Facts Regarding Your Social Security Disability Claim
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The Social Security Act provides two benefit programs for disabled persons: Social Security Disability (SSD) and Supplemental Security Income (SSI).
Social Security Disability
Social Security Disability is available to individuals who have contributed to a Social Security account. These individuals earn "quarters of coverage" based on their contributions. To meet the required number of quarters, an individual usually must work five (5) out of the last ten (10) years. There are some allowances for younger persons who have not had the opportunity to work for that long.
Supplemental Security Income
Supplemental Security Income is a need-based program for individuals who are not covered by the SSD program. These benefits are determined based on individual income and assets. The standard in determining whether an individual is disabled for this program is the same as the SSD program.
Who is "Disabled?"
To be eligible for either of the above benefits, individuals must demonstrate that they are "totally disabled." This means they must prove they have a physical or mental impairment (or a combination of impairments) severe enough to prevent them from performing substantial gainful activity (any regular paying job) for at least twelve (12) consecutive months.
The catch is not whether an individual would be offered a job, but whether there are jobs available that he or she could perform. There are certain allowances for individuals of advanced age allowing for a more realistic look at age, education, and experience in meeting this test.
The Application
To begin a Social Security claim, an individual must file an application with the Social Security Administration. Our staff will help in the preparation of that claim and explain the process in detail. It is important that the application is thoroughly completed with the appropriate information.
The Denial
Unfortunately, an individual should expect that his or her application will be denied. This should not be discouraging as the vast majority of these claims are denied at the initial application. It is important that an individual who truly feels that he or she is disabled appeal this decision within sixty (60) days of the denial.
Request for Hearing
If an individual is denied, he or she is entitled to request a hearing before a Federal Administrative Law Judge. It is very important during this appeal that the individual's medical records be thoroughly compiled and organized. They should be presented to the Administrative Law Judge in a clear and concise way, highlighting the appropriate Social Security regulations.
The Hearing
The hearing is the most crucial stage of the appeal process, but there is no need to be nervous or apprehensive about it. The Administrative Law Judge who presides over the hearing will take testimony under oath, but in an informal manner. This is a private hearing usually held in a small room with only the Judge, the hearing assistant, the claimant's attorney and the claimant attending.
All the medical records that have been submitted will be admitted into evidence and the testimony of the claimant will be taken concerning the alleged conditions and limitations the individual may have in the workplace. Occasionally, the Judge may call in a "vocational expert" to testify about the possibility of training an individual for a different job.
It is important that the Administrative Law Judge be given a clear picture of not only an individual's diagnosis, but also of the limitations he or she is suffering with. The Administrative Law Judge will understand that in certain cases, an individual may be able to suffer through one day of work, but would not be able to hold down employment five days per week.
The Decision
The Administrative Law Judge will not announce a decision at the hearing. A written decision will be sent, usually within four (4) to six (6) weeks. If the decision is favorable, the claimant will normally begin receiving benefits after a short period. If the decision is not favorable, an appeal to the Appeals Council must be filed within sixty (60) days.