Social Security - FAQ

1. What is the definition of disability used by Social Security?

Under the Social Security Act, "disability" means "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."

2. How do I apply for Social Security disability benefits?

Call the Social Security Administration at 1-800-772-1213. They will set a date for an additional conference to obtain details about your application. You may also visit the SSA web page for details on filing the initial application.

3. I am disabled, but I have plenty of money in the bank. Do I have to wait until this money is gone before I apply for Social Security disability benefits?

No. If you have worked enough to be eligible for Social Security benefits, your assets do not matter. However, if you are eligible for Supplemental Security Income (SSI) only, you must have less than $2,000.00 ($3,000.00 as a couple, if married and living together).

4. How much do I have to have worked to be eligible for Social Security disability?

If you have worked and paid payroll taxes five out of the ten years before becoming disabled you will probably have enough earnings in to potentially qualify for Social Security disability benefits. Persons under the age of 31 do not have to have worked as long. Also, a homemaker, if poor enough, can qualify for Supplemental Security Income (SSI) whether he or she has worked in the past or not.

5. How long do I have to wait after becoming disabled before I can file for Social Security disability benefits?

There is no reason to wait to file, provided that you are confident that your condition will keep you out of work for at least one year.

6. Can I get both worker's compensation and Social Security disability benefits?

Yes. However, worker's compensation benefits can be subtracted from the Social Security that you are owed. Be sure to contact our South Carolina disability or workers compensation attorneys for advice on strategies to minimize the impact of the offset.

7. Do I have to be permanently disabled to get Social Security disability benefits?

No. You have to have been disabled for at least a year or be expected to be disabled for at least a year or have a condition that can be expected to result in death.

8. Can I get Social Security disability benefits for a combination of impairments?

Yes. Most claimants for Social Security disability benefits have more than one health problem and the combined effects of all of the health problems must be considered.

9. What can I do to improve my chances of winning my Social Security disability claim?

Be persistent, and do not give up the first time your claim is denied. Hiring a lawyer can help. Statistically, claimants who employ an attorney to represent them are much more likely to win than those who go without representation. This is because lawyers know what limitations need to be established to help you qualify and develop the evidence to prove they are present.

10. If I am approved for Social Security disability benefits, how much will I get?

For disability insurance benefits, it all depends upon how much you have worked and earned in the past. If you call 1-800-772-1213, the Social Security Administration can tell you your Primary Insured Amount (PIA), which is normally the monthly check amount. If you have children under the age of 18, also ask for the Family Maximum (FMAX), to find out the total benefits for your family. Under the Supplemental Security Income (SSI) program, benefits cannot exceed $637.00/month in 2007, and back time is often reduced by one-third (1/3) if you are dependent on others to pay for your food and shelter.

11. How far back will they pay benefits if I am found disabled?

For Disability Insurance Benefits and for Disabled Widow's and Widower's Benefits, the benefits cannot begin until five months have passed after you become disabled. In addition, benefits cannot be paid more than one year prior to the date of the claim. For a Disabled Adult Child, there is no five-month waiting period before benefits begin, but benefits cannot be paid more than six months prior to the date of the claim. Supplemental Security Income (SSI) benefits cannot be paid prior to the start of the month following the date the disability application is filed.

12. What do I do if Social Security denies my claim for Social Security disability benefits?

First, do not be surprised. If you are denied at the initial level, unless you have already returned to work or expect to return to work in the near future, you should file a request for reconsideration. You should also consider employing an attorney to represent you. I would welcome your call.

13. What is "reconsideration"?

When a claim for Social Security disability benefits is denied at the initial level, you may then request "reconsideration" of that decision. The case is then sent to a different disability examiner for a new decision. You can and should submit new evidence at this stage. Unfortunately, at least 80% of the time, the reconsideration decision is the same as the initial decision - a denial.

14. How long does it take to get a hearing on a Social Security disability claim?

In 2007, the Columbia Office of Hearings and Appeals (OHA) has been calling cases for hearings well over eighteen months after the hearings are requested.

15. What is the Social Security hearing like?

The hearings are fairly informal. The only people likely to be there are the judge, a court reporter operating a recording device, the claimant, and the claimant's attorney. In some cases, the Administrative Law Judge has a medical doctor or vocational expert present to testify at the hearing. There is no jury nor are there any spectators at the hearing. There is no attorney at the hearing representing Social Security trying to get the judge to deny the disability claim.

16. If I get Social Security disability benefits and get to feeling better and want to return to work, can I return to work?

Yes. You are entitled to a nine-month trial work period, to test your ability to work. You can make as much money as you want during these three months, but afterwards, your work can be considered a reason to stop your benefits. The trial work period is not available to Supplemental Security Income (SSI) claimants.

17. How do lawyers who represent Social Security disability claimants get paid?

I normally am paid only if I win. The fee is one-fourth (1/4) of the back time plus expense reimbursement or $5,300, whichever is less.

18. I am a widow/widower. I have not worked in many years. I am disabled. Can I get Social Security disability benefits?

If you are over 50 and became disabled within seven years after your husband or wife died or within seven years after you last drew mother's or father's benefits from Social Security, you can get Disabled Widow's or Widower's Benefits. Perhaps more important, if you are poor, you can draw Supplemental Security Income benefits matter what age you are or when you became disabled.

19. I have a child who has been disabled since birth and has never been able to work. Can he get disability benefits from Social Security?

Possibly. If the child is under 18 and you are poor enough, the child may be able to qualify for SSI child's disability benefits. If the child is over 18, he may be able to qualify for SSI disability benefits without regard to the income of his parents. If the child's father or mother is drawing Social Security benefits of some type or is deceased, the child may be eligible for disabled child benefits.

20. I am already on Social Security disability benefits, but I am worried that my benefits will be stopped in the future. What are the chances of this happening?

Social Security is not supposed to cut off disability benefits for an individual unless his or her medical condition has improved. The most important thing to do to withstand a continuing disability review is keep getting all of your medical care. Younger individuals are reviewed more often.

21. My doctor says I am disabled, so why is Social Security denying my Social Security disability claim?

Helpful statements from doctors are not necessarily binding on the Social Security Administration. Doctors' statements that you are "totally and permanently disabled", and the like, do not help very much. What is really needed is an assessment of your functional limitations. That is, how much standing and lifting can you do and how well do you concentrate and get along with others.

22. VA says I am disabled, so why is Social Security denying my Social Security disability claim?

VA decisions are not binding on the Social Security Administration. Social Security and the VA have very different standards for approving disability claims.

23. I am 60% disabled. Do I get 60% of my Social Security disability benefits?

No. There are no percentages of disability in Social Security disability determination. For purposes of Social Security disability benefits, you are either disabled or not disabled.

24. I am disabled by mental illness. Can mental illness serve as the basis for a Social Security disability claim?

Yes. Mental illness is a frequent basis for awarding Social Security disability benefits. This is particularly true of people under fifty years of age who are expected to perform seated work if physically able.

25. Will it help if I ask my Congressional Representative to help me get Social Security disability benefits?

Many Social Security disability claimants become frustrated with claim delays and eventually ask their U.S. Representatives or Senator to help. The local Congressional office typically will have staffers who are experienced with Social Security procedures and personnel. A "Congressional Inquiry," as it is called at Social Security, may help get a stalled process moving again. Note that the inquiry will have no impact on how Social Security decides the case.

26. I am disabled. I need help with medical bills even more than I need cash income. How do I get help with medical bills?

Unfortunately, you have to wait until after you are awarded to be eligible for Medicare or Medicaid. After you are awarded, SSI claimants get retroactive Medicaid. Social Security claimants are eligible for Medicare the third year after they are eligible for a monthly check.

27. What is the difference between Medicare and Medicaid?

Medicaid is a poverty program and Medicare is not. Many disabled people who get Medicaid get it because they are on Supplemental Security Income (SSI). This is called "categorical" Medicaid eligibility. To get SSI and Medicaid, you have to be poor and disabled. Medicaid pays doctors at very low rates. People who have only Medicaid can have a hard time finding doctors willing to take them on as patients. Medicaid does pay for prescription medications. Medicaid can go back up to three months prior to the date of a Medicaid claim. Note that it is possible to apply for Medicaid directly, through a local Medicaid office, without having a companion claim for SSI.

For Medicare, it does not matter whether you are rich or poor. If you have been on Disability Insurance Benefits, Disabled Widows or Widowers Benefits or Disabled Adult Child Benefits for 24 months, you qualify for Medicare. The good thing about Medicare is that it pays doctors at a higher rate than Medicaid. Almost all doctors are happy to take Medicare patients. The bad things about Medicare are that it does not begin until after a person has been on cash disability benefits for two years and that it generally does not pay for prescription medications.

28. If I get Social Security disability benefits, will I get Medicaid?

If you are approved for SSI, you will get Medicaid. It is possible to get both Medicare and Medicaid if you are entitled to SSI and some other type of Social Security disability benefit.