Social Security Disability (SSD)

Am I Eligible for SSD?

Simply put, Social Security Disability (SSD) provides financial protection to working individuals who have become disabled and can no longer work.

In order to be eligible, an individual must first have a disability. The disability must be severe enough that the individual will likely be unable to work for at least one year. One general misconception is that the disability must be a physical limitation. While it is common for individuals who have suffered from physical injuries (such as work-related injuries) to apply for SSD, individuals who suffer from mental disabilities are also eligible. After an individual is found to have a disability, the Social Security Administration (SSA) will then determine whether an individual’s disability prevents him or her from working.

With regard to work, the SSA will attempt to determine whether or not an individual is engaged in a “substantial gainful activity.” For example, after appropriate deductions, an individual who earned on average more than $1130 per month in the year 2016, would be considered to have been engaged in a substantial gainful activity; therefore, the individual would be ineligible for SSD. It is important to note that the SSA does not include unearned income in its determination. For example, if you own an apartment complex and collect rent from it, the rent you receive is unearned income and not considered substantial gainful activity.

Furthermore, an individual need not be out of work for a year in order to be eligible for SSD. An individual only has to prove that the disability will last for at least one year and prevent him or her from working during that time. For example, if an individual was hurt in month 1 and in month 3 it is determined that the individual will not be able to go back to work until at least month 13, that individual will be eligible to apply for benefits immediately. It does not matter that the individual has only been disabled for 3 months, what matters is how long the individual is expected to be disabled.

The second part of eligibility requires the individual to have worked and paid taxes. Instead of a safety net, SSD should be thought of as a security blanket. Money collected from the Social Security tax is meant to be drawn upon by those who have paid into the system. When an individual works and pays Social Security taxes, he or she receives “credits.” An individual can earn up to four credits per year. An individual’s age will determine how many credits he or she needs to be considered eligible. For example, in the year 2017, an individual between the ages of 31 and 42 needed to have earned 20 credits to be considered eligible.

Social Security is the largest Federal program to ever exist in the United States. The application and appeals process can feel overwhelming and difficult. Moreover, many SSD claims are denied at the initial level. At Rankin & Gregory, we understand that it is hard to deal with legal matters while having to manage your disability. Contact us today for a free case evaluation. Let us handle your claim so that you focus on getting better.

How SSD can be Affected by Other Benefits

Some public disability benefits can reduce your Social Security Disability (SSD) benefits. Workers’ compensation is perhaps one of the most common benefits that can cause a reduction in SSD benefits. If you are currently receiving public disability benefits you can still apply for SSD, but the Administration will not allow your combined benefits to exceed 80% of your average current earnings prior to the onset date of your disability. If you are awarded SSD benefits and they exceed 80% of your average current earnings, the Administration will deduct your award until it meets the 80% criterion. This reduction is commonly referred to as an “offset.”

In order to determine an offset, the Administration must determine an individual’s average current earnings. There are three ways to determine an individual’s average current earnings, and the highest of these three will be used in calculating a potential offset. The first way, “High-1,” will use a person’s average monthly income based on a single calendar year from covered employment. Under High-1, the Administration will only consider a single calendar year’s income for the year that a claimant’s disability began or for any of the five years preceding the beginning of the disability. The second way, “High-5,” will use a claimant’s average monthly earnings over a consecutive period of five years. Unlike High-1, High-5 will consider any five consecutive years of income. The third way, “AMW,” will use the average monthly wage of a claimant’s un-indexed disability primary insurance.

Not all benefits you receive will be considered in determining a possible reduction of SSD benefits. The following is a list of benefits that are NOT considered in determining an offset:

  • All Department of Veterans Affairs benefits
  • Unemployment benefits
  • Need-based benefits
  • Federal, State, or local disability benefits based on State or local employment, all or almost all of which were covered for Social Security purposes
  • Private pension or private insurance benefits
  • Black Lung Part B benefits
  • Railroad Unemployment Insurance Act (RUIA) sickness benefits
  • Railroad injury settlement payments under the Federal Employer’s Liability Act (FELA)
  • Sick pay paid by an employer
  • Proceeds from third party settlements
  • Interest or other income generated by workers’ compensation investments
  • Jones Act payments
  • Payments from tort (negligence) lawsuits
  • Workers’ compensation/public disability benefits paid under a law or plan enacted by an American Indian Tribal Government
  • Workers’ compensation payments made to the employer

The attorneys at Rankin & Gregory are experienced in both workers’ compensation and SSD. When we settle a workers’ compensation case, we make sure to put our client into a position that will allow him or her to maximize any potential SSD benefits. For more information on workers’ compensation, check out our sister website: https://www.rginjurylaw.com/. Your injury does NOT have to be work-related for you to be considered eligible for SSD benefits. If you have become disabled and can no longer work, call us today for a free consultation.

The Claims Process

Initial claims for Social Security Disability (SSD) usually take three to five months to process; therefore, you should apply as soon as you become disabled. This way you can receive your benefits as early as possible. An individual can file an initial claim at https://secure.ssa.gov/iClaim/dib.

If your initial claim is denied, you have the right to appeal it. An appeal must be made within 60 days of the day you received a letter indicating a denial for benefits. Many states have four levels of appeal, but Pennsylvania typically only uses three of the four. The first level of appeal is a reconsideration; however, Pennsylvania will often skip this step and go straight to a hearing by an administrative law judge (ALJ). A hearing before an ALJ is either done in-person or by video. The ALJ will also have played no part in the initial determination and will provide you with the date and place of your hearing. At the hearing, you will be permitted to testify about your condition and you will also be permitted to have witnesses. A medical expert or vocational expert will often be at the hearing as well and you or your attorney will be allowed to question the expert.

In the event that you are denied after the hearing, you may appeal your denial to the Appeals Council. While the Appeals Council will review all cases in which an appeal was requested, it may deny a request for appeal if it is in agreement with the ALJ. After review, the Appeals Council has the option to make a decision on your case or send it back down to an ALJ for further review. If the Appeals Council also denies your claim, you may then file a suit in Federal District Court.

If you have been denied benefits at the initial level and are thinking about appealing, contact us for a free consultation; there is limited time to exercise your appeal so it is important not to hesitate. At Rankin & Gregory, we provide our clients with zealous representation and we will not take a fee unless you receive a favorable outcome.

What Should I Provide My Attorney

If you decide to hire an attorney you should be prepared to provide him with an extensive medical background and work history. Before seeing your attorney, make a list of all the doctors and medical professionals you have visited. It is important for your attorney to be able to review your medical records and gain a full understanding of your medical conditions.

For example, a primary care physician will likely see an individual over several years; thus, creating a medical profile of the individual. A medical profile can be especially useful in showing an individual’s capabilities prior to his or her disability. This history can assist an attorney on explaining how a disability has caused an individual’s inability to work. Specifically, an attorney will be able to show medically how your disability now limits you, and that you did not have these limitations prior to the onset of your disability. If you fail to provide your attorney with a full list of medical professionals you have visited, it may be more difficult to prove your
case.

With regard to work history, you will need to do develop a complete record over the last 15 years prior to submitting your application. When assessing a claim, the Administration will consider whether you are able to perform any relevant work you have done. The following factors should be fleshed out in order to build a strong work history:

  • Dates of Employment
  • Number of Hours Worked per Week
  • Salary
  • Typical Job Duties
  • Exertional Requirements
  • Reason for Leaving the Job

It is important to provide as much detail as possible to your attorney. For example, if you were fired from one of your previous jobs, be sure to try and explain why (were you unable to get along with your fellow employees, were you unable to complete work on time, did you miss too many days, etc.). Also, be sure to provide your attorney with any pay stubs that you have received because this may help in determining the amount of benefits that you are entitled.

Having to deal with any major government organization can be nerve-racking. Moreover, it is easy to get lost in the bureaucratic process. The attorneys at Rankin & Gregory are here to help, and we will not charge you a fee unless we recover money for you. If you are considering whether to hire an attorney to assist you with your claim, call us today and we will provide you with a free consultation.

Supplemental Security Income (SSI)

The Difference Between SSD and SSI

While Social Security Disability (SSD) is considered a security blanket for those who have worked, Supplemental Security Income (SSI) can be considered a safety net for those who have limited income and resources. The main difference between SSD and SSI is that an individual need not have accumulated the minimum required work credits to be eligible for SSI. In other words, an individual can be considered for SSI regardless of his or her work history.

In order to be eligible for SSI, you must be at least 65 years of age, blind, or disabled. Determining whether an individual is disabled is generally conducted in the same manner for both SSD and SSI; that is, does the individual have a medically determinable physical or mental impairment that prevents him or her from working.

Both SSD and SSI allow for retroactive benefits. For SSD, individuals may be eligible for retroactive benefits up to 12 months prior to the submission of their application for benefits. For SSI, individuals will be eligible for retroactive benefits beginning the month after they submit an application.

Furthermore, those who are eligible for SSI usually qualify for Medicaid. Those who qualify for SSD will instead qualify for Medicare. With regard to Medicare, there is a two-year grace period before these benefits start.

Is My Child Eligible for SSI?

Individuals under the age of 18 (or in some cases, under the age of 22) can also be considered for Supplemental Security Income (SSI). In order to be eligible for SSI, a child must be blind or disabled. For the purposes of SSI, there is no minimum age requirement for eligibility; thus, a child can be determined to be disabled as early as birth.

Similar to benefits for adults, the child’s disability must last or be expected to last for at least one year. The disability can be physical or mental, and it must also result in severe functional limitations.

If a child is awarded SSI benefits, he or she may receive these benefits until reaching the age of 18 (or in some cases, the age of 22). After that, the child will then be evaluated for impairments based on the definition of disability/blindness for adults.

When applying for SSI benefits for a child, it is also important to consider SSA’s practice of “deeming.” If a child is determined to be eligible for SSI, the Administration will then look at the parents’ income to see what resources are available to the child. The amount of income a child’s parents earn may impact the amount of SSI benefits that a child can receive. It is important to note, that once the child reaches the age of majority, deeming will cease and the child will be eligible for full benefits (assuming he or she still qualifies for benefits as an adult).

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