SOCIAL SECURITY DISABILITY 101

Everything You Want to Know About Social Security Disability

• Not everyone is covered by Social Security Disability Insurance (SSDI). Only persons who have worked and paid enough FICA have earned enough quarters of coverage to have insured status.

• How much does Social Security pay for a disability? The amount is different in each case, determined by age and lifetime earnings. The average benefit is around $1,300 per month.

• Does family income effect eligibility for SSDI? No. SSDI does not consider income or wealth in awarding benefits.

• What medical conditions can be approved for Social Security disability? Any severe medical or mental condition that prevents the ability to work may qualify for SSDI--if it is expected to last at least 12 consecutive months OR to end in death.

• Is SSDI difficult to get? Yes. Social Security's definition of "disability" can be difficult to meet. It often requires one or more appeals to be awarded benefits.

• Does it take a long time to get SSDI approved? Yes, it often can take a long time. It usually takes 6 to 12 months to process a new disability application. Appeals, if required, will take even longer.

• Must you have an attorney to try for SSDI benefits? No, you are not required to have an attorney. However, most individuals choose to get an attorney/advocate to help them with the complicated SSDI process. Data shows that a claimant who uses an attorney or professional advocate are at least twice as likely to be approved.

• What are attorneys allowed to charge for Social Security representation? Social Security will approve no more than 25 percent of back pay or $6,000 (whichever is less) for an attorney's fee. This fee can only be charged if the claimant gets approved and received back pay.

• If a claim is denied, how many appeals are available? (In order):

1. Reconsideration

2. Hearing before an administrative law judge

3. Appeal to the Appeals Council

4. Lawsuit in Federal District Court

5. Theoretically, appeal to US Supreme Court, but not a practical option since this Court will hear only 1 or 2 Social Security cases per year, if any.

• Can you have witnesses at your hearing? Yes, the presiding administrative law judge may permit your witnesses to give testimony at a hearing.

• How do individuals who have never worked get Social Security benefits? A person who has never worked might get benefits on another individual's work record--such as a widow/widower getting survivor's benefits, or a dependent child who receives benefits on a disabled parent's work record. [Social Security administers a totally separate program called Supplemental Security Income (SSI), which does not require any work history. SSI is income/resource restricted, however].

• What percentage of first-time disability applications does Social Security approve? On average, only about 30 percent get approved on the initial application level.

• What are the odds of approval at a hearing before an administrative law judge (ALJ)? While every case is different, the national average shows about 42 percent of claims being approved at the hearing level.

• What factors will Social Security consider in deciding my case? They will consider the claimant's age, work history, education/skills, and residual functional capacity (RFC) -- defined as what the claimant can still do in spite of his/her impairments.

• Who is usually present at a disability hearing?

1. Administrative Law Judge (ALF)

2. Claimant

3. Claimant's Attorney or representative

4. Vocational Witness

5. Hearing Clerk

6. Any other witnesses - possibly a Social Security medical expert.

• I would like my spouse or family member to attend my hearing with me. Is that permitted? No, in most cases visitors are not permitted in hearings due to the strictly confidential nature of the proceeding. The judge has final say on who may attend a hearing.

What can an attorney do to help with my case?

1. Prepare and submit forms and paperwork

2. Gather and submit evidence

3. Read, analyze and make arguments/statements about medical or vocational evidence

4. Help meet deadlines and keep the process on track.

5. Make legal or technical arguments about the merits of the case or the evidence.

6. Answer the claimant's questions about the case.

7. Prepare and submit pre-hearing and/or post-hearing briefs.

8. Attend a hearing with the claimant, after preparing the claimant for the hearing.

9. Make arguments at the hearing.

10. Help clarify technical or legal aspects of a case for the judge.

11. Cross examine or redirect Social Security's vocational or medical witnesses

• Is there a "waiting period" for Social Security disability (SSDI) benefits? Yes, under the regulations, no payment is made for the first full 5 months of disability. For example, an individual found disabled on April 10th would not be eligible for a benefit until October. Many people fail to consider this waiting period when protecting their families from the potential of a disability. Also, it is very unlikely to a get a claim approved within 6 months. We recommend private disability insurance (through the job, if possible) and savings to protect against disability. One in four Americans will become disabled before reaching retirement age. This should be considered in your family's financial planning. There is often very little or no benefit aside from Social Security to help you in the event of disability.