Commonly Asked Questions about Social Security Disability Benefits
Social Security disability benefits can be complex and confusing. Whether you are applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits, the experienced attorneys at Phillips Disability, P.C. have the answers you need.
Listed below are a collection of questions that our attorneys are asked by many of our clients along with the answers to those questions.
If you or someone that you love is having difficulty applying or re-applying for disability benefits, we're here to help.
Social Security Disability Insurance & Supplemental Security Income
Social Security Disability Income (SSDI) is an insurance program provided by the federal government. SSDI provides benefits to workers who become totally disabled and cannot work for at least one year. The program is administered by the Social Security Administration (SSA). SSDI pays cash benefits to disabled persons every month for as long as they remain disabled.
In order to qualify for SSDI benefits, you must have worked in a job that paid into the Social Security system. Additionally, you must be disabled according to the SSA's guidelines, and be unable to work for at least a year.
The SSA considers a person to be disabled if you can no longer perform the work you used to do, and cannot do other types of work because of your disability. Your disability must either be on the SSA's list of disabling conditions, or your impairment must be of equal severity to a medical condition on that list.
In general, no. In order to qualify for SSDI benefit, you must have paid in to the Social Security system through your regular paychecks. However, you may be able to qualify for SSDI benefits if your spouse is disabled.
Additionally, if you are disabled and you have no work history, you may be eligible for Supplemental Security Income (SSI) benefits, a separate government program which provides cash benefits to disabled adults and children with limited incomes, as well as person over 65 without disabilities.
A disabled person can receive SSDI benefits until either their disability ends, or they reach retirement age. Once a disabled person reaches age 65, their SSDI benefits stay the same, but will be funded by the Social Security retirement system.
SSDI benefits are for disabled people who have spent at least a portion of their life working and paying into the federal Social Security system.
Supplement Security Income (SSI) benefits provide monthly payments to people who are 65 and older, as well as low-income children and adults who are disabled from birth or are disabled with little or no work history.
A person is eligible for SSI benefits if he or she is aged 65 or older, or if he or she is a disabled child or adult and meets federal income requirements.
The income requirements for receiving SSI benefits can be complicated, and depend on many factors.
The Social Security Administration will take into account your entire family's income, as well as your assets. You are allowed to make some income while receiving SSI benefits, and allowances are made in these calculations. However, your countable income must be less than your federal benefit rate, or you will not qualify.
An experienced SSI attorney like those at Phillips Disability can help you determine if your income fits within the SSA's guidelines
If you receive SSI payments (not SSDI), then many states will provide additional cash payments to residents on top of what they receive from the federal government. These payments can range from an additional $10 to $200 per month, and the eligibility guidelines for state and federal SSI benefits are similar.
The following states do not provide additional supplements: Arizona, Arkansas, Mississippi, Oregon, Tennessee, Texas, and West Virginia.
Questions About The Application Process?
In order to apply for disability benefits, you will need to fill out an application. You can download these forms online, complete them over the phone by calling (800) 772-1213, or visit your local Social Security office.
Usually, you will also need to meet with a SSA representative to complete your application.
No, there is no charge to apply for Social Security benefits.
Before you apply, you should gather important materials to help speed along the process. In general, you will need the following (if applicable):
- A copy of your birth certificate
- A copy of your military discharge paperwork
- W2s and income tax returns from the last year
- Direct deposit information for your benefit payments
- Any workers compensation claim information you may have
- Information about your medical condition, including dates of treatments and the contact information for anyone who treated you
- Medical test information, including dates and the provider who performed them
- Medication records
- Copies of any other medical records
- A list of your last five jobs and the dates you have worked over the past 15 years.
This information is necessary to complete your disability benefits forms and will speed along your application meeting with the social security administration.
This is up to your medical provider, however, you will generally be charged for copies of your medical records.
After your benefits application is complete, it will be reviewed by the Social Security Administration.
During the application process, you will be asked to sign a release which allows the SSA to contact your medical providers. If the SSA needs more information regarding your claim, they may contact you or your doctors.
While your application is being reviewed, you may check the status of your application online. When the SSA has made a decision about your claim, it will send you a letter advising you of the outcome.
Usually it takes 3 to 5 months for the SSA to make a decision on your claim. The claims decision process may take longer if your application is incomplete or if the SSA needs additional information from you or your doctor.
No, you do not need an attorney to apply for benefits. However, it is useful to have your application reviewed by an experienced Social Security attorney to check for errors or omissions.
Many people only retain an attorney if their disability application has been denied.
Has Your Disability Claim Been Denied?
Many claims are denied at first. If your claim has been denied, don't give up! Phillips Disability can help you get the benefits you deserve.
If your initial claim has been denied, the first step of the appeals process is to ask for a reconsideration. During a reconsideration, a new SSA employee will review your information for a second time to determine if your initial reviewer made a mistake.
If you do not receive a favorable decision after your reconsideration, you can appeal your claim to an Administrative Law Judge (ALJ). The ALJ will hold a hearing, where you and your attorney will argue your case.
If the ALJ denies your appeal, you can also have your claim reviewed by the Appeals Council, which will review the ALJ's decision.
If you not agree with the Appeals Council's decision, or if the Appeals Council declines to hear your case, your only recourse would be to either re-file your initial claim with new evidence, or file a lawsuit in a federal district court.
If your initial claim has been denied, you have the right to request a reconsideration of your claim. During a reconsideration, a new SSA analyst will review your claim with fresh eyes and reconsider the decision of the first SSA analyst.
You will need to fill out a reconsideration request form within 60 days of your claim decision. You will be able to submit any new or additional medical evidence to support your claim with your reconsideration request.
Once your request is received, a new claim representative will review your information again and make a new decision.
If your initial claim and your reconsideration request were denied, you have the right to a hearing in front of an Administrative Law Judge (ALJ).
You must request a hearing within 60 days of receiving your denied reconsideration claim. If you miss the 60 day deadline, your claim may be permanently denied and you may have to begin the process again.
Once you have filed a request for a hearing, it generally takes at least a year for a hearing to be scheduled. In some parts of the country, it may take up to two years.
No, there is no requirement that you attend the hearing in person, but it is a very good idea to attend. Without your presence, the ALJ only has medical evidence and paperwork to review. Attending in person can help make your disability more evident and more personal to the ALJ deciding your claim.
At the hearing, your judge will ask you or your attorney questions about your medical condition and how your disability affects your life and your ability to work.
Your attorney can also ask you questions to solicit relevant testimony about your case. You may bring your doctor to the hearing to provide additional evidence, or expert medical witnesses may be called to explain your disability at greater length. You can also request that your spouse, former employer, friend, or other person testify about the effect your medical condition has had on your life.
It is unlikely that your ALJ will make a decision about your claim immediately. Usually, he or she will take some additional time to review evidence and testimony before making a decision about your claim.
Yes, you may submit any new evidence regarding your case to the ALJ, so long as it is submitted prior to your hearing.
Sometimes, the ALJ in charge of your hearing will make a decision about your claim immediately.
However, it is more likely that you will receive a decision about 6 weeks after your hearing.
Yes, you have the right to appeal the decision of the ALJ to the Appeals Council.
You must send your request in writing to the Appeals Council within 60 days of receiving the ALJ's decision.
The Appeals Council is made up of 68 ALJs, 42 Appeals Officers, and several hundred support staff.
Members of the Council review over a hundred thousand appeals from individual ALJs every year (Appeals Council panels considered 172,000 cases in 2013).
The Appeals Council will review your case, and will decide on one of three options:
- Your claim may be scheduled for a hearing in front of the Council,
- Your claim should be sent back to your original ALJ for reconsideration, or
- Your claim will be denied and the decision of the original ALJ will stand.
If the Appeals Council declines to review your case or decides against you, your final option is to file an appeal in a federal district court seeking review of the claim decision. Making it to this stage is very rare.
Most people faced with a denial at the Appeals Council stage choose to re-file their claim, adding additional information which may increase its chances of being approved.
Miscellaneous Questions About Your Benefits
This answer depends on the type of disability benefits you apply for and how much you used to earn before you became disabled.
If you are applying for Social Security Disability Insurance Benefits, your monthly payments will depend on how much your paychecks were before you became disabled. If you are applying for Supplemental Security Income, your payments will depend on your household income and your personal assets.
Both programs have maximum limits set by Congress. Your payments cannot exceed these maximums. For SSDI, the maximum disability benefit in 2014 is $2,642 per month, with the average amount being $1,148 per month.
For SSI benefits, the standard base rate is $721 per month, which may fluctuate based on the state where you live, your family's income, and your marital status.
In most cases, your attorney's fees for representing you on your benefits appeal will be 25% of the past-due benefits you are awarded. This amount is usually capped at $6,000.
Occasionally, your attorney may apply to the SSA for his or her fees to be calculated in a different way. Always make sure you understand what you will be charged for legal representation before you hire your attorney.
Unfortunately, it may take several months or even years to get a final decision on your disability benefits.
While you are waiting, you will have to find a way to continue living without your benefits, whether it be with the assistance of your family and friends, or through limited part-time work.
Once your benefits are approved, you will receive the back payments you missed while you were waiting for a decision.
This depends on when you applied, and the type of benefits for which you filed a claim. Once your benefits have been approved, you should be paid on the next month's payment date.
For SSDI, there is a statutory waiting period of five months after your injury. So, for example, if you were injured on January 1st, you could not receive your SSDI payments until May 1st. However, by the time your benefits are approved, most people have past this waiting period.
The date of your SSDI payments depends on your birthday. If you were born on the 1st through the 10th of a month, then you will receive your payment on the second Wednesday of the month. If you were born on the 11th through the 20th, then you will receive your payments on the third Wednesday. If you were born on the 21st through the 31st, then your payments will arrive on the fourth Wednesday of the month.
For SSI benefits, there is no five-month waiting period. Your SSI benefits are paid on the first day of the month (if it is a weekend or holiday, then you will be paid on the banking day prior to the 1st.)
Yes, your spouse and/or children may be eligible for benefits based on your disability payments.
In general, a child who is under the age of 18, and unmarried is entitled to an average of 50% of his or her disabled parent's SSDI payments.
A spouse may receive SSDI payments as well if he or she either cares for minor children who are eligible for SSDI benefits, or is over the age of 62.
Yes, disabled children are eligible for Supplemental Security Income benefits if they meet the qualifications set by the Social Security Administration.
Possibly. This mainly depends on your age and your family status.
If you are caring for a child under the age of 16 who receives SSDI benefits from your deceased spouse, then you can keep your spouse's benefits.
Or, if you are at least 60 years old (or at least 50 years old and disabled yourself) then you may also keep receiving your spouse's SSDI benefits.
This depends on the type of benefits you receive. Supplemental Security Benefits have income limitations, and your family's income and assets will be used to determine your eligibility for SSI benefits.
Social Security Disability Insurance, however, is based on your work history and not your family's income and assets.
Possibly. If you are able to work full-time, or are able to make a significant amount of money, then you will not be eligible for benefits.
However, you can both work and receive SSDI benefits as long as you earn less than the monthly income limit (usually $1,070 per month in income with a few exceptions).
Yes, though it may hurt your your chances of being approved for benefits.
While technically you are allowed to work part-time (as long as you make less than $1,070 per month), the person evaluating your claim might be more likely to deny your benefits if he or she believes that you could do full-time work. The closer you are to the upper income limit, the more likely it is that your work may affect the application process.
Both the SSDI and SSI programs have initiatives which allow you to try working again full-time while your benefits are on hold.
If you and your doctor determine that you are not able to work full-time, you will be able to resume receiving your benefits without having to re-apply, assuming you stay within the required time frame.
No. Even though eligibility for both programs is determined by your injury or disability, the qualification and evaluation process for Workers' Compensation is different than the requirements to receive SSDI benefits.
For example, you could receive Workers' Compensation and still be able to work full-time within a year, which would make you ineligible for SSDI.
Unfortunately, you will need to apply for SSDI benefits separately even if you have already been approved for Workers' Compensation benefits.
Possibly. If you do not have much work history, and your monthly SSDI benefit payments are very low (under $721 per month) then you may be able to supplement your income with SSDI benefits.
Yes, if your injury qualifies for both. You will not, however, receive the same amount of benefits from each program as you would if you were just receiving one or the other. Your SSDI payments will be reduced so that your total benefits do not equal more than 80% of your average earnings before you became disabled.
Yes, if you qualify for both. If you had the required work history (either in civilian or military life) and qualify for SSDI benefits, then you can collect SSDI in addition to veterans' disability benefits.
If you do not have enough work history for SSDI, and have a low income and few assets, then you may be able to collect both VA benefits and SSI payments, as long as you are still under the SSI program's income limits after accounting for your veterans' benefits.
If you are receiving SSDI benefits when you reach retirement age, you will continue receiving the same amount of benefits - however, your benefits will come from the Social Security retirement fund, rather than the SSDI fund. You will not receive additional benefits once you reach retirement age.
Usually yes. Everyone who receives SSDI benefits is eligible for Medicare after a 24-month waiting program. During the waiting period, you may be eligible for other forms of health insurance through your employer.
If you receive SSI, your eligibility for Medicaid benefits may depend on your state. In most states, an application for SSI acts as an application for Medicaid, while in others, you may need to apply for Medicaid through a separate agency.
Do You Have Questions? Contact Us Today
Was your SSDI or SSI claim denied? Do you have additional questions about what you should do? At Phillips Disability, P.C., our experienced Social Security attorneys have years of experience helping people just like you get the benefits you deserve.