For those of you who are unable to work due to your disabilities, the Social Security Administration provides both financial and medical benefits. Although dealing with any government agency can at times be frustrating and time consuming it is certainly a worthwhile resource to consider.
Basically there are two types of Social Security benefits for the disabled. For those who have worked enough quarters and whose employers paid into the Social Security system, the appropriate program is Title II (also known as Social Security Disability or SSD). The amount of time worked necessary to quality for this program varies based upon age and other circumstances but a rough rule of thumb is ten years of work in which at least several hundred dollars a month was made.
Under the Title II program the disabled person will receive a monthly benefit, (which varies greatly and is based upon the highest five years of earnings) as well as early eligibility for Medicare card. Under Title II the monthly benefit amount is subject to a cost of living increase every year. These benefits will be paid for the rest of the recipient’s life as long as he or she remains disabled.
Supplemental benefits may also be paid under some circumstances to a spouse and to the recipients dependent children under the age of 21. Also under this program, if the disabled completes a vocational training program or for some other reason wants to attempt to work a “trial work period" of up to nine months, it is allowed to enable him or her to make sure that the new career or job is something that is truly going to be viable.
For those whose work history does not contain enough quarters in which Social Security payments were made the Supplemental Security Income or SSI program may be an option. The requirement of permanent disability is the same under SSI as it is under Title II. However, under SSI you need not have paid anything into the Social Security system in order to be eligible.
There are, however, some very strict income and resource limitations for a recipient on the SSI program. For individuals whose income and resources do not exceed the SSI limits, this can be a worthwhile program. The SSI monthly benefit amount in California is currently approximately $600 per month.
Again as with Title II the disabled individual is entitled to these benefits for the rest of their life or for as long as they remain disabled. Instead of receiving a Medicare card, SSI recipients automatically qualify for Medical benefits. There is no annual cost of living increase and there are no supplemental benefits available for dependents and spouses under the SSI program. There are, however, similar provisions under SSI to the trial period option of Title II, for those who wish to attempt to re-enter the work force.
The requirements for obtaining Social Security Disability benefits are that you must be totally and permanently disabled. "Permanently disabled" means that your disability must last or be expected to last 12 months or longer. Total disability means that you have a “severe” impairment which substantially limits your ability to work, either in past work or performing any other work existing in significant amounts in the national economy for which you might be reasonably suited. Social Security may also consider you to be disabled if the only work you can find is work where an employer would have to make special accommodations for you; or if you can work but, only with extreme pain.
(Some of you who may be familiar with other systems should note that Social Security's definition of disability is different than that of the worker's compensation system or that of personal injury. Although the Social Security standards may seem stricter, it is noteworthy that Social Security does not require your disability to arise from an industrial injury or even from a situation where someone else was at fault. Disability is considered under the Social Security definition not based upon causation or liability but simply upon the bottom line result of its effect upon your ability to work).
Applying for Social Security Disability benefits is fairly simple. You can apply to any Social Security district office in your community. In many cases the district office will even take your application over the telephone. What frustrates most applicants for Social Security Disability and SSI is the length of the process and the fact that many disabled people do initially get denied for benefits.
Currently the Social Security Administration is so overwhelmed with applications that the processing times have been greatly delayed. It is not unusual to experience a four to six month wait to learn whether or not your application has been accepted or denied. You will be informed of this by mail.
If you are accepted, then congratulations. If, however you are denied, the notice will explain that you have 60 days to request a "reconsideration" of your claim for disability benefits. Unfortunately, this is where many applicants get discouraged and give up on pursuing their cases at a hearing. You should not be discouraged because many people who are truly disabled are denied at the initial and even at the reconsideration stages and then go on to win their cases at a hearing.
Once you file your request for reconsideration (an attorney can help you with this or the Social Security district office can provide you with a form), a wait of anywhere from four to seven months during the reconsideration process is not unusual. (There is good news in that there are plans underway to eliminate the reconsideration process which would then speed up the processing of most people's claims by four to seven months).
If your reconsideration request is denied (and many are), you then have 60 days to apply for a hearing. The hearing level is where most people win these claims. Unfortunately, Sacramento county is currently so backlogged with claims that it is taking anywhere from 10 to 14 months from the day the hearing is requested to the actual hearing itself.
As a consolation for the long wait, however, most applicants, once they win their benefits, will be awarded a "back benefit award" which will go back to the application date and in some cases even earlier. At the hearing the applicant meets face to face with an administrative law judge who will take testimony under oath, examine the record and all relevant medical evidence and then has 30 days to made a decision about the case.
An attorney who specialized in Social Security law can help you ease your way through the process and may increase your chances of success. It is a standard practice for Social Security attorneys not to charge any fee unless and until your case is won. At that time when you receive your back benefit award the attorney will request 25% of that award if the attorney has been successful in helping you win your case.
If your case is not won, most Social Security attorneys such as myself will not ask you for any money whatsoever. The attorney typically does not take any portion of the monthly Social Security Disability or SSI benefits which you can expect to receive for the rest of your life. In my opinion and in the opinions of clients for whom I have obtained benefits, the Social Security Disability programs are a valuable resource. Anyone whose permanent disability prevents them from working should certainly consider applying for one of these programs.
Med-Sell Newsletter, Auburn, CA. Nov. 1994.- Kansas Connection May 95