your wife have. If you are single and have other income which at 2007 levels is higher than $25,000, a portion of your Social Security disability benefits may be taxable. For married persons, the level is $32,000, and for those who are married and filing separately, potentially all of the Social Security benefits may be taxable. If you and your spouse have other income besides your Social Security benefits, you should check with a tax professional at the time you file your Federal income tax return, as to whether you should pay taxes on your Social Security benefits.