What is the definition of disability used by Social Security?

Under the Social Security Act, "disability" means "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months." Top

How many different types of Social Security disability benefits are there?

There are at least five major types of Social Security disability benefits. Disability Insurance Benefits is the most important type of Social Security disability benefits. It goes to individuals who have worked in recent years (five out of the last 10 years in most cases) who are now disabled. Disabled Widow's and Widower's Benefits are paid to individuals who are at least 50 and become disabled within a certain amount of time after the death of their husband or wife. The late husband or wife must have worked enough under Social Security to be insured. Disabled Adult Child Benefits go to the children of persons who are deceased or who are drawing Social Security disability or retirement benefits. The child must have become disabled before age 22. For Disability Insurance Benefits, Disabled Widow's or Widower's Benefits and Disabled Adult Child benefits, it does not matter whether the disabled individual is rich or poor. Benefits are paid based upon a Social Security earnings record. Supplemental Security Income benefits, however, are paid to individuals who are poor and who are disabled. It does not matter for SSI whether an individual has worked in the past or not. SSI child's disability benefits are a variety of SSI benefits paid to children under the age of 18 who are disabled. The way in which disability is determined is a bit different for children. Top

How do I apply for Social Security disability benefits?

To ensure you have properly applied for Social Security disability benefits, please visit www.ssa.gov/disability - Top

How long do I have to wait after becoming disabled before I can file for Social Security disability benefits?

Not even one day. You can file for Social Security disability benefits on the very same day that you become disabled. To prevail in a claim though, there must be medical proof that you meet the standard. There is no reason to file a Social Security disability claim if one has only a minor illness or one which is unlikely to last a year or more. However, an individual who suffers serious illness or injury and expects to be out of work for a year or more should not delay in filing a claim for Social Security disability benefits. Top

How does Social Security determine if I am disabled?

Social Security is supposed to gather your medical records and carefully consider all of your health problems, as well as your age, education, and work experience. In general, Social Security is supposed to decide whether you are able to do your past work. If Social Security decides that you are unable to do your past work, they are supposed to consider whether there is any other work which you can do considering your health problems and your age, education, and work experience. Top

Who decides if I am disabled?

After an individual files a Social Security disability claim, the case is sent to a disability examiner at the Disability Determination agency in your state. This individual, working with a doctor, makes the initial decision on the claim. If the claim is denied and the individual requests reconsideration, the case is then sent to another disability examiner at the Disability Determination agency, where it goes through much the same process. If a claim is denied at reconsideration, the claimant may then request a hearing. At this point, the case is sent to an Administrative Law Judge who works for Social Security. The Administrative Law Judge makes an independent decision upon the claim. This is the only level at which the claimant and the decision maker get to see each other. Top

Why does Social Security consider my age in determining whether I am disabled?

Social Security has to consider age, because that is what the Social Security Act requires. As people get older, they become less adaptable, less able to switch to different jobs to cope with health problems. A severe foot injury which might cause a 30- year- old to switch to a job in which he or she can sit down most of the time, might disable a 60- year- old person who could not make the adjustment to a different type of work. Top

If I am approved for Social Security disability benefits, how much will I get?

For disability insurance benefits, it all depends upon how much you have worked and earned in the past. For disabled widow's or widower's benefits, it depends upon how much the late husband or wife worked and earned. For disabled adult child benefits, it all depends upon how much the parent worked and earned. For all types of SSI benefits, there is a base amount that an individual with no other income receives. Other income that an individual has reduces the amount of SSI which an individual can receive. Top

What do I do if Social Security denies my claim for Social Security disability benefits?

First, do not be surprised. Only about 30% of Social Security disability claims are approved at the initial level. If you are denied at the initial level, unless you have already returned to work or expect to return to work in the near future, you should appeal, that is, file a request for reconsideration. You should also consider employing an attorney to represent you. Top

What is "reconsideration"?

When a claim for Social Security disability benefits is denied at the initial level, the claimant may then request a further review. At this time that review is called "reconsideration." The case is then sent to a different disability examiner at the same disability agency for "second look" and more development as he/she deems it necessary. Reconsideration approvals are rare, causing the Social Security Administration to rethink this step in the appeals process. In many states Reconsideration has already been eliminated and cases go directly to administrative hearing. Currently, the Social Security Administration has announced that Reconsideration will be replaced with a new process. That is now being phased in nationally wherein a federal reviewing officer, outside the state disability determination agency will review claims. Top

Who makes the reconsideration determination?

A disability examiner at the state Disability Determination Section makes the reconsideration determination. A claimant does not meet in person with a disability examiner. Under the new procedures, when adopted, a decision will be made by a Reviewing Officer, outside the state agency. This officer will be an attorney. Top

What are my chances of winning at reconsideration?

Statistically, about 15% of the time a claimant wins at reconsideration. Top

Do I have to go through reconsideration?

If you want to appeal a denial of Social Security disability benefits, you have to go through reconsideration. There is no way to avoid it. Top

How long does it take to get a hearing on a Social Security disability claim?

There is much variation around the country. In a few areas of the country the wait is only three months. In a few areas of the country the wait is more than a year. Top

What are my chances of winning at a hearing?

Statistically, over half of the claimants who have a Social Security disability hearing win. Top

What is the Appeals Council?

The Appeals Council exists to review Administrative Law Judge decisions. The Appeals Council is located in Falls Church, Virginia, and neither the claimant nor the attorney sees the people at the Appeals Council who are working on the case. Top

What happens if my Appeals Council case is denied?

After being denied by the Appeals Council, it is possible for a claimant to file a civil action in the United States District Court, requesting review of Social Security's decision. A Social Security disability claim can go all the way to the Supreme Court. Perhaps once every year or two years, the United States Supreme Court actually hears an appeal about a Social Security disability case. The scope of review is quite limited and a $350 filing fee applies. Top

I am a widow. I have not worked in public work in many years. I am disabled. Can I get Social Security disability benefits?

If you are over 50 and became disabled within seven years after your husband or wife died or within seven years after you last drew mother's or father's benefits from Social Security, you can get Disabled Widow's or Widower's Benefits. Perhaps more important, if you are poor, you can draw Supplemental Security Income benefits no matter what age you are or when you became disabled. Top

How long does it take before Social Security makes a decision once I file a claim for Social Security disability benefits?

In most cases Social Security makes the first decision within four months. Top

How long does it take for Social Security to make a reconsideration determination on my Social Security disability claim?

In most case Social Security makes the reconsideration determination within four months. Top

How long does it take for Social Security to act upon a request for Appeals Council review?

About a year, though maybe longer. Top

What is the difference between Medicare and Medicaid?

The short answer is that Medicaid is a poverty program and Medicare isn't. Many disabled people who get Medicaid get it because they are on Supplemental Security Income (SSI). This is called "categorical" Medicaid eligibility. To get SSI and thereby get Medicaid you have to be poor and disabled. Medicaid pays doctors at very low rates. People who have only Medicaid can have a hard time finding doctors willing to take them on as patients. Medicaid does pay for prescription medications. Medicaid can go back up to three months prior to the date of a Medicaid claim. Note that it is possible to apply for Medicaid directly - through a local Medicaid office - without having a companion claim for SSI.

For Medicare it does not matter whether you are rich or poor. If you have been on Disability Insurance Benefits, Disabled Widows or Widowers Benefits or Disabled Adult Child Benefits for 24 months you qualify for Medicare. The good thing about Medicare is that it pays doctors at a higher rate than Medicaid. Almost all doctors are happy to take Medicare patients. The bad things about Medicare are that it does not begin until after a person has been on cash disability benefits for two years and that it generally does not pay for prescription medications. Top

If I get Social Security disability benefits will I get Medicare?

If you are approved for any kind of Social Security disability benefit other than SSI you will get Medicare after you have been entitled to Social Security disability benefits for two years. Top

If I get Social Security disability benefits will I get Medicaid?

There is a likelihood but no guarantee that you will receive Medicaid if you are granted Social Security disability benefits. In the state of Indiana the determination process is separate and slightly different. Top

If you or a loved one has been denied Social Security benefits because of your physical or cognitive impairment, the law offices of Keller and Keller are available to you for a free, confidential consultation with an attorney from our firm who is experienced in handling personal injury claims. You can either contact us by phone at 1-800-2KELLER or through the use of our Free Case Evaluation submission form.

Should you decide to retain our services after the initial consultation, we will work on a contingent fee basis. This means that our offices will only be paid for our services once we make a recovery on your behalf from the insurance company.