SSDI Frequently Asked Questions

1. How does the Social Security Administration (SSA) define disability?

You need to show that you are disabled from working, and that your disability has lasted for 12 continuous months, or that your disability is likely to last for 12 continuous months, or that your disability is likely to result in death.

Specifically, the definition of disability under the Social Security Act is "the inability to do 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."

2. I'm working some, but not as much as I used to due to my illness. Can I get benefits?

Perhaps. The Social Security Administration's (SSA) definition of disability does not necessarily preclude you from working completely. If you are disabled, but working part time and not earning above the allowable income threshold, you may be entitled to benefits.

3. What disability programs does the Social Security Administration (SSA) offer?

The two main disability programs offered by the Social Security Administration (SSA) are: Social Security Disability Insurance (SSDI) under Title II of the Social Security Act and Supplemental Security Income (SSI) under Title XVI of the Act.

4. What is the difference between Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI)?

There is no difference between Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) in regards to disability.

For both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), a person must be blind or found disabled due to a physical or mental impairment, or a combination of both.

The non-disability requirements for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are very different however.

• Social Security Disability Insurance (SSDI) is a disability insurance program paid for by Social Security taxes. To be eligible for Social Security Disability Insurance (SSDI) benefits, a person must have worked and paid Social Security taxes for a period of time to earn sufficient work credits to be insured.

• Supplemental Security Income (SSI) however, is not based upon work credits, but financial need. Claimants with limited resources may be eligible for Supplemental Security Income (SSI), whether they worked or never worked.

Supplemental Security Income (SSI) is also available to blind or disabled children under age 18 if their parent(s) have limited resources and income.

In some instances, claimants are eligible for both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

5. Are there any other Social Security Disability benefits available to me or my family members?

Yes, there may be.

The Social Security Administration (SSA) extends Widow's or Widower's benefits (DWB) under Title II of the Social Security Act.

Widow's or Widower's benefits are paid to disabled individuals age 50 or older, who become disabled during a prescribed period. Since these benefits are payable under the late spouse's earnings record, the late spouse must have worked enough under Social Security System to be insured.

The Social Security Administration (SSA) also provides for Childhood Disability Benefits (CDB) under Title II of the Social Security Act. These benefits are available to unmarried Adult Children age 18 or older, who became disabled before age 22. Further, the adult child's parent must be either a wage earner covered under the Social Security System who is deceased, disabled and drawing Social Security Disability Insurance (SSDI) or retired and collecting Social Security retirement benefits.

If you are found disabled and approved for Social Security Disability Insurance (SSDI) benefits, your dependent children under 18 may also be entitled to benefits. Children under 19 may be eligible if they are still in school full time.

6. What conditions does the Social Security Administration (SSA) recognize as disabling?

In simplest terms, one can be found disabled due to just about any disease, medical condition, or injury. An individual can be found disabled for a single reason, or a combination of reasons.

7. I have been diagnosed with Depression. Does the Social Security Administration (SSA) recognize Depression as a condition for which I can be found disabled?

Yes, you can be found disabled for just about any condition provided the condition is severe enough according to Social Security Administration (SSA) standards. Conditions for which you can be found disabled include both physical and mental ailments.

Therefore, if you suffer from Depression, Bi-Polar, Post-Traumatic Stress Disorder (PTSD), Anxiety, Schizophrenia or another mental condition, you may qualify for Social Security Disability (SSDI) or Supplemental Security Income (SSI) benefits.

8. I have been diagnosed with Fibromyalgia. Does the Social Security Administration (SSA) recognize Fibromyalgia as a condition for which I can be found disabled?

Yes. Like any other condition, the severity of your condition is evaluated by the Social Security Administration (SSA) to determine whether you are considered disabled.

9. How does the Social Security Administration (SSA) determine disability?

For adults, the Social Security Administration (SSA) employs a five step process in determining whether a claimant is disabled.

The process begins with determining if you are working at the Substantial Gainful Activity (SGA) level. If you are working full time making more than the allowable income level, then your claim will generally not proceed. However, if you are not working, or at least not working at the SGA level, then your claim can proceed.

The next 4 steps in the process involves determining the severity of your condition, how it limits you, your ability to return to your prior jobs in light of your condition, and your ability to perform other work considering the limiting effects of your condition, your age, prior work experience, transferability of work skills, and education.

This is a very simplified explanation of the process.

10. How does the Social Security Administration (SSA) determine disability for children?

Under the Social Security Act, a child under 18 will be considered disabled if he/she has a "medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months."

This standard is slightly different than for an adult, as the majority of children do not work, at least not on a full time basis. If a child is working, however, and is earning above the allowable income level, generally then the child cannot be found disabled.

11. Who determines if I am disabled?

The answer to this question depends upon the stage of your claim.

At the early stages of your claim for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) benefits, your case is sent to a state agency to determine whether you are disabled. There, your medical records and reports may be reviewed by a disability examiner, as well as a physician and/or a mental health professional.

However, if your claim needs to be appealed and sent before a Social Security Administrative Law Judge, then the judge will make the determination.

12. Will the Social Security Administration (SSA) send me to a doctor to help decide my claim?

Often the state agency will schedule an examination for you if the medical evidence in the file is considered insufficient to make a determination. This is called a Consultative Examination. Consultative Examinations are scheduled with physicians and/or mental health professionals. A Social Security judge may also request a Consultative Examination, although this occurs less frequently.

13. Will I be charged for the Consultative Examination?

No, the Consultative Examination is performed at the expense of the Social Security Administration (SSA). If they request that you undergo tests, those tests are also paid by the Social Security Administration (SSA). In fact, in some instances they may provide transportation, or pay for travel expenses to and from the Consultative Examination.

14. What can I expect at my hearing?

The hearing is conducted by a Social Security Administrative Law Judge. Hearings are recorded, and therefore a hearings room assistant attends the hearing for that purpose.

At the hearing, you and any other witnesses may offer testimony under oath. The judge may require the services of either a medical or vocational expert to testify. In some cases, both a medical and a vocational expert will be required to testify at no cost to you.

If you hired an attorney, your attorney will be at the hearing for the purposes of asking questions and making arguments on your behalf. The judge typically questions witnesses as well.

15. Do I need to be out of work for a year before applying for Social Security Disability benefits?

No! We cannot stress this enough. You can file the day you become disabled. In fact, it is best to file as early as possible.

There are a couple of reasons why it is best to file as early as possible.

• First, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims generally take quite a while to process.

• Secondly, the amount of retro-active benefits that you are entitled may be tied to the date you file your claim.

With respect to Social Security Disability Insurance (SSDI) and Disabled Widow's and Widower's Benefits, retro-active benefits only go back as far as one year prior to the date of the claim. Therefore, if you wait too long to file a claim, you may miss out on benefits you may otherwise have been entitled.

With respect to an Adult Child claim under Title II of the Social Security Act, retro-active benefits only go as far back as six months prior to the date of the claim. Once again, it is best to file as early as possible.

Supplemental Security Income (SSI) retro-active benefits can only go as far back as the filing date of the claim. In fact, these benefits do not begin until the next full month. Once again, it is best to file as early as possible.

As you can see with all of these programs, it makes sense to file early. As each month passes and you wait to file, you may lose benefits that you would otherwise have been entitled.

16. What are past or retro-active benefits?

Retro-active benefits are also referred to as past-due benefits. In simplest terms, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims generally take some time to process. Fortunately, if you are found disabled, and your disability is determined to have begun sometime in the past, you may be owed retro-active benefits. In many instances, retro-active benefits can be substantial.

17. I have been found disabled by the Social Security Administration (SSA). How much money should I expect to receive?

Social Security Disability Insurance (SSDI) monthly benefits vary. It depends on how much you have worked paid into the Social Security System.

Disabled Widow's or Widower's benefits depend upon how much the late spouse worked and paid into the Social Security System. The reason for this is that although you are disabled, you are collecting these benefits based upon your late spouse's contributions to the Social Security System.

Adult Child's benefits under Title II of the Social Security Act depend upon how much the parent worked and paid into the Social Security System, as these benefits are based upon his/her parent's earnings under the Social Security system.

Supplemental Security Income (SSI) benefits vary as well. However, Supplemental Security Income (SSI) benefits vary due to financial considerations, as to be eligible, you must have limited resources.

18. If I'm found disabled by the Social Security Administration (SSA), am I entitled to Medicare or Medicaid benefits?

One of the major reasons to apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits is the possibility of obtaining affordable healthcare and prescription medication coverage.

If you are collecting Supplemental Security Income (SSI) benefits, you are eligible for Medicaid.

Medicare differs from Medicaid. With respect to other Social Security Disability programs including Social Security Disability Insurance (SSDI) benefits, Disabled Widow's or Widower's benefits or Adult Child's benefits under Title II of the Social Security Act, you will qualify for Medicare provided that you have been disabled for 24 months.

If you have been diagnosed with Amyotrophic Lateral Sclerosis (ALS) - commonly referred to as Lou Gehrig's Disease - and you have been found disabled by the Social Security Administration (SSA), you do not have to wait to be entitled to Medicare.

In some cases, you may be eligible for both Medicaid and Medicare. For instance, if your Social Security Disability Insurance (SSDI) benefits are very low, and you are collecting Supplemental Security Income (SSI) benefits as well, you may be entitled to both Medicaid and Medicare.

19. I'm disabled according to the Veteran's Administration and I am collecting VA benefits. Can I apply for Social Security Disability benefits as well?

Yes. You can apply, and it may benefit you to do so for a number of reasons.

• First, it could mean more money in your pocket every month.

• Secondly, you may be entitled to retro-active benefits.

• Third, Social Security Disability benefits may provide you with the ability to receive Medicaid/Medicare.

If you are receiving VA disability benefits, and you are awarded Social Security Disability benefits, your Social Security Disability benefits may be reduced. It is important to note that the combined benefits may be greater than the VA disability benefits alone.

20. I'm on Worker's Compensation. Can I file for Social Security Disability benefits as well?

Yes, it may benefit you to apply. If you are awarded Social Security benefits, these benefits may be reduced. Still, the combined benefits may be greater than the Worker's Compensation benefits alone.

Another advantage in applying for Social Security benefits is that you may be eligible Medicare if you are awarded benefits.

21. I lost my Worker's Compensation Claim. Can I still qualify for Social Security Disability benefits?

It's very possible. You may have lost your Worker's Compensation claim for reasons unrelated to your disability.

Fortunately, the Social Security Administration (SSA) does not make the same distinction as Worker's Compensation Insurance policies. You may be awarded Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits for both work-related impairments and non work-related impairments.

22. I still have a Social Security Disability Claim pending, but my condition improved and I returned to work. Am I still entitled to benefits?

You may be entitled to benefits for the period of time that you were out of work, provided that your disability lasted for at least 12 continuous months and you were not working at the Substantial Gainful Activity (SGA) level.

23. Will I have to travel far for my hearing?

No. The Social Security Administration (SSA) provides for hearings in every state, often in multiple locations.

24. Will it cost me to consult with your law firm regarding Social Security benefits?

No. As disability attorneys, we are paid only upon successful completion of your claim. If you are not awarded disability benefits, we do not collect any attorneys fees.

25. Why should I hire an attorney to represent me before the Social Security Administration?

Unfortunately, each and every day, the Social Security Administration (SSA) denies people who are disabled. It doesn't matter if you are young or old as too many truly disabled people have been denied benefits. In fact, just recently, unjust denials have been the topic of national television news stories.

It is your burden to prove that you are disabled according to Social Security standards and unfortunately, the Social Security regulations and forms are complex.

We can help!

Click here, or contact our office toll-free for a free consultation and let Bostock Donais, PLLC assist you in this complex process. If hired, we only get paid if we win your case.

26. When can I hire Bostock Donais, PLLC?

We can represent you at any stage in your claim. You may hire Bostock Donais, PLLC at the beginning of your claim, after you started your claim, or before a hearing.