Maybe Social Security was missing some of your records.
Maybe you had a mistake in your application.
Maybe the government decided your health problems are not severe enough to prevent you from working.
You can go through all of the levels of appeal review on your own, if you wish, but statistically claimants who are represented by an attorney, have a far better chance of being granted benefits more than those who are not represented.
What is the definition of disability used by Social Security?
Under the Social Security Act, a disability means an inability to engage in 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.
If I have a physical illness, disease, or injury, or a mental illness, am I eligible to receive Social Security disability benefits?
Yes. If you have a medical condition that has lasted, or is expected to last, for at least one (1) year or that will result in death, you may be eligible to receive Social Security disability benefits.
What should I do if I think I am eligible for Social Security disability benefits?
You should apply for Social Security disability benefits by contacting the Social Security Administration through the Internet at www.socialsecurity.gov or you can call the Social Security Administration’s toll-free telephone number, 1-800-772-1213 between 7:00 A.M. and 7:00 P.M. to make an appointment to file a disability claim at a Social Security office near your home. If you are deaf or hearing-impaired, you can call the Social Security Administration’s toll-free TTY number of 1-800-325-0788. Once you have scheduled an appointment, a Disability Starter Kit will be mailed out to you which help you prepare for your disability claims interview.
When should I apply for Social Security disability benefits?
You should apply for Social Security disability benefits as soon as you become disabled. The processing of a disability benefits application can take a long time so it’s important you get started quickly.
When can/should I contact Olinsky Law Group to assist me with my disability claim?
You can and should contact Olinsky Law Group at any stage of your disability claim. We have experienced attorneys and paralegals that can assist you at any level; including initial applications, hearings before an Administrative Law Judges, and appeals of hearing decisions to the Appeals Council and Federal Court.
Who decides if I am disabled?
Olinsky Law Group will provide a free case analysis to help you decide if you may qualify for SSI or SSD benefits. However, the Social Security Administration will review your application to see if you meet some of the basic requirements for disability benefits. Your current work activities and if you have worked long enough to qualify to receive Social Security disability benefits will be reviewed. If it is decided that you have met these requirements, your application will be sent to the Disability Determination Services Office in the state where you live. The state agency completes the disability decision by looking at the medical evidence from your doctors, hospitals, clinics, and/or institutions where you have treated. Your doctors will be asked about your medical condition, when it began, how it limits your activities, what medical tests show about your medical condition, and the type of treatment you are receiving for your medical condition. Your doctors will also be asked about your ability to perform work-related activities but will not be asked to decide if you are disabled.
How is the decision made?
The following five-step process is used to determine whether or not you are disabled:
1. Are you working at substantial gainful activity level?
2. Is your medical condition severe (has it lasted or is it expected to last for at least 12 months)?
3. Is your medical condition on the List of Impairments?
4. With your limitations, can you return to work that you have performed in the past?
5. With your limitations, is there any other type of work that you can perform?
How will I know when a decision has been reached?
The state agency will send you a letter. If your application has been approved the letter will show the dollar amount of your benefits and the date on which your payments will start.
What do I do if my application for Social Security disability benefits is not approved?
If you are not satisfied with the decision that has been made on your claim you can appeal it. The steps that you can take to appeal the decision include arranging to be represented by an attorney of your choice when challenging the decision made on your claim.
Where and how can I appeal?
If you decide to appeal the decision concerning your claim, you will need to put your request to appeal the decision in writing within sixty (60) days from the date that you have received the letter concerning the decision about your claim. If you find you need help, contact the Social Security Administration office near your home.
How many levels of appeal are there?
There are seven appeal levels through Federal court up to and including the US Supreme Court. Generally speaking there are three or four levels of appeal depending on the state you live in before the Social Security Administration and four appeal levels within Federal Court:
Reconsideration involves the review of your files without the need for you to be present at the time of the review and is constructed by someone who was not involved with any aspect of the first decision. Reconsideration is not required in certain states.
Hearing A hearing is conducted by an Administrative Law Judge who was not involved with any aspect of the first decision and is usually held at a hearing site near your home. The hearing must be attended by you and your representative, if you have one, to explain the reason you are unable to work. You are permitted to look at information and to provide new information.
Appeals Council If you disagree with the decision reached at the hearing concerning your claim, you can ask for a review by the Appeals Council.
Federal Court Should you not agree with the decision reached by the Appeals Council or if the Appeals Council decides not to review your case, you have the option of filing a lawsuit in a Federal District Court. The appeal process in Federal Court starts with the Federal Magistrate Judge making a recommended decision for review by the District Court Judge. If the Magistrate judge does not recommend in your favor, you can file an objection with the District Court Judge. If the District Court denies your application the next level of appeal is to the US Circuit Court of Appeals. If the result at the Circuit court is not satisfactory then the last appeal is to the US Supreme Court.
How can an attorney from Olinsky Law Group assist me?
Our attorneys are experienced in meeting the strict deadlines required by the Social Security Administration. Our staff of paralegals are available to answer questions about the different processes on a daily basis. Our Attorneys are also experienced in reviewing and evaluating medical records and formally presenting evidence to show how and why our clients meet the standards for disability. Disability law is all that we do.
How long will it take to receive my disability benefits?
The entire process from beginning to end could take from three months to five years.
Does age make a difference when I apply for benefits under Title II or Title XVI?
Yes. The Social Security Administration looks at age as one of the factors in determining disability. The Social Security Administration evaluates age as follows:
* 18-49 is a younger worker
* 50-54 is closely approaching advanced age
* 55-59 is advanced age
* 60-64 is closely approaching retirement age
Does education level make a difference when applying for benefits under Title II or Title XVI?
Yes. The Social Security Administration looks at education level as one of the factors in determining disability. The Social Security Administration evaluates education as follows:
* up to 6th grade is marginal
* up to 11th grade is limited
* H.S. graduate or GED is high school
* College is more than high school.
Can a child receive disability benefits?
Yes a child can receive either SSI or SSD if they are disabled. There is a set of criteria for children. They can get SSD based on their parents earning record, or SSI if no earning record or a combination up to the maximum SSI amount.
I am disabled, but I have plenty of money in the bank. Do I have to wait until this money is gone before I apply for Social Security disability benefits?
No. If you have worked in recent years and are applying for SSD or if you are applying for Disabled Widow’s or Widower’s benefits or Disabled Adult Child benefits, it does not matter how much money you have in the bank. There is no reason to wait to file the claim.
Do you have to be permanently disabled to get Social Security disability benefits?
No. You have to have an impairment that has lasted for at least a year or is expected to last for at least a year, or have a condition that can be expected to result in death.
I have several health problems, but no one of them disables me. It is the combination that disables me. Can I get Social Security disability benefits?
Social Security is supposed to consider the combination of impairments that an individual suffers in determining disability. Many, perhaps most claimants for Social Security disability benefits have more than one health problem and the combined effects of all the health problems must be considered.
If I get on Social Security disability benefits and get to feeling better and want to return to work, can I return to work?
Certainly you can return to work. Social Security wants individuals drawing disability benefits to return to work and gives them every encouragement to do so. For persons receiving Disability Insurance Benefits, Disabled Widow’s and Widower’s Benefits, and Disabled Adult Child Benefits, full benefits may continue for nine months after an individual returns to work at SGA levels. Even thereafter, an individual who has to stop work in the following three years can get back on Social Security disability benefits immediately without having to file a new claim. In SSI cases, things work a differently, but there is still a strong encouragement to return to work.
Do I in fact have to hire a lawyer to represent me in my Social Security disability claim?
No. You can go through all of the levels of review on your own, if you wish, but statistically claimants who are represented by an attorney win a good deal more often than those who are not represented.
How do lawyers who represent Social Security disability claimants get paid?
In almost all cases, the attorney receives 25% of the back benefits if the claimant wins and no fee if the claimant loses. Note: This may be different for cases that have been remanded by the Appeals Council or Federal Court before being approved by an Administrative Law Judge.
I know someone who is on Social Security disability and he does not look a bit disabled. Why is this so?
When it comes to disability, looks can be very deceiving. There are many people who look quite healthy but who are quite disabled by anyone’s standard. For instance, many individuals who suffer from very severe psychiatric illnesses appear physically healthy but have other work-related limitations.
I am disabled, but I have never worked. Can I get Social Security disability benefits?
You can qualify for Supplemental Security Income (SSI) if you are disabled, even if you have never worked in the past. It is also possible to qualify for Disabled Adult Child Benefits on the account of a parent if you became disabled before age 22 or for disabled widow’s or widower’s benefits on the account of a late husband or wife.
I am a widow. I have not worked in many years. I am disabled. Can I get Social Security disability benefits?
If you are over 50 and became disabled within seven years after your husband or wife died or within seven years after you last drew mother’s or father’s benefits from Social Security, you can get Disabled Widow’s or Widower’s Benefits. Perhaps more important, if you have no income and very few assets, you can draw Supplemental Security Income benefits no matter what age you are or when you became disabled.
My doctor says I am disabled so why is Social Security denying my Social Security disability claim?
Social Security’s position is that it is not up to your doctor to determine whether or not you are disabled. It is up to the Social Security Administration and they will make their own decision regardless of what your doctor thinks.
I am disabled by mental illness. Can mental illness serve as the basis for a Social Security disability claim?
Yes. Mental illness is a frequent basis for awarding Social Security disability benefits.
I am a Senior with Dementia. Can this serve as the basis for a Social Security disability claim?
Yes. Click here to view a guide on accessing disability benefits if you have Dementia.
Will it help if I ask my Congressional Representative to help me get Social Security disability benefits?
Many Social Security disability claimants become frustrated with claim delays and eventually ask their U.S. Representative or Senator to help. The local Congressional office typically will have staffers who are experienced with Social Security procedures and personnel. A Congressional Inquiry, as it is called at Social Security, may help to get a stalled process moving again. Note that the inquiry will have no impact on how Social Security decides the outcome of the case.
What is the difference between Medicare and Medicaid?
The short answer is that Medicaid is a poverty program and Medicare is not. Many disabled people who get Medicaid get it because they are on Supplemental Security Income (SSI). This is called categorical Medicaid eligibility. To get SSI and thereby get Medicaid you have to be poor and disabled. Medicaid pays doctors at very low rates. People who have only Medicaid can have a hard time finding doctors willing to take them on as patients. Medicaid does pay for prescription medications. Medicaid payment to a provider or hospital can go back up to three months prior to the date of a your Medication application. Note that it is possible to apply for Medicaid directly through a local Medicaid office without having a companion claim for SSI.
For Medicare it does not matter whether you are rich or poor. If you have been found disabled and on Disability Insurance Benefits, Disabled Widows or Widowers Benefits or Disabled Adult Child Benefits for 24 months you qualify for Medicare. The good thing about Medicare is that it pays doctors at a higher rate than Medicaid. Almost all doctors are happy to take Medicare patients. The bad things about Medicare are that it does not begin until after a person has been receiving disability benefits for two years and that it generally does not pay for prescription medications.
If I get Social Security disability benefits will I get Medicaid?
If you are approved for SSI you will get Medicaid immediately.
Can you appeal my case to the Federal Courts?
Yes we can. We do not however take all cases to Federal Court. The case must meet certain requirements. First the ALJ’s decision must have a legal error which the federal courts consider reversible. Next, the error must have been harmful to the result of your case. (harmless errors are not actionable) Finally, you must not have any debt which has been reported to the US treasury for collection.
What are some examples of federal debt which would disqualify me from representation?
If you have federal debt you are not disqualified from bringing a federal court action. Having federal debt means that if you win, the governments reimbursement of your legal fees paid under EAJA will be diverted and will not be available to be used as legal fees for your representation.
What is an EAJA fee?
Individuals who sue an agency of the federal government, such as Social Security and win are entitled to reimbursement of their legal fees thru the Equal Access to Justice Act. The EAJA act permits us to represent you on a contingent basis without you having to pay up front legal fees. If you win a remand of your case back to the agency for a new hearing the federal government will pay your legal fees. These fees do not come out of your back benefits but are paid by the government.
What if I was represented by another attorney or non-attorney representative before the Social Security Administration? Will you still take my case?
Yes. Many of our Federal Court cases are referred to us by other attorneys and representatives who do not practice in Federal Court.
I am an attorney or non-attorney representative and wish to refer a claim to you for federal court representation. How do I do that?
Push the Attorney Referral button at the top of the page. We will screen your client to see if they have a viable federal court claim. First we will conduct a treasury debt check. Then we will screen the case on its merits to see if we think it has a good chance of winning. If we accept the case, we will represent them in federal court. You continue to represent the claimant at the administrative level. Upon a successful remand we send the file back to you so you can represent your clients case at the remand hearing.
SSI vs. SSD
What is the difference between Social Security Disability (SSD) and Supplemental Security Income (SSI)?
Supplemental Security Income, or SSI, is a program financed through general tax revenues-not through Social Security trust funds. SSI disability benefits are paid to people who have a disability and who do not own much or have a lot of income.
Social Security disability insurance, or SSD, is a program that workers, employers and the self-employed pay for with their Social Security taxes. You qualify for these benefits based on your work history, and the amount of your benefit is based on your earnings. To qualify for Title II benefits one must have paid in for 20 quarters over the last 10 years. Supplemental Security Income is for those who are disabled, but do not have enough credit to qualify for Social Security Disability Title II.
Should I apply for Social Security Disability (SSD) Title II or Supplemental Security Income (SSI) Title XVI?
Always apply for both. An SSI application is also an application for SSD. But an SSD application is not an application for SSI.
Are there earnings requirements for disability benefits? How do I meet the earnings requirement for disability benefits?
It depends. For SSI there is no earnings requirement. However, there is an earnings requirement for disability insurance benefits. To qualify to receive disability benefits, there are two different earnings tests that you must meet.
1) A recent work test that is based on your age at the time you become disabled; and
2) A duration work test to determine if you have worked long enough under Social Security.
Am I eligible to receive Supplemental Security Income (“SSI”)?
SSI is a federal program that provides monthly cash payments to people who have very little income or do not own many things.
Elderly individuals, blind or disabled individuals of any age as well as children can receive SSI. In other words, if you are 65 or older, or totally or partially blind; or have a medical condition that keeps you from working and could result in death or last at least for one (1) year, and you are a United States citizen, you could be eligible to receive SSI.
What would be the amount of the SSI payments?
The basic monthly SSI payment for 2014 is around $721, for one person, or $1,082 for a couple. Certain States supplement the benefit paid by the federal government which increases the amount you can receive. Not all states provide a supplement.
Initial Application and Reconsideration Levels
What should I do if I think I am eligible for Social Security disability benefits?
You should apply for Social Security disability benefits by contacting the Social Security Administration through the Internet at www.socialsecurity.gov or you can call the Social Security Administration’s toll-free telephone number, 1-800-772-1213 between 7:00 A.M. and 7:00 P.M. to make an appointment to file a disability claim at a Social Security office near your home.
If you are deaf or hearing-impaired, you can call the Social Security Administration’s toll-free TTY number of 1-800-325-0788. Once you have scheduled an appointment, a Disability Starter Kit will be mailed out to you which help you prepare for your disability claims interview.
When should I apply?
You should apply for Social Security disability benefits as soon as you become disabled and/or unable to work. The processing of a disability benefits application can take a long time so it’s important you get started quickly.
How will I know when a decision has been reached?
The state agency will send you a letter. If your application has been approved the letter will show the dollar amount of your benefits and the date on which your payments will start.
What do I do if my initial application for Social Security disability benefits is not approved?
First, do not be surprised. Only about 40% of Social Security disability claims are approved at the initial level. If you are denied at the initial level, unless you have already returned to work or expect to return to work in the near future, you should appeal, that is, file a request for reconsideration, or request for a hearing depending on which State you live in. The steps that you can take to appeal the decision include arranging to be represented by an attorney of your choice when challenging the decision made on your claim.
Where and how can I appeal?
If you decide to appeal the decision concerning your claim, you will need to put your request to appeal the decision in writing within sixty (60) days from the date that you have received the letter concerning the decision about your claim. If you find you need help, contact the Social Security Administration office near your home.
How long will it take to be scheduled for a hearing with an Administrative Law Judge after I file a request for a hearing?
Generally it takes about a year for a claimants case to be scheduled before an Administrative Law Judge after they have filed a request for hearing. Expedited hearings do occur under some rare circumstances. Olinsky Law Group attorneys can assist in assessing whether your case is one that may be eligible for an expedited hearing with an Administrative Law Judge.
Who decides if I am disabled at the hearing level?
At this point, the case is sent to an Administrative Law Judge who works for Social Security. The Administrative Law Judge makes an independent decision upon the claim. This is the only level at which the claimant and the decision maker get to see each other.
What is the Social Security hearing like?
The hearings are fairly informal. The only people likely to be there are the judge, a courtroom clerk who makes a computerized digital recording, the claimant, the claimant’s attorney. In some cases the Administrative Law Judge has a medical doctor or vocational expert present to testify at the hearing. There is no jury nor are there any spectators at the hearing. There is no attorney at the hearing representing Social Security. During the hearing, the claimant will testify about their impairments and how the impairments prevent them from working. The claimant’s representative will assist you in testifying and will present legal arguments for why you should be found to meet the standards for Social Security Disability.
What are my chances of winning at a hearing?
Statistically, about half of the claimants who have a Social Security disability hearing win. Statistics also show that claimants represented by an attorney are much more likely to win.
How long will it take to get a decision from the Administrative Law Judge?
Once the administrative record is complete and the Judge has claimant’s entire medical information relating to the disability, the Judge will begin the decision writing process. Generally this process takes around 30 to 90 days before a decision is issued in writing. In some cases, the process can be shorter or longer, depending on a number of factors including the type of disability alleged, the Judge, and the information within the claimant’s medical file.
Where and how can I appeal and unfavorable decision from the Administrative Law Judge?
If you decide to appeal the decision you have sixty (60) days to appeal in writing from the date that you have received the letter denying your claim. Note: This may be different for cases that have previously been remanded by the Appeals Council or Federal Court.
What level of appeal is available if I disagree with the hearing determination?
Appeals Council – If you disagree with the decision reached at the hearing concerning your claim, you can ask for a review in writing by the Appeals Council.
Appeals Council
What is the Appeals Council?
The Appeals Council exists to review Administrative Law Judge decisions. The Appeals Council is located in Falls Church, Virginia, and neither the claimant nor the attorney sees the people at the Appeals Council who are working on the case.
What levels of appeal are available if I disagree with the Appeal Council determination?
Federal Court – Should you not agree with the decision reached by the Appeals Council if the Appeals Council decides not to review your case, you have the option of filing a lawsuit in a Federal District Court.
Federal Court
Can I appeal a case beyond Social Security to the Federal Courts?
Yes. If a claim is denied at the Appeals Council, it is ripe for review for possible appeal to the United States District Court A claimant appealing to the United States District Court actually sues the Commissioner of Social Security. A Federal Court case is decided by the court without a trial after reviewing the pleadings, including Briefs submitted on behalf of the claimant and a brief submitted by the US Attorney’s office representing the Commissioner. A Social Security disability claim which is denied by the federal district court is then appealed to the U.S. Circuit Court of Appeals and possibly all the way to the Supreme Court. About once every three or four years, the United States Supreme Court hears an appeal of a Social Security disability case.
Approved Claims
What happens if I qualify for Social Security Disability benefits?
Once the Social Security Administration determines that you are eligible to receive benefits, you will then be paid the benefits that you are entitled to. You may be entitled to retroactive benefits which are paid in a lump sum. You will also receive monthly benefits that are paid out for as long as you continue to be disabled. For SSD recipients, the retroactive benefits, by law, are calculated so that you only receive benefit payments for the period beginning five full months after you became disabled up until the present. If you are awarded SSI, your back benefits and/or you monthly payment will begin the month after you file your SSI application provided you were found disabled back to that date.
How much money will I receive if I qualify for Social Security Disability benefits?
The total amount of money you receive will depend on how much time you have worked, when you last worked, and how much money you have paid into the Social Security system. The calculation of Social Security Disability benefits is the same as the calculation of your Social Security Retirement benefits. Therefore, you can expect to receive a monthly benefit payment that is equivalent to what your retirement benefit payment would have been.
How far back will they pay benefits if I am found disabled?
For Disability Insurance Benefits and for Disabled Widow’s and Widower’s Benefits, the benefits cannot begin until five months have passed after the person becomes disabled. In addition, benefits cannot be paid more than one year prior to the date of the claim. For a Disabled Adult Child, there is no five-month waiting period before benefits begin, but benefits cannot be paid more than six months prior to the date of the claim. SSI benefits cannot be paid prior to the start of the month following the date of the claim.
When will I receive benefits?
The time from application to receipt varies from case to case. An applicant who is approved after making just one application to the Social Security Administration can expect to receive benefits three to four months after submitting the application. However, government statistics clearly show that most people who apply for Social Security Disability are not approved after submitting their first application. Usually, it will require two or three appeals before benefits will be awarded. Many times, a claim must go to a hearing stage before it is approved. Once you have been approved, the benefits you are paid will include back benefits due which represents the benefits you should have received during the time that your claim was being processed.
How do lawyers who represent Social Security disability claimants get paid?
In almost all cases, the attorney receives 25% of the back benefits if the claimant wins and no fee if the claimant loses. Note: This may be different for cases that have been remanded by the Appeals Council or Federal Court before being approved by an Administrative Law Judge.
I am already on Social Security disability benefits, but I am worried that my benefits will be stopped in the future. What are the chances of this happening?
Social Security is not supposed to cut off disability benefits for an individual unless his or her medical condition has improved, but they discontinue benefits for many reasons. When Social Security reviews a case of someone already on Social Security disability benefits, they will discontinue benefits in the vast majority of cases. It will take an appeal to get the benefits started again. In recent years, Social Security has been doing many reviews to determine whether or not individuals already on Social Security disability benefits are still disabled. 90% of individuals who are subjected to a Continuing Disability Review will have their benefits terminated if they are unrepresented. However, 90% of individuals who are represented by an attorney who are reviewed will see their Social Security disability benefits continued.
If Social Security tries to cut off my disability benefits, what can I do?
You should appeal immediately. If you appeal within 10 days after being notified that your disability benefits are being ceased, you can ask that your disability benefits continue while you appeal the decision cutting off your benefits. If you continue your benefits however, it will be difficult to secure legal representation because a representative is paid from past due benefits. If you choose to keep getting benefits during the Continuing Disability Review process you may end up with a substantial over payment should you not be successful in continuing benefits. You will want to talk with an attorney about representation on your case, but you should file the appeal immediately.
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