Do You Have Questions About Ssi And Ssdi Benefits
Do you qualify for disability? If so, the next step is to identify whether youre eligible for benefits from SSI, SSDI, or both. At Bross & Frankel, PA, we can help disability applicants throughout New Jersey, Pennsylvania, and Delaware win the benefits and access to the medical care they need to manage their disability and cover their living expenses. If you have questions about whether you should apply for SSI and SSDI benefits, schedule your free consultation today by calling 856-210-3345 or contacting us online.
Which Medical Conditions Are Likely To Qualify For Disability
While any of the above medical conditions are qualifying disabilities, some medical conditions are more likely to lead to an approval of benefits than others. We recently surveyed our readers about their experiences in applying for disability benefits and compared their answers to government statistics. The conditions most likely to get approved were multiple sclerosis and some types of cancers. Respiratory disorders and joint disease were also high on the list. For the details, see our article on survey statistics on getting Social Security disability for common medical conditions.
What Should I Do If My Claim Is Moving Slow
If your claim seems to have come to a screeching halt, make sure you have checked these proactive three steps off your to-do list:
If youve accomplished all of these, there are a couple of common reasons why your claim could have slowed down. The most likely is that your case has slipped through a crack at the DDS, or, you may have a second Consultative Examination scheduled. The DDS schedules CEs if your medical evidence isnt comprehensive or current enough.DEs have the incentive to complete older cases because it affects their numbers, but if your claim is, say 90 days old, it may not be receiving much attention. You may also have a DE who is inexperienced or simply tolerant of having a large caseload with many old cases.
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What We Mean By Disability
The definition of disability under Social Security is different than other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability.
We consider you to have a qualifying disability under Social Security rules if all the following are true:
- You cannot do work and engage in substantial gainful activity because of your medical condition.
- You cannot do work you did previously or adjust to other work because of your medical condition.
- Your condition has lasted or is expected to last for at least one year or to result in death.
This is a strict definition of disability. Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities, including workers’ compensation, insurance, savings, and investments.
Does A Medical Condition Have To Match The Listing
No, an applicant filing for Social Security disability benefits doesn’t necessarily have to satisfy the exact listing requirements for a particular illness or condition to be awarded disability benefits based on the condition. You can get disability benefits if Social Security considers aspects of your condition to equal the criteria in a listing. This is called “equaling a disability listing.”
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Does Family Members’ Income Count Against The Ssi Income Limit
When a child SSI applicant applies for SSI, part of the parents’ income is considered toward the SSI income limit. For the amount of income that Social Security will “deem” to a child, see our article on family income deeming.
Likewise, marriage can have a strong effect on your financial eligibility for SSI. SSI considers your entire household’s income and resources, not just yours. Even if only one member of a couple is medically eligible for disability benefits, both spouses’ incomes are considered to be part of the applicant’s countable income. Fortunately, Social Security “deems” only part of a spouse’s income to be available for your use. For more information, see our article on the deeming of marital income.
Should You Apply For Both Ssi And Ssdi Benefits
If you are applying for SSI, your countable income each month cannot exceed the cap of $1,767 per month for an individual or $2,607 for a couple. Considering these limitations, what is the value of applying for SSI and SSDI concurrently?
There are actually several circumstances where you may want to consider drawing both. For one thing, if your SSDI benefits are minimal because you worked minimum-wage jobs all your life, collecting SSI at the same time can increase your monthly income, either permanently or until youre able to start working again.
- You can receive back pay for both SSI and SSDI- that is, the disability payments the SSA owes you for the months before your concurrent disability claim is approved. Considering that the SSA can take a while to finally approve benefits, you may be looking at a significant payout.
- SSDI has a mandatory waiting period, with benefits starting six months after the date of your disability onset. With SSI, there is no similar delay, so you could collect financial benefits while waiting for your monthly payments from SSDI to start.
- Concurrent claims also provide faster access to necessary health care. Most SSDI recipients are eligible for Medicare once they have been receiving benefits for 24 months. In most states, SSI recipients are automatically eligible for Medicaid, which may cover your health costs until Medicare begins. In addition, you may be able to stay on Medicaid, which covers some costs that Medicare does not.
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Can You Get Ssi And Ssdi More About Concurrent Claims
SSI and SSDI are aimed at two different types of claimant. The former provides financial benefits to people who cannot work, have few assets and have a limited income while the latter is aimed at solely disabled workers and is not means-tested. Despite these dissimilarities, in some cases, you may be eligible for concurrent benefits, meaning that you can collectboth SSI and SSDI at the same time.
This could happen if you:
- Became disabled early in your career
- Worked a minimum-wage job
- Did not work full-time during the 10 years before you became disabled
Bross & Frankel, PA can help you understand the eligibility criteria and other rules associated with these programs and explain your options for maximizing your income. We will also assist you in fighting for the benefits you qualify for, even if your initial application has been denied.
Information You Need To Apply
Before applying, be ready to provide information about yourself, your medical condition, and your work. We recommend you print and review the . It will help you gather the information you need to complete the application.
Information About You
- Your date and place of birth and Social Security number.
- The name, Social Security number, and date of birth or age of your current spouse and any former spouse. You should also know the dates and places of marriage and dates of divorce or death .
- Names and dates of birth of children not yet 18 years of age.
- Your bank or other and the account number.
Information About Your Medical Condition
- Name, address, and phone number of someone we can contact who knows about your medical conditions and can help with your application.
- Detailed information about your medical illnesses, injuries, or conditions:
- Names, addresses, phone numbers, patient ID numbers, and dates of treatment for all doctors, hospitals, and clinics.
- Names of medicines, the amount you are taking, and who prescribed them.
- Names and dates of medical tests you have had and who ordered them.
Information About Your Work:
- Award letters, pay stubs, settlement agreements, or other .
We accept photocopies of W-2 forms, self-employment tax returns, and medical documents, but we must see the originals of most other documents, such as your birth certificate.
Do not delay applying for benefits because you do not have all the documents. We will help you get them.
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What If A Condition Isn’t In The Listing Of Impairments
An applicant doesn’t need to have an impairment that is listed in Social Security’s Blue Book to be awarded disability benefits. For instance, migraine headaches are not included in a listing, but if an applicant’s migraines are severe enough and are well documented, Social Security may grant disability benefits if the migraines make it impossible for the disability applicant to work a full-time job. Other common impairments that aren’t listed in Social Security’s blue book include:
- be a “medically determinable impairment,” and
- reduce someone’s RFC enough so that they can’t do their prior job or any type of work.
What If Your Ssi Disability Claim Is Denied
Without a doubt, the SSI disability process is a fairly difficult one, except in the most clear-cut cases. Most SSI applications are initially denied . To get SSI, you’ll probably need to appeal the initial decision and go to a hearing.
If the SSA denied your SSI claim, you should probably consider finding a lawyer to represent you at the hearing. The lawyer will organize your medical records and get the evidence you need to prove that your medical impairments are disabling.
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Disability Evaluation Under Social Security
We no longer publish Disability Evaluation Under Social Security in hardcopy because we publish updated versions of the Listing of Impairments electronically.
Our Disability Determination Process Most Social Security disability claims are initially processed through a network of local Social Security Administration field offices and State agencies . Subsequent appeals of unfavorable determinations may be decided in a DDS or by an administrative law judge in SSAs Office of Hearing Operations.
Social Security Disability Planner for applying for disability benefits online
Social Security representatives in the field offices usually obtain applications for disability benefits in person, by telephone, by mail, or . The application and related forms ask for a description of the claimants impairment , treatment sources, and other information that relates to the alleged disability.
The field office is responsible for verifying non-medical eligibility requirements, which may include age, employment, marital status, or Social Security coverage information. The field office then sends the case to a DDS for evaluation of disability.
The DDSs, which are fully funded by the Federal Government, are State agencies responsible for developing medical evidence and rendering the initial determination on whether or not a claimant is disabled or blind under the law.
Get Your Medical Records In Order
Besides hiring an attorney, we believe getting medical records squared away is the number one trick to speeding up the disability determination process. Whether you are seeking social security disability insurance or supplemental security income , complete medical records are essential.
There are two methods of getting medical records more quickly:
- First, persistently follow-up with your provider. In some cases, your primary care physician will have all your records but more often you will need to contact multiple sources.
- Second, consider enlisting a disability attorney or family members to help you get social security disability medical evidence.
You may not know where to begin in collecting medical records, in which case a law firm that is experienced in obtaining a medical history from you is a great place to start. Such firms offer a free evaluation and help you get your medical visits and history in order.
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What Automatically Qualifies For Disability
Special senses and speech, such as impaired hearing, sight or speech. Respiratory illnesses, such as asthma, chronic obstructive pulmonary disease and cystic fibrosis. Cardiovascular illnesses, such as arrhythmia, congenital heart disease and heart failure. Digestive system, such as bowel or liver disease.
Wait Time For Decisions And Hearings
The amount of time it takes for an application to be approved or denied varies, depending on whether it is an initial decision or a decision based on an appeal. In fiscal year 2019, it took an average of 120 days for SSA to make an initial determination on a disability claim. The figure increased following the COVID-19 pandemic and, for months in fiscal year 2021, the average wait time for an initial decision is 165 days.
The high number of cases and long wait times for a hearing before an Administrative Law Judge has drawn significant attention from Congress in recent years. Congress provided additional funding for this workload and the number of cases and wait times have declined. In fiscal year 2020, the average wait time for a hearing was 386 days .
For some cases, SSA will expedite disability determinations. These include Quick Disability Determination and Compassionate Allowance cases. These are cases where statistical models or medical diagnoses indicate the person has an extremely severe medical condition. These cases can often be processed in under 30 days. Additionally, many cases involving military veterans are expedited.
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How Difficult Is It To Get Disability
Social Security disability applications face an overwhelming 70% denial rate upon initial evaluation That is a huge number but it is based upon several very different factors, such as applying for a condition that does not meet the criteria or lack of proper medical documentation.
You can usually expect your back pay and first monthly check to start 30-90 days after the award letter As far as insurance is concerned, if you were approved for SSI, you will receive If approved for SSI, will receive Medicaid benefits automatically depending on the state you live in.
Other Ways You Can Apply
Apply With Your Local Office
You can do most of your business with Social Security online. If you cannot use these online services, your local Social Security office can help you apply. You can find the phone number for your local office by using our Office Locator and looking under Social Security Office Information. The toll-free Office number is your local office.
Apply By Phone
If You Do Not Live in the U.S. Or One of Its Territories
Contact the if you live outside the U.S. or a U.S. territory and wish to apply for retirement benefits.
Mailing Your Documents
If you mail any documents to us, you must include the Social Security number so that we can match them with the correct application. Do not write anything on the original documents. Please write the Social Security number on a separate sheet of paper and include it in the mailing envelope along with the documents.
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If Your Application Is Denied
After we review your application and the information you provided, we may decide you do not meet the qualifications for disability benefits.
If you disagree with our decision, you have the right to ask us to look at your application again. The notice you receive from us that says you don’t qualify will explain how to appeal our decision and the time period in which you must make the request.
If we decide you don’t qualify:
Because you are not disabled under our rules, you can appeal our decision online.
The online disability report will ask you for updated information about your medical condition and any treatment, tests, or doctor visits since we made our decision.
Back Payments And Retroactive Payments Are Often Included Once You Are Approved
When you are approved for SSDI or SSI, you are often approved with back payments or retroactive payments included. Back payments are any disability benefits that are past due, or the benefits that you would have been paid if your initial application was approved right away.Retroactive payments are for the months that you were disabled and could not work. You are eligible for retroactive payments only with SSDI and not SSI.
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Do Some States Have Higher Limits
There’s another wrinkle that raises the income limits in most states: the “state supplement.”
Most states add money to the federal SSI payment called a state supplement. This means that the allowed income level, as well as the SSI payments, are higher than the federal maximums in those states. Every state except Arizona, North Dakota, and West Virginia has a state supplement.
The amount of the state supplement varies between states, from about $10 to about $400. In some states, the amount of the state supplement can depend on whether you are single or married and on your living arrangements. For instance, some states pay a supplement only to those living in a nursing home other states pay a higher supplement to those without full kitchens. For these reasons, unless you live in a state without a state supplement, it might be difficult for you to estimate whether your income falls under the SSI limit.
For more information, see our article on the supplemental payments, including state supplement amounts.
Supplemental Security Income Application Process And Applicants’ Rights
CHECK IF YOU ARE ELIGIBLE FOR SSI AND HOW TO APPLY
We strongly recommend you check the eligibility requirements for SSI before you start your application or contact us to make an appointment. If you are unsure you may qualify after reading these requirements, call us at 1-800-772-1213 .
You can apply for SSI benefits by:
Visiting our Apply Online for Disability Benefits website to start the disability application process online. You may be eligible to apply for SSI through the online disability application.
Having someone else call and make the appointment for you or assist you with your application for SSI.
You will have to provide information and work with us to get documents concerning SSI eligibility.
WHEN TO APPLY
Apply as soon as possible so that you do not lose benefits. We cannot pay benefits for time periods earlier than the effective date of your application.
If you call us to make an appointment to apply and you keep your appointment and file an application, we may use the date of your call as your application filing date.
If you do not keep this appointment and you do not contact us to reschedule the appointment, we will try to contact you. If we do not get in touch with you to reschedule the appointment, we will send you a letter. The letter will say that if you file an application within 60 days from the date of the letter, we will use the date of your original contact with us as your SSI application date.
|See our SSI Spotlight on Prerelease Procedure.|
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