Social Security provides income benefits to people that are disabled, unemployed, or retired. The monthly stipends from the Social Security Administration (SSA) are a lifesaver for millions of families in America. However, the SSA reports that it denies over half of the claims it receives. To ensure the SSA accepts your claim, speak to Ted A. Greve & Associates, P.A. to enlist the help of a SSDI attorney in Charlotte, NC today.
What is Social Security Disability Insurance and how does it differ from Social Security Insurance?
Social Security Disability Insurance provides benefits to “insured,” disabled workers. Workers buy into the program by contributing funds each paycheck into the Social Security trust fund. If you were an employee and had your taxes automatically withheld, the Social Security taxes withheld from your paychecks are essentially your payments for premiums into the insurance program. The amount of contributions you made were dependent upon your earnings.
Not everyone has a long or full enough work history to qualify for SSDI, though. For those who cannot work due to age, blindness, or disability and do not have a sufficient work history to qualify for SSDI, the SSA provides another benefit option: the Social Security Income (SSI) program.
The SSI program, funded with general tax revenues, provides cash assistance payments to blind, disabled, and aged people who have very limited income. Blind or disabled children can also receive SSI. In order to qualify for SSI, applicants must not only prove their disability to the SSA, but they must also prove that their income and resources are below a certain threshold. (It does not matter what your income/resources are if you are applying for SSDI – only your work history and disability.)
What are the qualifications to obtain SSDI benefits?
In 2014, the SSA distributed disability benefits to nearly 800,000 disabled workers, according to the SSA’s Annual Statistical Report. In order to qualify for these types of cash benefits, you must be able to prove two conditions:
- You must have worked long and recently enough to have earned enough “work credits” as per the SSA’s guidelines.
Work credits are the markers that the Administration uses to gauge if you have worked enough to earn SSDI benefits. You can earn up to four credits per year, and your credits will stay on your record even if you work intermittently.
The number of credits you need to qualify for SSDI are determined by your age. For example, if you under the age of 24, you only need to have earned six credits within the last three years. If you are over the age of 62, you will need to have earned 40 credits, at least half of which you need to have earned in the last ten years. You can find the precise number you need in the SSA’s Benefits Planner.
- You must meet the SSA’s definition of disabled.
The SSA’s 2016 Red Book specifies: “To meet our definition of disability, you must not be able to engage in any substantial gainful activity (SGA) because of a medically-determinable physical or mental impairment(s) that is expected to result in death, or that has lasted or is expected to last for a continuous period of at least 12 months.”
Which types of disabilities qualify someone for SSDI?
Numerous types of disabilities can qualify someone for SSDI. The SSA maintains a detailed “Listing of Impairments” in its Blue Book that lists specific impairments affecting each of the body’s major systems that could prevent someone from working or engaging in SGA. There is a separate listing for adults and children.
The SSA has categorized qualifying impairments into 14 categories.
- Musculoskeletal System
- Special Senses and Speech
- Respiratory System
- Cardiovascular System
- Digestive System
- Genitourinary Disorders
- Hematological Disorders
- Skin Disorders
- Endocrine Disorders
- Congenital Disorders that Affect Multiple Body Systems
- Mental Disorders
- Immune System Disorders
Very specific factors must be present in order for the SSA to consider the condition disabling.
For instance, under the musculoskeletal system category, soft tissue injuries such as burns can qualify someone for SSDI, but only if the injury was on:
- “An upper or lower extremity, trunk, or face and head,
- Under continuing surgical management… directed toward the salvage or restoration of major function,
- And such major function was not restored or expected to be restored within 12 months of onset.”
If you are applying for SSDI, you must be able to prove your condition using the required supportive diagnostics and medical tests. However, if your precise condition is not on the list, it does not mean you cannot qualify. If you have a different condition or a combination of conditions that prohibit you from SGA, the SSA may still accept your claim.
How does the SSA calculate SSDI benefits?
According to its 2014 Statistical Report, the SSA shelled out over $11.4 billion in December 2014 to disabled beneficiaries. The average individual monthly benefit amount is $1,256.64.
If the SSA accepts your SSDI application, the Administration will determine your benefit amount using your total lifetime earnings covered by Social Security. To determine how much your particular SSDI benefit checks would be, you first need an estimate of your lifetime earnings.
If you do not know what those are, you can request a statement. The easiest way to request a statement of your earnings is open an online Social Security account, where you will get to see your earnings, the amount of taxes you have paid, and estimates of your future benefits. (It is free to enroll.)
If you know your estimated earnings, you can use the SSA’s online calculator to determine your benefit amount. Ask your SSDI attorney for help if you are having trouble estimating your benefits or want to verify what you have tallied.
While the SSA cannot disqualify you from SSDI if you were a high wage earner, your benefit will be subject to the SSA’s maximum. The maximum allowable benefit changes annually due to inflation and cost-of-living adjustments (COLAs). For 2016, the SSA caps SSDI benefits at $2,639.
How do I apply for SSDI?
To apply for benefits, you will need to go through a specific application process, as well as provide the evidence necessary to prove your disability. Note: The SSA is very particular about its definition of disabled, and the case managers carefully and systematically comb through each SSDI application to determine whether the applicants meet all the requirements.
There are three ways to apply for SSDI benefits:
- Virtually using the online application
- In-person – You can find your local SSA using the Social Security Office Locator. For example, in Charlotte, the nearest office is located at 5800 Executive Ctr. Dr., Suite 300.
- Telephone – 1-800-772-1213
You will need to have substantial amount of information with you with you apply. You need documents and info related to:
- Birth and citizenship
- Marriage and divorce
- Your children
- Military service
- Employer details
- Job history
- Education and training
- A list of your medical conditions
- Doctor information for all of your medical providers
- Workers’ compensation
You can submit required documents either via mail or in-person, but because many of these documents are difficult and time-consuming to replace if lost, you might want to opt to submit them in-person. Delays in submitting forms and documents will delay the entire application process.
Once you have submitted your application, you will receive a confirmation that the SSA has received your application. After it has reviewed all of your documents, the Administration will mail a decision to you.
Why do I need a SSDI attorney?
CAUTION: Before you begin the application process, we strongly urge you to at least consult a SSDI attorney. Simple mistakes can devastate your claim. A Charlotte SSDI attorney can check your forms and paperwork for thoroughness and accuracy, and ensure you have followed the SSA’s guidelines to a T so that the SSA does not wrongful deny your application.
What do I do if the SSA denies my application?
There are numerous reasons the SSA may deny an applicant for SSDI. Below are a few examples.
- You might earn too much via SGA.
- Your disability might not be severe enough to meet the SSA’s definitions.
- You might lack sufficient evidence.
- You might not have submitted the requested documents.
- You might fail to follow through with your physical therapy.
- You are in prison because of a felony.
- Alcoholism or drug addiction contributes to your disability.
- You lied on your application.
If the SSA denied your application and you think the denial was unjust, you have the right to appeal the claim. Appealing your claim gives you another chance to show the Administration why you deserve SSDI benefits.
The SSA recognizes four levels of appeals:
- A hearing by an administrative law judge (ALJ)
- A review by the Appeals Council
- A Federal Court review
At each level, you must make your requests for appeals in a certain way and within an allotted amount of time. The SSA explains: “When we send you a letter about a decision on your application, we will tell you how to appeal the decision.”
It is important to be fully prepared before moving forth with an appeal; you want to arm yourself with adequate evidence that supports your case.
Should I consult a Charlotte SSDI attorney about benefits?
Yes, you absolutely should consider working with a Charlotte Social Security disability attorney when applying for disability benefits. SSDI benefits can help your family stay afloat when you are disabled and can no longer provide for them. When you have contributed to the Social Security system through your years of contributions into the American economy and you can no longer work due to disability, you deserve income benefits; you have earned them.
To greatly improve your chances of obtaining disability benefits, you owe it to yourself to have a legal professional facilitate your claim. A SSDI attorney can not only explain what you need to qualify and how much you can expect to get, but they can help you navigate the application process, gather medical evidence, and file for appeals.
In addition, you generally do not have to be concerned with not being able to afford a SSDI attorney because most disability attorneys work on a contingency basis, that is, you do not pay them unless they secure your benefits. Also, because Congress regulates the amount disability attorneys can charge for representation (25 percent of the back pay they win for you), you do not have to worry about surprises or paying anything up-front, out-of-pocket.
For questions about Social Security Disability Insurance benefits or to get started with your application, contact an SSDI attorney from Ted A. Greve & Associates, P.A. in Charlotte today at 704-326-7688.