Social Security Disability and Supplemental Security Income - Frequently Asked Questions
INTRODUCTION
What types of benefits does the Social Security Administration offer for people with disabilities?
Social Security pays benefits under two programs: the Social Security disability insurance program and the Supplemental Security Income (SSI) program. For most people, the medical requirements for disability payments are the same under both programs and a person's disability is determined by the same process. While eligibility for Social Security disability is based on prior work under Social Security, SSI disability payments are made on the basis of financial need. And there are other differenced in the eligibility rules for the two programs. This website deals primarily with the Social Security disability insurance program. For information on SSI disability payments, ask at any Social Security office for the booklet, SSI (Publication No. 05-11000). For specific information about your case, contact Social Security.
What is meant by "Disability"?
Disability under Social Security is based on your inability to work. You will be considered disabled if you cannot do work you did before AND when Social Security decides that you cannot adjust to OTHER work because of your medical condition(s). Your disability also must last or be expected to last for at least ONE YEAR or to result in death.
Who can get Disability benefits?
You can received Social Security disability benefits until age 65. When you reach age 65, your disability benefits automatically convert to retirement benefits, but the amount remains the same. Certain members of your family may qualify for benefits on your record. They include:
- Your spouse who is age 62 or older, or any age if he or she is caring for a child of yours who is under age 16 or disabled and also receiving checks.
- Your disabled widow or widower age 50 or older. The disability must have started before your death or within seven years after your death. (If your widow or widower caring for your children receives Social Security checks, she or he is eligible if she or he becomes disabled before those payments end or within seven years after they end.)
- Your unmarried son or daughter, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be under age 18 or under age 19 if in high school full time.
- Your unmarried son or daughter, age 18 or older, if he or she has a disability that started before age 22. These children are considered disabled if they meet the adult definition of disability. (If a disabled child under age 18 is receiving benefits as the dependent of a retired, deceased or disabled worker, someone should contact Social Security to have his or her checks continued at age 18 on the basis of disability.)
How much work do I have to have done to qualify for Social Security Disability Insurance Benefits?
To qualify for Social Security disability benefits, you must have worked long enough and recently enough under Social Security. You can earn up to a maximum of four credits per year. The amount of earnings required for a credit increases each year as general wage levels rise. Family members who qualify for benefits on your work record do not need work credits.
The number of work credits you need for disability benefits depends on your age when you became disabled. Generally you need 20 credits earned in the last 10 years ending with the year you became disabled. However, younger workers may qualify with fewer credits.
SIGNING UP FOR DISABILITY
How do I apply for Social Security Disability Benefits?
You should apply at any Social Security office as soon as you become disabled. You may file by phone, mail or by visiting the nearest office. Note that, while you may receive back benefits from the date you became disabled, they are limited to one year before the date you filed for benefits.
Who decides if I am Disabled?
After helping you complete your application, the Social Security office will review it to see if you meet the basic requirements for disability benefits. They will look at whether you have worked long enough and recently enough, your age and, if you are applying for benefits as a family member, and your relationship to the worker. The office then will send your application to the Disability Determination Services (DDS) office in your state. The DDS will decide whether you are disabled under the Social Security law.
The rules for determining disability are different from the disability rules in other government and private programs.
SPECIAL RULES FOR BLIND PERSONS
You are considered blind under Social Security rules if your vision cannot be corrected to better than 20/200 in your better eye or if your visual field is 20 degrees or less, even with a corrective lens. There are a number of special rules for persons who are blind. The rules recognize the severe impact of blindness on a person's ability to work.
WHEN A CLAIM IS APPROVED
Are benefits taxed?
Some people have to pay federal income taxes on their Social Security benefits. This usually happens only if your total income is high. At the end of the year, you will receive a Social Security Benefit Statement (Form SSA-1099) showing the amount of benefits you received. Use the statement to complete your federal income tax return if any of your benefits are subject to tax.
Can I get medicare if I'm Disabled?
Social Security will automatically enroll you in Medicare after you get disability benefits for two years.
Medicare has two parts―hospital insurance and medical insurance. Hospital insurance helps you pay hospital bills and some follow-up care. The taxes you paid while you were working financed this coverage, so it's free. The other part of Medicare, medical insurance, helps pay doctors' bills and other services. You will pay a monthly premium for this coverage if you want it. Most people have both parts of Medicare.
Is my case reviewed?
In general, your benefits will continue as long as you are disabled. However, we will review your case periodically to see if you are still disabled. The frequency of the reviews depends on the expectation of recovery.
▪ If medical improvement is "expected," your case normally will be reviewed within six to 18 months.
▪ If medical improvement is "possible," your case normally will be reviewed no sooner than three years.
▪ If medical improvement is "not expected," your case normally will be reviewed no sooner than seven years.
What can cause benefits to stop?
There are two things that can cause Social Security to decide that you are no longer disabled and to stop your benefits.
- Your benefits will stop if you work at a level considered to be "substantial." Usually, average earnings of $800 or more a month are considered substantial.
- Your disability benefits also will stop if it is determined that your medical condition has improved to the point that you are no longer disabled.
WHEN A CLAIM IS DENIED
What should I do if my claim is denied?
If your claim is denied or you disagree with any part of the decision denying your claim, you may appeal the decision. The Social Security office, or our office, can help you complete the paperwork.
You have 60 days from the time you receive the denial letter to file an appeal. They assume that you received the letter with the decision five days after the date on it, unless you can show that you received it later.
SEEKING LEGAL REPRESENTATION
At what point should I consider legal representation?
We generally advise people to file their initial application by themselves with Social Security. Many people are awarded benefits at this step―so there is no need to incur the expense of an attorney. HOWEVER, once you have been turned down on this initial application, we advise you to seek representation immediately as you have only 60 days to appeal the decision of Social Security, which generally entails asking for a hearing in front of a judge.
What does it cost to have an attorney represent me?
We handle these based on a CONTINGENT FEE basis―meaning there is NO FEE unless we are successful. Our fee is set by the government. But generally, the fee is 25% of past due benefits only (subject to a "cap", i.e. maximum set by the government).
You could get benefits for 30 years of more―and there is no fee on those monies. We do charge "win or lose" for expenses. By expenses, we mean the cost of medical records, conferences or statements by your doctor, or other related expenses to your case―not our general operating expenses.
All fees charged have to be approved by the Social Security Administration.
Source: Social Security Administration. Publication No. 05-10029. Social Security Disability Benefits. January 2003.
If you have any questions, please feel free to call us at (810) 694-3006 and we'll be happy to answer any of your questions.