Monday, July 06, 2009

Thoughts on how to get Social Security Benefits if You are Disabled

I recently came across an interesting article in the Wall Street Journal that analyzed why so many individuals have problems securing Social Security disability benefits. The article presented some interesting factoids about disability such as: A) 7.4 million Americans are receiving Social Security disability benefits (this is a small percentage of the overall Social Security benefit payout; by and large retirement benefits are a much greater percentage of the overall Social Security benefit payout) and B) the number of adults reporting a disability has dramatically increased according to the Centers for Disease Control and Prevention between the years of 1999 and 2005.

Of course, it goes without saying that the realities of our sour economy have increased the number of individuals who are applying for Social Security disability. In this time of harsh economic conditions, you are finding many more individuals who are older and who have medical problems being laid off from their jobs. Consequently, many workers have been forced into the Social Security disability programs and Social Security retirement just to make ends meet.

The article went on to list some common errors to avoid should you find yourself disabled and in need of Social Security disability benefits.

1) One of the most common mistakes that individuals make when considering whether or not to file for Social Security disability is not having a clear understanding of what Social Security disability is. Although the article did not mention the complete definition of disability for Social Security, I thought I would include the definition from the “Disability Evaluation Under Social Security” Handbook (the disability guidebook used by Social Security to make disability-medical decisions).

“For all individuals applying for disability benefits under title II (SSD), and for adults applying under title XVI (SSI), the definition of disability is the same. The law defines disability as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment (s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”

As you can see, Social Security is a total disability program, not a short-term or long-term disability program, nor is it a percentage-of-disability program such as veteran’s disability.

Disability applicants also seem to erroneously think that this means “disabled from their past work activity alone” and they do not realize that it really means that they must be unable to perform any type of work performed in the general economy for which their particular vocational profile (education, work skills, age, and current limitations) might make them suitable.

2) The article was correct in mentioning the fact that disability applicants often wait too long to file their disability claim once they have been forced to stop performing substantial work activity. When you consider the fact that it takes anywhere from 30 to 100 days on average to process an initial disability approval or denial, and if you have to pursue the Social Security disability appeal process the time could be months or even years, then it becomes fairly clear that delaying the filing of a claim can be potential harmful.

The article also mentioned that Robert Pepper, public affairs specialist for the Social Security Administration stated that, in addition to the processing time for initial disability claims, there is the five-month wait from an individual’s date of onset before they receive monthly benefit checks. There are so many things affected by a disability applicant’s date of onset and filing date. For instance, the article correctly mentioned that it is twenty-four months after the month of entitlement before an individual can receive health coverage through Medicare.

3) Financial Mistakes ……well this is where I think that the article does not have its hand on the pulse of the average disability applicant. Although it is good advice to prepare for the length of time it takes to be awarded disability benefits both financially and mentally, they mention financial planning in the sense that a typical applicant can make it until they get monthly benefits and beyond to Medicare entitlement.

Quite frankly, most individuals do not have the financial resources and means to do any kind of real financial planning. Most are just getting by as it is, let alone to plan for two years into the future.

It has been my experience that nearly all individuals who apply for disability will suffer some kind of financial hardship and mental duress, and most will suffer both severe financial hardship and mental duress before they are approved for disability.

The article mentioned a few other errors that are for the most part common sense items like being organized, being persistent, getting help when you need it, and making sure that you correct any inaccurate information on your yearly Social Security statement.

In summary, if you decide to file for Social Security disability make sure that you are organized with your medical information. You do not have to acquire your own medical records but you should be able to give the names, addresses, treatment dates, tests, and medication prescribed by each of you treating medical professionals.

If you are denied on your initial disability claim, do not be discouraged, just begin the Social Security appeal process. It is true that there are significant backlogs at most hearing offices around the country, but if you actually get your administrative law judge hearing, (and you will if you file the request and wait for the scheduling, which, it goes without saying, will be long), then you have approximately a sixty -six percent chance of being approved for disability benefits.

National disability hearing approval statistics indicate that roughly two thirds of all disability hearings result in disability awards for the applicants. Generally, persistence does pay off for disability applicants who do not give up.

If you do not feel that you are capable of being organized and keeping up with appeals, then get a Social Security representative to handle your case for you. A representative will receive copies of your correspondence, will file your appeals for you and can make status calls on your case.

While representation is typically not crucial at the first appeal level, the request for reconsideration, disability representation is highly recommended for those whose claims will be decided at an administrative law judge hearing. And, in fact, many or most disability judges will offer claimants who show up at a hearing minus representation the opportunity to have the hearing rescheduled so that a disability attorney or a disability non-attorney representative can be located.

Remember, if you do obtain the services of a representative they will have you sign a fee agreement that will allow them to be paid twenty five percent of any back payment up to a certain maximum amount (Social Security sets the maximum fee amount). Sometimes, representatives include other incidental expenses such as travel, copying, obtaining medical records, etc. Unfortunately, you may be required to pay the incidental fees win or lose, so read your fee agreement thoroughly prior to signing.

Return to the Social Security Disability SSI Benefits Blog

Other Posts

How many people win Disability Benefits from Social Security ?
Getting Disability - Social Security Disability and SSI
Social Security Disability Requirements and Eligibility Criteria
Social Security Disability SSI and Chronic Pain
Social Security Back Pay

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Blogger Kimberly said...

I have a ?? I cant find the answer to and hope u can help.
I applied for SSI and was denied,I filed a appeal and hired a attorney. I also filed for medicaid and recieved notice recently that I am going to be recieving medicaid .I read SS and Medicaid have the same guidelines on determination and wondered why would I be denied SSI and awarded medicaid for a disability.Im also wondering if winning the medical portion will help my SSI case?

8:12 PM  
Blogger Disability Blogger said...

Hi Kimberly, I posted a response on this page: Social Security Disability and Medicaid for Disabled Adults

7:42 AM  

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