What is SSD?
SSD is an acronym for Social Security Disability.
How does a person become eligible for SSD?
A person may obtain benefits under SSD if they have paid enough taxes to be fully insured. This means a person must have worked at least 1 quarter with coverage for each year after their 21st birthday AND worked 20 out of 40 quarters prior to becoming disabled.
What is the SSD benefit amount?
The SSD benefit amount is based on earnings.
What are the medical benefits under SSD?
The recipient of SSD benefits receives Medicare benefits after they have received 24 months of benefits.
What is the definition of disabled according to Social Security?
The issue of what constitutes a disability is defined as an impairment that prevents a person from engaging in substantial gainful (economic and income producing) activity. The impairment must be severe and of a year's duration and prevent a person from returning to their previous employment and from performing other work that exists in substantial numbers.
What is the process of receiving SSD benefits?
To obtain Social Security Benefits, a person must first apply with the Social Security System at the local office for an initial determination of benefits. It is extremely common to have benefits denied at the initial determination. Upon receiving a letter of denial, a person generally has 60 days to appeal the initial finding. The Social Security System may impute an additional 5 days to appeal the denial as an allowance for the time it takes to mail and receive the denial letter. It is extremely important that the denial is appealed in a timely manner.
After the appeal, the attorney will obtain medical information from various sources used to show the claimant applying for benefits falls under the Social Security Administrations definition of disabled. The regional office responsible for handling Social Security claims will thereafter schedule a hearing to be attended by the claimant and their attorney. After the hearing, the Administrative Law Judge who held the hearing will issue a written decision within 3 to 5 weeks. Those benefits will initially pay a lump sum check that accrues when they are deemed initially disabled. The lump sum paid to the claimant will have an amount deducted for the initial waiting period and attorneys fees.
The decision will be favorable, partially favorable, or unfavorable. Favorable decisions generally will provide for retroactive benefits starting from the original impairment date requested. Partially favorable decisions will generally provide for retroactive benefits going back to a date that is not as far back as requested as the initial impairment date. This is obviously not as a good as a fully favorable decision. Depending on the result, the claimant may appeal the decision.
What is the role of the attorney and how are they paid?
At the point of the appeal, it is extremely beneficial for a person applying for benefits to obtain the services of an attorney experienced in handling Social Security Disability Matters. The attorney will advocate on behalf of the client and is barred from receiving payment from an applicant until benefits are actually granted. The Social Security System will actually pay the attorney to represent the applicant out of benefits the applicant receives that have accrued as of the award letter. This amount is capped at 25% of the amount of accrued benefits received at the time of the award up to $5,300.00.
What is the time frame it usually takes to start receiving benefits?
In Southeastern Pennsylvania, it typically takes 14-16 months after the appeal has been filed. Although this sounds like a long time, this is actually short compared to other districts throughout the country. In general, there is a backlog of close to 750,000 cases in the United States as of January 1, 2009.
What is the medical burden of proof to receive SSD benefits?
The medical burden of proof is a 5 step sequential evaluation process. This is the part of the process where the attorney usually earns their money. When a determination of disability can be made at any step, evaluation under a subsequent step becomes unnecessary. Those steps are as follows:
- Is the claimant engaged in substantial economic activity? Effective January 1, 2008, work generating an average earning of more than $940.00 is per month is considered substantial gainful activity. As an aside, unearned income does not constitute substantial gainful activity. If the answer is yes, then the claimant is not considered disabled and will not receive benefits. If the answer is no, the process proceeds to step 2.
- Does the claimant have a severe impairment? A severe impairment is defined as one that significantly limits physical and/or mental capacities to perform basic work related functions. The impairment must last 12 months or more. If the answer is no, the claimant is not considered disabled and will not receive benefits. If the answer is yes, the process proceeds to step 3.
- Does the claimant have an impairment listing that qualifies for automatic disabling status? I have included a list of impairments on the home page of this website. If you do have one of these impairments, your case will be easier to prove. If the answer is yes, the claimant will automatically be considered disabled and start receiving benefits. If the answer is no, the process proceeds to step 4.
- Is the claimant able to perform work related to their past relevant work? Only work performed in the past 15 year period preceding the alleged onset date of disability will be considered relevant. If the answer is yes, the claimant is not considered disabled and will not receive benefits. If the answer is no, process proceeds to step 5.
- Is the claimant able to perform work found in significant numbers in the national economy? At this point, the burden of proof falls on the government to show the claimant can engage in some other kind of work which exists in the national economy after factoring the claimants impairment, age, education, and work experience. This step of the process is also referred to as the grids. If the answer is yes, the claimant will not receive benefits. If the answer is no, the claimant is considered disabled and will start receiving benefits.
Can a person receive SSD benefits if Drug Addiction and Alcoholism are a reason for their disability?
This can be a complicated question, but the answer is still yes. In a nutshell, the ALJ will determine whether the claimant would still be found disabled even if they stopped using drugs or alcohol. Thus, if you suffer from an ancillary condition that would render you disabled under the Social Security Guidelines you would generally be able to obtain benefits.
