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Answers To Common Questions About Social Security

Does a person need to be totally and permanently disabled to qualify for Social Security Disability benefits?

No. The laws governing Social Security Disability benefits do not require that a person be totally and permanently disabled. “Disability” for Social Security is defined as the inability to perform substantial gainful activity on a regular and sustained basis due to a medically determinable condition for a minimum period of one year. That means that you must have an illness or other medical condition that can be identified by medical professionals; that the condition either has lasted or is expected to last at least one year; and that you are limited by either the condition or treatment for the condition such that you can’t work day in and day out and earn at least approximately one thousand dollars per month. This is still a very strict standard for disability, but it is not exactly the same as “totally and permanently disabled.”

I have heard that everyone gets turned down the first time they apply for disability. Is that true?

No, but it is true that the majority of cases are turned down at the initial application level. There are several reasons for that statistic. However, the majority of cases that are appealed at least to a hearing level are approved. Good representation at the hearing level is very likely to improve your chances of approval.

If my doctor fills out a form for my employer or for welfare saying that I can’t work, doesn’t that mean I should get Social Security Disability?

Not necessarily. The forms that a doctor fills out for other government agencies, for employers, or for insurance companies may be based on different standards than the Social Security Administration uses. There may be far less information on the form or letter your doctor prepares than Social Security needs to decide your case. It is great if your doctor is on your side; it’s just that he or she may need to provide more or better information, focused on what Social Security considers important to your claim.

I don’t like doctors and I hardly ever see a doctor. I have heard that Social Security has to send you to one if their doctors if you file a claim. Shouldn’t I just wait until I file my claim and let them use their doctor to examine me?

That would be a mistake. Social Security is not required to send you for an examination in every case. If you are sent to a doctor who has contracted to perform examinations for Social Security, the doctor may or may not be a specialist in the type of problem you have. In any event, Social Security’s regulations require every person filing a claim to prove their case with medical evidence, and the regulations provide that the opinion of a doctor who has treated you and is familiar with your condition is worth more than one who has only seen you once. Social Security is also allowed to consider the type and frequency of treatment you get when determining how seriously your conditions limit your ability to work. If you don’t get much treatment, they can and often do conclude that you are not very sick.

I am still working, but I have had to cut back on my hours because I just can’t make it through the workday every day. Could I be eligible for disability benefits?

Possibly. It depends on how much work you are still able to do and whether your limitations can be proven to be the result of your medically determinable impairments. This is an area where an experienced Social Security Disability attorney can evaluate your situation and give you a more definitive answer.

I got denied for disability benefits and they said it was because of my age, my education, and my past work experience. Why does that matter if I can’t work?

Many people become very upset when they see these factors listed on their Notice of Denial. However, they are listed on every denial notice and are not specific to you. They are factors that the Social Security Administration almost always considers as part of the process of making a determination. In general, a person who is older or who has less education may be more likely to be approved for benefits. This depends on the individual situation. Again, this is an area where an attorney’s advice is helpful.

I have never worked much, but now I can’t work at all. Could I qualify for any kind of benefit from Social Security?

You might qualify a number of ways, assuming that your case is medically strong. Although you may not have worked much, you may have worked enough to qualify for benefits on your own earnings. You may also qualify under certain circumstances for benefits on the record of a deceased spouse, or on the record of one of your parents. If none of these apply, or the benefit is very low, you may qualify for Supplemental Security Income. This is a benefit for disabled people who have not worked enough in the right period of time to qualify for Social Security benefits at all, or for only a small amount. When you apply for Social Security benefits, you generally apply for Supplemental Security Income benefits too.

I applied for Social Security Disability benefits and I got turned down. It might be too late to file an appeal. What should I do?

There are several things you can do. First, you should check the date on your denial notice. You may still have time. If it is more than 65 days later than the date you were denied, and you have good reason, you may be able to file your appeal late. Otherwise, there are other avenues to follow including filing a new claim and requesting reopening of the earlier claim. You will benefit from advice and evaluation of your options by an attorney if this has happened to you. Do not let more time go by; look for help right away.

My child has medical or emotional issues and the school counselor suggested that I file for SSI for him. How does a child receive disability benefits?

Supplemental Security Income (SSI) is available for children who qualify medically and financially. The standards to determine whether a child is disabled are different from the standards for adults. This makes sense since it is the rare child who holds or is expected to hold a full-time job. When the child reaches age 18, his or her case will be re-evaluated using adult disability standards.

How do I know how much I will receive from Social Security if I am found disabled?

You can obtain an earnings statement online or request one through your local office that will tell you what the amount for you would be and the maximum your family could receive. Social Security also periodically sends out statements that contain this information. However, check the next question, since the statements might not account for all factors that apply to you.

The statement I got from Social Security says that I do not have enough credits to qualify for benefits. Should I just forget about applying for disability benefits?

Not on the basis of that statement alone. The statement is calculated based on the last reported earnings. You may have earnings in the current year that would change that determination. Also, if you haven’t had earnings, or very little earnings, in a long time, the statement will say you do not have enough credits. The statement tells you that you don’t have enough credits if you become disabled now. You may have been disabled for a long time, and possibly, the disability can be proven to have existed continuously during that time period. You may also be eligible for benefits on the record of a deceased spouse or a parent. If you qualify financially as well as medically, you may qualify for Supplemental Security Income benefits.

Why should I have a lawyer represent me in my claim? I think it’s obvious that I am disabled and a judge couldn’t possibly fail to agree with me.

It is not a good idea to assume that a judge will see things the way you do. When a person believes that their disability is obvious, he or she may not be aware of the requirements for Social Security Disability. The problems he or she is experiencing may have become overwhelming, but this may not be reflected in the records that the judge has available. He or she may not understand the purpose of testimony at the hearing or what areas should be discussed.

The judge is bound by laws and regulations and may not find the support for your case that you may think is there. A lawyer who is experienced in handling these claims can analyze your claim, obtain necessary evidence and present your case in the framework of the law. A lawyer can prepare you for the hearing process, present additional witnesses or other nonmedical (but relevant) evidence, and cross-examine witnesses called by the Social Security Administration. A lawyer can present oral or written argument in favor of your case. In the event that your claim is denied, a lawyer can pursue further appeals.

You have enough problems dealing with the way your health affects your day-to-day life. Put your legal issues in the hands of a professional.