If you’re unable to work due to a disability, you may be entitled to benefits from the Social Security Administration (SSA). There are two types of disability benefits offered by the SSA: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Based on your particular situation, you may qualify for one or both types of federal programs, each of which offer benefits in the form of monthly payments.
The process of applying for disability benefits can often be overwhelming, particularly if your initial claim is denied and you need to file an appeal. A skilled disability benefits attorney can help you, from assisting you with the initial application to handling SSA hearings and appeals.
The law firm of Bross & Frankel was founded by a former Social Security benefits authorizer with a simple goal in mind: to give our clients an edge in fighting for the Social Security benefits that they need. We combine the skills of trial attorneys with the knowledge of disability advocates to help our clients achieve the best possible result.
Am I Eligible for Social Security Disability Benefits?
To qualify for either SSDI or SSI, you must meet specific requirements. For both types of benefits, you must first prove that you are disabled. Generally, you may be considered disabled if you are unable to work due to a long-term disability.
The SSA uses a five step sequential process to determine if a person is disabled:
- A person cannot earn more than $1,260 a month from working (gainful employment) when claiming disability;
- A person must have an impairment or combination of impairments that significantly limits their ability to basic work and is expected to last for at least 12 months or result in death;
- Social Security will review whether a person’s condition meets all of the requirements for a condition on SSA’s list of disabling conditions, or has other factors that equal a condition on that list;
- If not, then the medical impairment must prevent them from performing any of their past work; and
- They must not be able to do any other type of work, considering their impairment, age, education, past work experience and any transferable skills (this last step requires Social Security to identify other work that exists in significant numbers in the national economy).
If the SSA determines that an applicant is disabled, then they may qualify for SSDI and/or SSI.
SSDI is available to those individuals who have paid into the system; it is funded by Social Security taxes. For most people, you must have earned 40 work credits (up to 4 per year), 20 of which must have been earned in the 10 years prior to applying. Younger people may be able to qualify for SSDI with a lower number of credits.
SSI is a needs-based program. To qualify, you must meet the income and assets criteria set forth by the SSA. In most states, if you qualify for SSI benefits, you may also be eligible for Medicaid, which is also a needs-based program. Depending on your situation, you may also qualify for Medicare.
The formula for determining which assets and income counts for SSI benefits can be complicated. If you are curious about your eligibility, reach out to a Cherry Hill disability benefits lawyer.
While both SSDI and SSI require proof that you have a disability that is expected to last for 12 months or longer, this doesn’t mean that you cannot apply for benefits until you have been unable to work for a year. You can apply for benefits the moment you become unable to work. The rule is designed to screen out temporary disabilities like broken bones and similar injuries that are expected to improve in less than a year.
How Do I Apply for Social Security Disability Benefits?
Filing your SSD or SSI claim can be a challenging and time-consuming process. It involves filling out lengthy forms and gathering information related to your claim, such as:
- Social Security Number
- Birth certificate
- Proof of citizenship or lawful status
- Records of your work history (Social Security focuses on your last 15 years of work)
- Information on any recent earnings (if possible, your most recent W-2 form)
- Contact information for doctors, therapists, and any hospitals where you have been treated
- Information on the medications you take
- An adult disability report
- Medical records already in your possession
- Pay stubs
Once you have gathered this information, you will need to decide how to apply. You can file a claim online, over the phone, or at a local Social Security field office.
No matter how you apply, your application will be initially processed through a local Social Security office and a state of New Jersey agency (usually called disability determination services). These field offices are responsible for verifying non-medical eligibility for benefits; if you meet this threshold, your file is sent to the disability determination services agency to determine if you are disabled under SSA standards. After making this determination, the agency returns the case to the field office for final action: denial or approval and payment of benefits.
The application process can be daunting, especially if you are unsure about whether you qualify or what you will need to prove. If you need assistance, contact a NJ Social Security disability benefits attorney for a free claim review.
How Do I Appeal a Denied SSDI or SSI Claim?
Most initial applications for Social Security disability benefits are denied. According to data from the SSA, 20.3% of all initial applications were approved in 2017. Significantly, most denials in that same year (40.1%) were for technical, as opposed to medical, reasons.
A denial at the initial stages can be caused by any number of issues. Sometimes there is critical evidence missing, or a well-meaning but unhelpful medical opinion. Other times, Social Security may determine that earnings on your record constitute work activity, and deny your claim without even evaluating your medical conditions. A skilled disability benefits attorney can review your claim, and identify any errors that may lead to a denial.
There are four levels of appeal after a denial of disability benefits. You can:
- Request reconsideration;
- Ask for a hearing before an administrative law judge (ALJ);
- Request review by the SSA Appeals Council; and
- File a lawsuit in federal court.
In most cases, you have 60 days after the notice of a decision by the SSA to file an appeal.
Our law firm has appealed issues related to both medical and non-medical denials countless times. We have successfully gotten improper denials reversed at each level of the process. If you claim has been denied, contact us as soon as possible for assistance with an appeal.
Can My Child Get Disability Benefits?
Possibly. Depending on your situation, they may receive SSDI or SSI benefits. First, a child may receive Social Security Disability Insurance (SSDI) if one or both of their parents is eligible for disability benefits. To be eligible for these family benefits, a child must be under the age of 18, 18 – 19 years of age and a full-time student, or 18 or older and have a disability that started before the age of 22.
These benefits are only available when a parent qualifies for SSDI benefits, and typically end when the child reaches age 18, unless they are disabled. The amount of benefits that your child may receive is based on your benefit amount and the number of family members who also qualify for SSDI benefits.
Second, a child with a disability may qualify for Supplemental Security Income (SSI). To be eligible, a child must be disabled and must have little or no income and resources. To be considered disabled, a child must meet two requirements:
The child must have a physical or mental condition(s) that very seriously limits their activities, and The condition(s) must have lasted or are expected to last for at least one year or will result in death.
The Social Security Administration (SSA) uses a complex formula to determine whether a child has limited income or resources. If you are interested in applying for SSDI family benefits and/or SSI benefits for a child with a disability, a New Jersey Social Security disability lawyer can help.
How Long Will It Take to Get a Decision on My Disability Application?
Generally, it takes 3 to 5 months to get a decision, but the length of time can vary significantly. The factors that influence this process include the nature of your disability, whether a medical examination is necessary, and how quickly the SSA can get medical evidence to support an application. Understanding the way that the SSA makes a determination on disability benefits can help you get a sense of how long it may take to get a decision.
The SSA uses a 5 step sequential process to determine if a person is disabled:
A person cannot earn more than $1,220 a month from working (gainful employment) when claiming disability; A person must have an impairment or combination of impairments that significantly limits their ability to basic work and is expected to last for at least 12 months or result in death; Social Security will review whether a person’s condition meets all of the requirements for a condition on SSA’s list of disabling conditions or has other factors that equal a condition on that list; If note, then the medical impairment must prevent them from performing any of their past work; and
They must not be able to do any other type of work, considering their impairment, age, education, past work experience and any transferable skills (this last step requires Social Security to identify other work that exists in significant numbers in the national economy).
If a person has a condition on the SSA’s list of disabling conditions, then the process ends at Step 3 and they will be approved for benefits. This means that a person with a condition on the SSA list will typically receive a decision faster, as the SSA won’t have to do a Residual Functional Capacity assessment. However, this isn’t always the case, particularly if a person fails to submit the required evidence.
You can speed up the process by (1) applying for benefits online; and (2) gathering documents to support your application. The SSA provides a checklist of documents that you may need to provide, such as your birth certificate, medical records, and pay stubs.
What Can I Do If My Disability Claim Is Rejected?
If your application for SSDI or SSI benefits is denied, then you may be able to file an appeal. There are four levels of appeal:
-Requesting reconsideration, which is a review of your claim by a person who did not participate in the initial decision.
-A hearing by an administrative law judge (ALJ), where the judge will consider your testimony, any new information or evidence, and the testimony of other witnesses (such as vocational experts) to make a decision on your claim.
-Review by the Appeals Council, where the Social Security Appeals Council will either grant or deny a request for review. If it accepts the request, the Appeals Council may decide the case or return it to an ALJ.
-A federal court lawsuit may be initiated if the Appeals Council denies your request or if you disagree with its decision.
Although you can represent yourself in these appeals, working with a disability benefits lawyer can help you achieve the best outcome.
How We Can Help
If you are considering filing for SSI or SSDI benefits, you may be worried about getting through the bureaucratic red tape. The process can be overwhelming, particularly if the SSA denies your initial application. We can help.
At Bross & Frankel, we are dedicated to helping people who are unable to work due to their disabilities. With experience within the agency as well as in private practice, we know what the SSA looks for — and how we can put together a strong application or appeal.
With law offices in both New Jersey and Pennsylvania, we represent clients in Camden, Burlington, Gloucester, Ocean, Monmouth Counties and throughout Southern New Jersey and the Philadelphia Metro area. To learn more or to schedule a free initial consultation, contact us online or call our office at 856-795-8880.