Social Security Disability Attorney

What does Social Security Disability pay?

​The amount of Social Security Disability benefit depends on many factors and the type of claim available to you. The amount for those who have worked enough and paid enough taxes into the system to be considered “insured” by Social Security will be based on their Social Security record. Other dependent family members may also be entitled to file a claim on another’s work record. Other types of Social Security benefits have nothing to do with having paid taxes but are based on the individual having limited income and resources and may be affected by family circumstances and household.    

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What are Social Security Disability requirements?

Some people think proving a disability is as simple as bringing in a doctor’s note saying they can’t work. But that’s just not how it works. You must legally prove you are “disabled” the way the Social Security Administration has defined it. 

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Under its rules, the agency considers you to be disabled if your medical condition meets or equals the criteria in its listing (i.e., an impairment specifically listed by the agency that is severe enough that Social Security considers it disabling), or if:

• You cannot perform work you were able to before;

• You cannot perform any other work due to your medical condition(s), age, education, and work experience; and

• Your disability has lasted or is expected to last for at least one year or to result in death.

 

Applying for Social Security disability benefits is a complicated legal process. You must prove you are “disabled” according to the Social Security Administration’s rules.

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How Social Security Disability is Calculated

It depends on the type of claim available to you. You can get your Social Security Statement (Statement) online by using your personal my Social Security account.   

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For those seeking disability on their own work record, who worked enough, and paid enough taxes into the system to be considered “insured” by Social Security, the amount will be based on their Social Security record. Your online Statement gives you access to estimates for retirement, disability, and survivors benefits you and your family may be eligible for. Other types of Social Security benefits have nothing to do with having paid taxes but is based on the individual having very limited income and resources and may be affected by your family circumstance and household. 

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How Social Security Disability Works

For individuals who are “insured” by Social Security standards and who filed a disability claim based on their work record, the Social Security Administration will evaluate your work record, medical evidence, and other factors to determine whether you are eligible. 

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Many people believe if they simply explain their situation to Social Security or bring in a doctor’s note, someone will understand and award them disability benefits. Unfortunately, that’s not the way Social Security works. Whether you are disabled or not is a legal determination made by the Social Security Administration under its rules. If you are found disabled under their rules, then generally, Social Security pays monthly benefits following a 5-month waiting period, which begins to run after the date they find your disability began, but that can be affected by when you filed your claim.

 

They may pay Social Security Disability benefits for as many as 12 months before you apply if they find you had a disability during that time and you meet all other requirements. You may be entitled to Medicare (i.e., government-provided health insurance) after 2 years of benefits eligibility. 

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Benefits usually continue until you can work again on a regular basis, but Social Security may also conduct a redetermination to see if you are still disabled even after your benefits begin. 

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There are different rules for individuals or children who have not worked enough to be considered “insured” by Social Security. They may be entitled to Supplemental Security Income (SSI). This type of claim also requires that you prove to Social Security that you are disabled, but also that you have very limited resources. The maximum amount of this benefit is known as the “federal benefit rate.” The amount of benefits can be affected by factors such as living situation, marital status, and assets owned by the individual (as well as parental income and assets for children’s claims).

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There is an application process.

It is extremely important that you fill out the application accurately. A claim is filed with the District Office (DO) or Field Office (FO) via telephone, online, or an in-person visit. If the claimant meets nonmedical requirements, then the file is sent to the Disability Determination Service (DDS), sometimes called the State Agency, to do the medical evaluation and make an initial determination. DDS will send forms to the claimant, order records, and may schedule consultative examinations if they need more medical information before they can decide if you have a disability. If denied at the initial level, then an appeal known as “reconsideration” can be filed within a limited time period. If DDS again denies the claim, then you may request a hearing before an Administrative Law Judge (ALJ) (again, within a limited time), which can be conducted either over the phone, video conference or in person at the local Hearing Office. There are also additional ways to appeal if you do not win your case before the ALJ, including taking your claim to Federal Court.

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Medical records are ordered based on the information provided by you. Eligibility determinations are made based upon all of the facts and medical evidence in your case.

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Social Security will ask about:

• Your medical condition(s);

• When your medical condition(s) began;

• How your medical condition(s) limit your activities;

• Medical tests results; and,

• What treatment you’ve received.

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They’ll also ask for information about your ability to do work-related activities, such as walking, sitting, lifting, carrying, and remembering instructions.

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Social Security Disability Five-Step Evaluation Process

1. Are you working?

If you’re working, it is difficult to meet the definition of disability. However, if you’re not working, or you are working so little that Social Security doesn’t consider it “substantial gainful activity,” then the agency looks at your medical condition at step two.​

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2. Is your medical condition “severe?”

For you to be considered disabled by Social Security’s definition, your medical condition must significantly limit your ability to do basic work activities — such as lifting, standing, walking, sitting, and remembering — for at least 12 months. If your medical condition isn’t severe, you won’t be considered to have a qualifying disability. If your condition is considered severe, the agency staff begins step three.

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3. Does your medical condition meet or medically equal a listing?

The agency’s listing of impairments describes medical conditions that they consider severe enough to prevent a person from doing any gainful activity. These conditions are deemed severe regardless of age, education, or work experience. Within each listing, experts specify the objective medical and other findings needed to satisfy the criteria of that listing. If your medical condition meets or medically equals (meaning it is at least equal in severity and duration to) the criteria of a listing, the agency can decide that you have a qualifying disability. If your medical condition doesn’t meet or medically equal the criteria of a listing, the agency goes on to step four.

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4. Can you do the work you did before?

At this step, the agency decides if your medical condition(s) prevents you from performing any of your past relevant work. If it doesn’t, then Social Security can decide you don’t have a qualifying disability. If they determine that it does, the agency proceeds to step five.

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5. Can you do any other type of work?

If you can’t do the work you did in the past, the agency will look to see if there is other work you can do despite your medical condition(s). Factors include your age, education, past work experience, and any skills you may have that could be used to do other work. If you can’t do other work, the agency may decide that you have a qualifying disability. If you can do other work, they can decide that you don’t have a qualifying disability.

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Why Social Security Disability is Denied

The Social Security Disability system involves complicated rules, regulations, and procedures. There are countless ways the Social Security Administration can deny your claim.

 

For example, the agency failed to obtain all your medical evidence, or the agency used the wrong legal standard when evaluating your claim. Medical records can be interpreted in a number of ways, sometimes against you – so can your work history or your education. The Social Security Administration may rely on the opinions of doctors who never examine you and may fail to get the opinions of the doctors who know you best – your own treating doctors.

 

Sometimes, the agency will even deny your benefits because they “believe” you will get better and will be able to return to work. You may also lose your case if an appeal is handled improperly.

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​Where to File Social Security Disability

A claim can be filed with the local District Office (DO) via telephone, online, or an in-person visit. You can visit ssa.gov to contact the Social Security Administration. If you are denied, then please call us and we can help you with your appeal. 

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Who Qualifies for Social Security Disability?

There are several types of disability benefits offered by the Social Security Administration. Each has its own set of rules and requirements. To receive Social Security Disability benefits, you must be eligible to apply, and you must meet the definition of disabled. We’ll help you determine whether you do.

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Are Social Security Disability benefits taxable?

Some Social Security Disability benefits may be taxable. You will need to consult your tax advisor to determine for sure.

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​Are Social Security Disability benefits retroactive?

Social Security Disability benefits based on your work record may be retroactive for a specified or limited period of time, depending on the circumstances and facts involving the claim and the onset of the disability. Generally, there is a 5-month waiting period, and they will pay your first benefit the sixth full month after the date they find your disability began. They may pay Social Security Disability benefits for as many as 12 months before you apply if they find you had a disability during that time and you meet all other requirements.  However, there are many different kinds of Social Security Disability benefits, and some do not allow for retroactive payments. We will help determine the type of benefits you may be eligible to receive.

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​Social Security Disability Without Work History

While a work history is required for some Social Security Disability benefits known as SSD, SSDI or DIB, it is not required for Supplemental Security Income (SSI).

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​Social Security Disability to Retirement

If you are receiving SSDI benefits when you reach full retirement age, your disability benefits automatically convert to retirement benefits, but the amount remains the same.

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Social Security Disability and Medicare

Everyone eligible for Social Security Disability Insurance (SSDI) benefits is also eligible for Medicare after a 24-month qualifying period. The first 24 months of disability benefit entitlement is the waiting period for Medicare coverage. During this qualifying period for Medicare, the beneficiary may be eligible for health insurance through a former employer. The employer should be contacted for information about health insurance coverage. There are two notable exceptions to this rule which do not require a 24-month waiting period: End Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis.