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Social Security Disability Benefits FAQ
1. What Is Social Security Disability Insurance?
The Social Security Disability Insurance (SSDI) program (sometimes called simply Social Security Disability, or SSD), pays monthly benefits to people who are unable to work because they have a medical condition. This condition must —
- Be expected to last for at least a year, or
- Be expected to result in death.
In some cases, benefits may be paid to members of the worker’s family.
In New York, as in all states, you must have worked and paid Social Security taxes to be eligible for Social Security Disability benefits. Social Security uses formulas to see if you are eligible based on how long you worked, how recently you worked, and your age.
Social Security must also find that you are totally disabled according to their definition of disability before you can receive benefits.
If you are eligible, then you will continue to receive monthly benefits as long as you are still too disabled to work. From time to time, Social Security will review your eligibility to see if you have improved enough to be able to go back to work.
2. Am I Eligible for Social Security Disability Insurance (SSDI) Benefits?
- You must be totally disabled. Other programs, such as Workers’ Comp or private insurance, may pay benefits for partial or short-term disability, but SSDI pays only for total disability.
- Your disability must be caused by a medical condition that is expected to last at least a year or to result in death.
- The disability must be severe. The Social Security Administration has a complex system for deciding which disabilities meet its definition of “severe.”
- Because of your disability, you are no longer able to do the work you did before.
- You are also not able to do any other kind of work. Social Security takes into account your disability, age, education, skills, and prior work experience in determining what kinds of work you can or cannot do.
- You must have worked in jobs that were covered by Social Security. That work has to have been long enough and recent enough to qualify under the Social Security Administration’s eligibility formulas.
3. What is the difference between Social Security Disability Insurance (SSDI) Benefits and Supplemental Security Income (SSI) benefits?
Both programs are for people who are disabled, and both have a similar process for determining who is considered disabled.
Beyond that, there are several important differences between the two programs:
- To get SSDI benefits, you must have worked in a job or jobs where you paid Social Security taxes, and that work must be recent and long enough (according to a Social Security Administration formula) for you to be considered “insured.” There is no such requirement to receive SSI benefits. You can receive SSI benefits even if you have never worked in a job covered by Social Security or if you not done so recently.
- The SSI program is only for people who have low income and have resources. SSDI does not have this requirement.
- The SSDI program pays benefits to disabled adults and, in some cases, their family members. The SSI program pays benefits to disabled children as well as disabled adults.
- SSI benefits are based on financial need. SSDI benefits are based on your lifetime income from jobs covered by Social Security.
- To be eligible for SSI benefits, your income from all sources must be low. For SSDI, there are limits on how much you can be earning from work, but there are no limits to income that you receive from non-work sources, such as from investments.
- People with low income who are over 65 may be eligible for SSI even if they are not disabled. In SSDI, only people who are disabled (and, sometimes, their family members) are eligible for benefits.
4. When Do I Know I Should Apply for Social Security Disability Insurance Benefits?
You should apply for SSDI benefits as soon as you become disabled because of a condition that is expected to last at least a year or to result in death. The sooner you apply, the sooner you can start receiving benefits if your application is approved.
5. How Long Does the SSDI Application Process Take?
After you file an application for SSDI benefits, it will usually take about three to five months for Social Security to process your application and for you to find out if your application has been approved or denied. However, it can sometimes take longer.
If your application is denied, we can file an appeal for you. There are four levels of appeal. The first is reconsideration. If your reconsideration is denied, you can have a hearing before an administrative law judge. If you lose that hearing, you can request an Appeals Council review. If the Council does not approve your benefits, you can have a review in Federal Court. Each of these levels of appeal adds more time to the process.
One of our experienced Social Security disability attorneys can help streamline the process so that it goes as quickly as possible. If you file an application or an appeal on your own, it could take extra time. You might forget to submit required information or documents and have to do that later. When you have experienced legal help, your attorney can help you avoid delays because he or she will know what to do to fulfill Social Security’s complicated requirements.
Our attorneys will also increase your chances of winning your case at an earlier stage than if you did it on your own. If you are approved after your initial application or at an early stage of appeals, you will the save significant time by not having to go through the later stages.
6. Can I Receive Both Social Security Disability Insurance and Workers’ Compensation at the Same Time?
Yes, you can receive both SSDI benefits and Workers’ Compensation benefits at the same time if you are eligible for both. However, if you receive Workers’ Comp benefits, that may affect the amount of your SSDI benefits. The total amount that you receive from both programs combined cannot be more than 80 percent of your average earnings before you become disabled.
7. What Are The Most Common Reasons For Denied Disability Claims?
When you file a Social Security Disability application in New York, it usually gets evaluated in two places. First, a local Social Security Administration field office will evaluate the non-medical parts of your application. Then, the New York State Division of Disability Determinations will evaluate your medical evidence to see if your condition meets Social Security’s definition of a “severe” disability. Your claim may be denied at either of these stages. These are the most common reasons:
- The most common reason for denying an application for SSDI benefits is because of your medical evaluation. Social Security will deny your application if it finds any of these —
- Your medical condition is not expected to last for at least 12 months or to result in death.
- Your disability is not severe enough to keep you from doing your usual job or doing another job that you are qualified to do, given your age, experience, and education.
- You have not provided enough medical evidence for Social Security to evaluate your application.
- Social Security also denies many applications because of non-medical reasons including any of these common reasons —
- You are earning money from work, and that working income is over the allowed limit.
- You are not “insured” by Social Security because you do not have the required recent work history in a job covered by Social Security, or that experience has not been for a long enough period of time.
- You haven’t submitted all the required information.
- You made a mistake on your application.
As many as 75 percents of initial SSDI applications are denied! An experienced Social Security Disability attorney can help you put together your information and evidence and file your application.
If your initial SSDI application is denied, you have the right to appeal. If you win your appeal, the original denial will be overturned, and you will start receiving benefits. Filing an appeal is often a good option if your claim has been denied. We would be glad to talk to you and evaluate your case.
8. My Social Security Disability Claim Was Denied. What Should I Do Now?
Don’t get discouraged if your claim was denied. As many as three-quarters of SSDI benefit applications are denied when they are first filed. If your application was denied, you have a legal right to file an appeal. This is usually a good idea. Many applications that are denied the first time they are filed are approved after an appeal.
The appeal process is complicated, and an experienced Social Security Disability attorney can be a big help. At Terry Katz & Associates, we guide you through the appeals process every step of the way. We help you —
- Get all the information that you need to include with your appeal to make a strong case.
- Help you get your medical records from all your doctors and from any clinics, hospitals, therapists, and any other medical providers you may have seen.
- Arrange for any other testing you may need.
- Prepare for your hearing with an administrative law judge.
We will come up with a strategy to present the strongest possible case, and we will represent you at your hearing.
It is very important that you file your appeal quickly. You must file a request in writing within 60 days from the time you get the letter from Social Security denying your application.
9. How Can a Social Security Disability Insurance Lawyer Help Me?
An experienced Social Security Disability Insurance Lawyer is very familiar with the process of filing and appealing SSDI claims. The Social Security Administration uses complicated formulas to calculate whether you have worked enough to be “insured” by Social Security. They use even more complicated formulas to determine whether your disability is severe enough to prevent you from doing any available work.
Experienced lawyers know what kind of evidence you need to present to fulfill the requirements in these formulas. They know what kind of records are essential and what evidence is the most persuasive. They make sure that you don’t leave out anything that would help your case.
10. I’m a U.S. Citizen, But I Live Outside the U.S.Abroad or Plan to Move Outside the U.S. Will I Be Able to Collect SSD Benefits?
Usually, if you have been approved for SSDI benefits, you will be able to receive them if you are a U.S. citizen living outside of the country. However, there are a few exceptions:
- Social Security will not send benefit payments to Cuba or North Korea. However, if you are living in one of those countries and then move to another country or back to the U.S., you will get all the payments that you missed.
- There are some other countries, including countries that were formerly Soviet Union republics, where Social Security will not send payments. However, for these countries, there are some exceptions for people who are eligible where Social Security will send checks on a special payment plan.
11. Can I Receive SSDI and SSI at the Same Time?
Yes. Many people receive benefits from Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) at the same time. The eligibility requirements for these two programs are different. As long as you meet the requirements for both, you can receive benefits from both.
12. What Are the Non-Medical Requirements for Social Security Disability Insurance?
In addition to providing evidence of your medical condition, you must also meet several non-medical requirements to be eligible for SSDI benefits:
- You must be “insured” by Social Security. This means that you worked in jobs (or were self-employed) where you paid Social Security taxes, and that work must be both recent and have lasted long enough to meet Social Security’s requirements. Social Security uses a complicated formula to calculate your eligibility, which is based on your age at the time you became disabled.
- The formula calculates “work credits,” which are based on how long you worked and how much you earned. You get credits for each year that you worked if you made more than a minimum amount. For example, if you made more than $5,280 in 2018 in income covered by Social Security, you will earn four credits for the year. How many credits you need depends on your age. Many people need a total of 40 credits, which is usually equivalent to 10 years of work. Of those 40 credits, 20 must have been earned in the 10 years before you became disabled. Younger people may need fewer credits to be eligible for benefits.
- If you are currently working, you cannot be making more than a certain amount of money from your work. In 2018, you could not be making more than $1,180 per month by working. You are, however, allowed to make a higher amount from non-work income, such as from investments.
- Social Security also looks at your age, previous work experience, and education to determine if there are any other jobs that you can do, given your disability. To be eligible for SSDI benefits, Social Security must find that there are no other jobs that you would be able to do
13. Are Social Security Disability Benefits Available in Same-Sex Marriages?
Yes. The Social Security Administration recognizes same-sex marriages and, in some cases, civil unions and domestic partnerships. Family members of disabled workers, including same-sex spouses and partners, may be eligible to receive SSDI benefits in certain circumstances.
14. How Will I Pay My Bills While Waiting for My Social Security Disability Insurance Approval?
After you file your application for SSDI benefits, you will have to wait about three to five months to find out if you’ve been approved. Sometimes the process can take much longer. Even if you get approved quickly, there is one more obstacle. Social Security has a five-month waiting period from the time you became disabled to the time you start to receive benefits. If your application is denied and you file an appeal, the wait will be even longer.
You will need income to support yourself and your family until you start receiving benefits. This is a difficult situation, but you do have several options:
- If you are able to work part-time, you can get a job. But you have to be careful not to earn too much money because too high an income from work will make you ineligible for benefits. In 2018, the earning limit was $1,180 per month. If you earn above that, Social Security may rule that you are not disabled. That will cause your application for benefits to be denied.
- You can apply for public assistance. New York State has several temporary assistance programs. You can apply for these programs in the Department of Social Services located in the county where you live unless you live in New York City. In that case, you would file at your local Job Center.
- You may have to rely on other income, such as income from a spouse’s work, assistance from friends or relatives, taking equity from your home, or borrowing against a retirement plan. You may have to cut your expenses to help make ends meet.
- You can hire an attorney to help get your application or appeal processed efficiently so that you receive a decision as quickly as possible.
15. Am I Allowed to Work While I Am Receiving Social Security Disability Benefits?
The Social Security Administration has many rules regarding work performed during a period of disability. Generally, if you return to work after you became disabled, you can make any amount of money for up to nine months. After nine months of work, your income must be below certain threshold levels, or else your benefits may be reduced or eliminated.
Social Security has a program called Ticket to Work where people receiving SSDI or SSI benefits can get free job training and other services that make it easier to return to work.
16. Will I be entitled to health insurance if I win my case?
Yes. After you have received SSDI benefits for two years, you will automatically be enrolled in Medicare. Social Security will enroll you in Medicare Part A, which pays for inpatient hospital costs. You will also be entitled to enroll in Part B, which covers doctors’ bills and other medical expenses. Part A is free. Part B requires a monthly premium payment.
If you receive Supplemental Security Income (SSI), you will be entitled to Medicaid immediately.
17. Why Do I Need An Attorney, and When Should I Hire One to File for Social Security Disability Benefits?
Social Security has a very strict definition of disability. It’s difficult to prove you are eligible. Everything in your application has to be done correctly. You need to provide proof that Social Security finds persuasive. An experienced Social Security Disability attorney understands Social Security’s complicated formulas. He or she knows the best way to present your case in the most favorable light so that you will be most likely to have Social Security approve your application.
There are two situations where an attorney will be helpful. One is when you are applying for benefits for the first time. The other is if your application has been denied and you want to file an appeal.
It is especially important to hire an attorney if you are filing an appeal. The attorney will know what to do to improve your initial application so that you have a better chance of winning your appeal. The attorney will make sure that you have all the necessary documents and medical records to provide a complete picture of your disability. Your chances of winning an appeal are much better when you hire experienced attorneys to help you.
Don’t worry if you don’t have enough money to pay a lawyer. At Katz & Associates, we don’t charge you any legal fees unless you win your case. If you do win, we take our fees out of your benefit award.
18. How Long Do Social Security Benefits Last?
Social Security Disability benefits will last as long as you are still disabled and unable to work. From time to time, Social Security will review your medical condition to see if you have improved enough to go back to work.
If you reach full retirement age, your SSDI benefits will automatically be converted into Social Security retirement payments.
If you die, in some situations your spouse or children may be able to get survivor’s benefits.
19. What Do I Do If I Need a New Social Security Card?
In New York you can apply to get a new Social Security card online if you are a U.S. citizen, at least 18 years old, have a mailing address in the U.S., have a New York State driver’s license or state-issued ID (or license or ID from another state that participates in this program). If you do not meet these requirements, you can apply for a new card at your local Social Security office by mail or in person. You will need the documents listed on the Social Security website, including your birth certificate if it exists.
20. Does the Social Security Administration Administer Any Other Disability Benefit Programs?
In addition to SSDI and SSI, the Social Security Administration administers several other disability programs. These programs are meant for widows and widowers age 50 to 60 who become disabled and for some adults who became disabled between the ages of 18 to 22 and are dependent on a disabled or deceased individual. There are numerous legal requirements for these programs, so to see if you may qualify, please contact the experienced disability attorneys at Terry Katz & Associates for a free consultation.
21. How Is Disability Defined by Social Security?
Social Security uses a very strict definition of disability. You must meet all of these conditions —
- You can’t earn over a certain amount of money from work. In 2018, that amount was an average of $1,180 per month. (However, you can have an income higher than that if it’s from non-work income). If your work earnings are over the limit, Social Security considers you able to work and therefore not disabled.
- Your disability must have a significantly limit your ability to do basic work-related functions, such as standing, sitting, walking, and being able to remember.
- These limits must be expected to last for at least a year.
- Social Security has a list of medical conditions that it considers serious enough to be qualifying disabilities. Your condition must either be on the list or be as serious, in Social Security’s evaluation, as the conditions on the list.
- You must not be able to do any type of work that you have done in the past.
- You must also not be able to do any other type of work despite your disability. Social Security takes into account your age, work experience, skills, and education in making this evaluation.
22. Where Do I Start? What Do I Need to Apply for Disability Benefits?
If you hire a Social Security Disability attorney, he or she will guide you through the process of applying for benefits.
If you are applying on your own, you can apply online, on the phone, or in person at your local Social Security office. Before you apply, you will need to gather information and documents. If you don’t have everything available right now, you can go ahead and start the application process anyway and provide the missing information or documents later.
You will need the following information —
- Your Social Security number
- Names, contact information (addresses and phone numbers) and treatment dates for your medical providers, including doctors, hospitals, clinics, and caseworkers.
- A list of all the medications you are taking, and their dosages.
- Where you worked and what kind of work you did.
You will need these documents —
- Birth or baptismal certificate.
- Medical records that you already have from all your medical providers.
- Lab and other test results.
- Your most recent W-2 Form or, if you are self-employed, your federal tax return for the past year.
23. If I Am Found Disabled, Will My Children Receive Benefits?
Minor children under the age of 18 may receive up to 50 percent of your benefit amount. Generally, the child or children must be living with you or dependent on you in order to receive benefits. The benefit amount, unfortunately, does not change depending on how many children you have.
24. What Fees Will I Be Responsible For? How Much Money Will This Cost Me?
At Terry Katz & Associates, you don’t have to pay any legal fees unless you win your case. If you do win, Social Security will take our fee from your first disability direct deposit payment.
Your first benefit payment will contain your back pay. This is the pay you are owed for the period from the time you became you disabled until the time your benefits application was approved, up to one year. Our fee is usually 25 percent of the back pay.
You may also need to pay your medical providers for the medical records that you submit with your application or appeal.