Boston Social Security Disability Frequently Asked Questions
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Boston Social Security Disability Frequently Asked Questions

GENERAL QUESTIONS

What does it mean to be disabled?
What is the difference between SSDI and SSI?
I’ve had these conditions my whole life; will SSA consider that?
Will Social Security take into account my mental health conditions?
Is it possible to speed up my disability case?
Can I work and apply for or collect disability?
Can I collect unemployment and apply for disability?
How much will I receive in monthly SSDI or SSI payments?
Are there retroactive benefits available for SSDI and SSI?

THE APPLICATION AND DISABILITY EVALUATION PROCESS

When should I apply for disability?
How do I start the disability application process?
I received a denial for my disability benefits; how do I file an appeal?
What happens after I apply for disability? What’s the process like?
How does Social Security evaluate my case?
What if my initial disability application is denied?

THE HEARING LEVEL

When should I file a request for disability reconsideration hearing?
What happens when I request a disability reconsideration hearing?
How long do I have to wait for my disability reconsideration hearing?
What happens at a disability reconsideration hearing?
What happens after the hearing? When can I expect the judge’s decision?
What happens if the judge denies my disability case?
How do I win my disability case?
Do I need an attorney for a Social Security Disability Case?
Why use Attorney Timothy Pope?

Becoming disabled is never easy. In addition to the added hardships in your day-to-day life, it can be a real challenge to make ends meet. Fortunately, Social Security Disability Insurance (SSDI) is available to those who qualify, but applying for this assistance is anything but straightforward. It’s not easy to know if you meet the necessary criteria, and it can be surprisingly easy to get denied benefits.

With that in mind, we’ve provided answers to some of the Social Security Disability (SSD) and Supplemental Security Income (SSI) questions we get asked most frequently:

 

What does it mean to be disabled?

Social Security pays only for total disability and not for partial or short-term disabilities. To be considered disabled, you must prove the following:

  • You cannot do any of the work that you’ve done in the past
  • You cannot adjust to any other type of work
  • Your disability has lasted or is expected to last for at least one year or result in death

 

What is the difference between SSDI and SSI?

SSDI is paid to people who are disabled, but who have also worked long enough and recently enough under Social Security:

  • Social Security will determine if you have worked and paid into the Social Security system enough to be eligible to apply for SSDI
  • However, a general rule of thumb is that to be eligible to apply for SSDI, you must have worked at least five years full time and “on the books” out of the last ten years

SSI is paid to disabled adults and children who have limited income and resources. There is no previous work requirement for SSI.

Both SSDI and SSI utilize the same evaluation process for determining if you are disabled under Social Security Administration (SSA) rules.

 

I’ve had these conditions my whole life; will SSA consider that?

Certainly, the length of time that you’ve dealt with your medical conditions will be considered. However, what is more important is how those conditions affect you in the present day and how those conditions impact your ability to work.

If you have been able to work through these conditions, you must demonstrate what has changed with these conditions that preclude your ability to work. In other words: Have your conditions gotten worse? What has changed?

 

Will Social Security take into account my mental health conditions?

Yes, Social Security considers all severe physical and mental health conditions that impact your ability to work. Indeed, many applicants for disability allege that they are disabled due to a combination of physical and mental health impairments.

 

Is it possible to speed up my disability case?

Yes, under limited circumstances, SSA may speed up or expedite your case by determining that it is “critical.” Examples of critical cases include the following:

  • Individuals with terminal illnesses
  • Veterans with 100 percent permanent and total disability
  • Dire-need situations in which a person is facing homelessness, eviction, or foreclosure

Note: If your case is deemed critical, it does not increase your chances to be awarded disability.

 

Can I work and apply for or collect disability?

Yes, an individual may work and apply for or collect disability simultaneously. However, an individual cannot exceed substantial gainful activity (SGA) and collect disability. In 2017, SGA is $1,170 per month (before taxes).

Please be aware that in evaluating your disability, SSA can consider part-time work as evidence that you are not disabled. For example, if you allege that you are disabled due to a lower back injury but work part time at a job requiring heavy lifting, this work activity may weaken your case.

 

Can I collect unemployment and apply for disability?

Yes, it is possible to apply for disability and still collect unemployment benefits. However, individuals who collect unemployment must certify that they are ready, willing, and able to work. This language contradicts your allegation to SSA that you are unable to work.

Some of SSA’s adjudicators, especially certain judges, will use the receipt of unemployment benefits during the disability application process to diminish an individual’s credibility.

 

How much will I receive in monthly SSDI or SSI payments?

SSDI payments are based on your lifetime average earnings. Essentially, the more you pay into the system, the higher your monthly payment will be. Most SSDI recipients receive between $800 and $1,700 per month.

SSI payments are around $700 per month, plus a potential state supplement. However, this amount may be reduced by certain personal and household assets or income.

 

Are there retroactive benefits available for SSDI and SSI?

Yes, for SSDI benefits, an individual may be entitled to retroactive benefits as far back as one year prior to the application date.

While SSI does not have retroactive payments, an individual may be entitled to payments as of the month after his or her application.

 

The Application and Disability Evaluation Process

 

When should I apply for disability?

You should apply for benefits as soon as you become disabled. While you must prove that your disability has lasted or is expected to last for at least one year, it is not necessary to wait a full year before you apply.

Do not delay! The process can take more than two years to complete.

 

How do I start the disability application process?

You can complete an application online, or you can call or visit your local Social Security office. Use this link to locate your local office via your ZIP code: https://secure.ssa.gov/ICON/main.jsp

Contact Joel H. Schwartz, PC and we may be able to file the application for you!

 

I received a denial for my disability benefits; how do I file an appeal?

You can appeal a denial by contacting your local Social Security office. Denials must be appealed within sixty days!

Unless you can show good reasons for missing an appeal deadline, you will have to start a new application if you do not appeal in a timely manner

Contact Joel H. Schwartz, PC and we can file the appeal for you!

 

What happens after I apply for disability? What’s the process like?

After you have filed your application, your case is sent to the Disability Determination Services (DDS) office in your state. DDS employs doctors and disability specialists to evaluate your conditions.

DDS will request medical records and may request that you see one of their medical examiners for what is known as a consultative examination. You must attend this consultative examination!

You can usually expect a decision on your application within about three to five months.

Joel H. Schwartz, PC’s approach to lower-level cases:

Many people whose applications for disability are denied complain that SSA did not receive or consider all their medical records. Frequently, DDS does not receive all your records and makes a decision based on an incomplete file!

At Joel H. Schwartz, PC—unlike most other firms—we request and receive medical records for our clients at every stage of the application process. This aggressive approach allows us to win many more cases at the lower levels of the application process than other firms do.

 

How does Social Security evaluate my case?

SSA uses a five-step process to determine if you are disabled:

 

Step 1: Are you working?

In 2017, the general rule is that if you are making more than $1,170 per month before taxes, SSA will not consider you disabled.

 

Step 2: Are your medical conditions “severe”?

Your medical condition must, at the very least, significantly limit your ability to do basic work activities, such as walking, standing, sitting, lifting, or concentrating, for at least twelve months.

**For many applicants, this is a relatively easy standard to meet.**

 

Step 3: Does your impairment meet or medically equal a listing?

SSA has compiled a list of impairments known as “listings” that they consider severe enough to prevent a person from working regardless of age, education, or past work experience. If you condition meets or equals the listing, you will be considered disabled.

If your condition does not meet a listing, SSA will proceed to step four.

 

Step 4: Can you do the work you did before?

SSA will consider all the work that you performed at an SGA level within the past fifteen years. This is called “past relevant work.”

If SSA determines that you can perform your past work, SSA will deny your application.

If SSA determines that you cannot perform your past work, SSA will proceed to step five.

 

Step 5: Can you do any other type of work?

SSA considers your age, education, past work experience, and any previously acquired skills to evaluate your capacity for other work.

In many instances, the older an applicant is, the easier it is to win at this stage. SSA has determined that the older a person gets, the more difficult it would be to adjust to another type of job.

 

What if my initial disability application is denied?

You should file an appeal (known as a request for reconsideration) within sixty days of that denial.

Do not give up! The vast majority of cases are denied at the initial stage! If your application is denied, contact Joel H. Schwartz, PC and we may be able to file the appeal for you!

 

The Reconsideration Process

A reconsideration is a complete review of your claim by a different staff member at DDS. This process can take another three to five months.

 

The Hearing Level

 

When should I file a request for disability reconsideration hearing?

If your request for reconsideration is denied, you must file a request for a hearing. With this appeal, you are requesting that a federal administrative law judge evaluate your application for disability.

 

What happens when I request a disability reconsideration hearing?

Each request for a hearing is transferred to a hearing office, officially known as an Office of Disability Adjudication and Review (ODAR). The particular ODAR to which your case is transferred is determined by your local Social Security office.

In Massachusetts, for example, there are ODARs in Boston, Lawrence, and Springfield. The Boston ODAR also has satellite hearing offices in New Bedford and Hyannis. The Springfield ODAR also has satellite hearing offices in Worcester and Pittsfield.

 

How long do I have to wait for my disability reconsideration hearing?

The length of time between when you file your request for a hearing and when your hearing is held varies depending on the particular hearing office.

However, most ODARs have more than a one-year wait.

Here is a link to Social Security’s statistics on hearing wait times: https://www.ssa.gov/appeals/DataSets/01_NetStat_Report.html

 

What happens at a disability reconsideration hearing?

You will appear before an administrative law judge (ALJ), accompanied by your attorney. Your attendance of this hearing is mandatory.

These hearings are private; there is no jury or audience observing your testimony.

Other individuals at your hearing may include a hearing reporter (or assistant), a vocational expert (an expert on jobs), and a medical expert (a doctor who reviewed your medical records).

Your testimony is taken under oath. For the most part, this is the most formal aspect of the hearing.

Most ALJs will ask you questions directly; your attorney cannot testify on your behalf.

ALJs have many different styles and preferences:

  • Some ALJs aggressively question the claimants (and the attorneys)
  • Other ALJs take a more passive approach and allow the attorney to ask the claimant the majority of the questions
  • **Given this variability, it is vital that your attorney have knowledge of the judge’s style and expectations, as this can make or break your case!**

In general, you will be questioned about your work history, your disabling impairments, how those impairments impact your ability to work, and how those impairments impact your activities of daily living. The hearing is an opportunity for you to tell your story.

 

What happens after the hearing? When can I expect the judge’s decision?

After your hearing, the judge will send you (and your attorney) a formal decision in the mail. There is no regulatory time limit to the decision process; the judges can take as long as he or she wants to make the decision.

The wait time varies based on a judge’s current case-load. However, most judge’s typically take between one and two months to finalize and mail a decision to you.

 

What happens if the judge denies my disability case?

If the judge denies your case, you have the right to file an appeal with the Appeals Council in Virginia. The Appeals Council handles appeals from all fifty states

The overwhelming majority of Appeals Council requests for review are denied. Therefore, in most instances, it make more practical sense to file a new application after the judge denies your case.

 

How do I win my disability case?

Medical Treatment!

  • In general, the most vital aspect to winning a disability case is consistent medical treatment
  • Medical records are evidence that prove to Social Security that you are disabled
  • Without medical treatment, it is very difficult for Social Security to evaluate your condition, making it difficult for you to win your case

Specialized Medical Treatment

  • Consistent treatment with specialized medical professionals can also strengthen a claim
  • For example, for lower back conditions, consistent treatment with orthopedics, neurosurgeons, and pain management specialists can strengthen your claim
  • Likewise, for psychiatric impairments, regular treatment with a psychotherapist and a prescribing mental health specialist is vital to your claim

Follow Prescribed Treatment

  • SSA expects claimants to follow the advice of their medical providers
  • With limited exceptions, an individual cannot be found disabled if he or she fails to follow the prescribed treatment that would be expected to restore that individual’s ability to work
  • To put it simply: Listen to your doctors!

Avoid Substance Abuse!

  • While it is clear that the abuse of substances is detrimental to your health, it can also severely weaken your disability case
  • If Social Security determines that substance abuse is a contributing factor material to the determination of disability, they will deny your case
  • Essentially, Social Security asks: Would you still be disabled if you stopped abusing or using drugs and alcohol?

Support from Your Providers

  • Letters or questionnaires of support from providers in which they summarize the effects that your conditions have on your ability to function can be invaluable
  • If these letters are supported by the medical evidence, they can help win a case

 

Do I need an attorney for a Social Security Disability Case?

While it is not legally required to obtain a representative, retaining the services of a disability expert will almost always help a case.

However, not every attorney specializes in disability law, so it is vital to retain an expert.

 

Why use Attorney Timothy Pope?

Attorney Pope has specialized solely in Social Security Disability law for nearly ten years. He has attended more than 2,000 hearing throughout New England.

Furthermore, Attorney Pope knows the local judges and is an expert at preparing each case and client for the specific judge.

We are available to answer your questions! Please contact Joel H. Schwartz, PC for a free consultation by one of our social security experts. Simply call 1-800-660-2270 or complete the contact form below.

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