Monthly Archives: November 2011

How do I start the SSDI application?

Many claimants want to know how to start their SSDI application. First, you must figure out how to navigate the application process and apply for SSDI benefits. The first step is to contact the Social Security Administration and complete an SSDI application. You can do this in three ways:

• Call the Social Security Administration at 1-800-772-1213 and request they send you the SSDI application in the mail.
• Visit the Social Security Administration online at www.socialsecurity.gov and start the SSDI application online.
• Visit a Social Security Administration Regional Office and have the SSA representative help you finish the SSDI application. The nearest SSA Office can be found by visiting the SSA website office locator page. Enter your zip code and the closest office in your area will be listed.

Whether or not you choose to visit in person with a SSA representative or apply for SSDI  online will most likely depend on how much help you need with your SSDI application and if you consider yourself computer savvy enough to navigate the online SSDI registration process. If you feel like you need a little extra help, the best thing to do is call the SSA and schedule a meeting with a SSA representative.

The representative will not complete the SSDI application for you. Millions of claimants apply each year for SSDI and SSI benefits, and SSA workers simply do not have the time to fill out everyone’s SSDI application. They may be able to answer a few questions and make sure you are on the right track.

What documents do I need to complete the SSDI application process?

According to the Social Security Administration’s website (www.ssa.gov), you will need to gather all of the following records and documents to complete the Social Security Disability Insurance program:

• Your work records for the last fifteen years and your last day worked
• Prescription information, including, names, dosage amount and prescribing doctors
• The names, phone numbers and addresses of all of your doctors
• Your Social Security Administration
• A Valid birth certificate
• Marriage and dependent information
• Public benefit information
• General information about your disability
• W-2 tax forms

Do I have to gather my own medical records for my SSDI application?

Many claimants want to know if they have to request their own medical records for their SSDI application. No, the SSA has the responsibility to gather your medical records so they can evaluate your SSDI claim. You will, however, have to provide information about all of your treating sources such as your doctor’s name, address and phone numbers and dates of treatment.

Keep in mind gathering medical records is one of the most time-consuming aspects of evaluating your SSDI claim so if you have copies of your most recent medical records you can expedite your claim by making copies and giving them directly to the SSA for their review.

After you have completed your application for SSDI the SSA estimates that you should receive an answer from them within 90 to 120 days.

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Can I apply for both SSDI and Supplemental Security Income (SSI)?

To answer this question it is important to understand the difference between the two disability programs offered by the Federal Government.

The first program is SSDI or Social Security Disability Insurance which is a wage replacement benefit provided to disabled workers who have a severe mental or physical health condition which is expected to last for at least 12 continuous months and who are no longer able to work or to perform work at a “substantial level.”

To qualify for SSDI, workers must not be working at a substantial level and they must have worked long enough and paid enough in payroll taxes to be considered “insured” by the Social Security Administration (SSA). To be insured a worker must generally have 20-40 work credits, but the amount will vary based on the age of the claimant at the time they become disabled.

Supplemental Security Income (SSI)

Supplemental Security Income is the second cash assistance program provided to the aged (65 years or older), blind or disabled who are not considered “insured” by the Federal Government but need cash assistance to meet their minimum monthly expenses.

Supplemental Security Income is a “needs” based program but it only provides cash assistance to claimants who have VERY limited income and resources. Claimants who are attempting to qualify for SSI due to a disability must also be unable to work for at least 12 continuous months.

Can I apply for both SSDI and SSI?

When a claimant applies for disability benefits the SSA will first determine if they meet the nonmedical criteria of the SSDI program and determine if they have enough work credits. If they do not have enough work credits for SSDI, they will be denied benefits regardless of the severity of their condition. At this point the claimant’s only option is to either return to work or apply for SSI benefits.

In the scenario listed above, the claimant may potentially qualify for SSI, but they will not get SSDI.

So what happens if you qualify for SSDI?

Claimants who meet the medical and nonmedical criteria of Social Security Disability Insurance are paid based on their average earnings and payroll tax contributions to Social Security. The more claimants have paid into Social Security, the more in monthly benefits they are entitled to receive.

The only way a claimant may get both SSDI and SSI benefits is if their SSDI payment is lower than the federal benefit rate (FBR), which is the maximum amount paid to SSI claimants. For instance, the Federal Benefit Rate is $674 per month for an individual and $1,011 per month for a couple in 2011. If the SSDI claimant’s payment is less than this they can contact the SSA to find out if they might also qualify for SSI benefits (assuming they meet the other requirements of the SSI program).

Hiring a Disability Lawyer

Do you have to hire a disability lawyer to apply for benefits? No, many claimants win benefits the first time they apply and they do not need legal assistance. If you have been denied, however, you have 60 days from the date of denial to file an appeal. A disability lawyer can help you with all disability appeals.

Sarcoidosis and SSA Disability Benefits

Sarcoidosis (sahr-koi-DO-sis) is a disease that is caused by the development of clumps of inflamed cells called granulomas. Although the clumps of cells can develop in different areas of a claimant’s body, they generally occur in the eyes, skins, lymph nodes and lungs. As the clumps of granulomas accumulate in an organ, they cause the organ function to deteriorate.

Although it is unclear what causes this condition, some experts believe that it is from an abnormal immune system response which can be triggered by bacteria, dust, viruses and chemicals. While this condition may disappear in some individuals, others may experience symptoms of scarcoidosis for a lifetime.

Signs and Symptoms of Scaroidosis

Signs and symptoms can vary but generally include a persistent cough, shortness of breath and skin rashes. Inflammation in the form of red bumps may appear on an individual’s face, legs and arms. Skin rashes can also include color change, lesions, and nodules. Additionally, claimants may suffer from unexplained weight loss, swollen lymph nodes, night sweats, wheezing, chest pain, and extreme fatigue.

Symptoms may develop gradually and persist for years; other may have sudden symptoms which quickly disappear. Some claimants may have the condition and experience no symptoms and only realize they have the condition after a chest X-ray.

In some rare cases, sarcoidosis can cause chronic conditions in the lungs, eyes, kidneys, heart, nervous system and reproductive system. To gather medical information about this condition, claimants can request lab tests, X-rays and CT scans.

Getting disability benefits for Scaroidosis by meeting a listing

The Social Security Administration has created a list of impairments they consider so severe that claimants with these conditions are assumed to be unable to work. This list is called the Listing of Impairments or SSA Bluebook. Claimants, whose condition “meets or exceeds” a condition on this list, will be considered automatically disabled.

Sarcoidosis can affect a variety of different organs and body systems. To meet a listing on the Social Security Administration Blue Book the SSA will generally evaluate the listing for whichever body part has been affected. For example, if sarcoidosis has severely limited your lung function the Social Security Administration will evaluate your condition under Section 3.0 Respiratory System, listing 3.02 Chronic Pulmonary Insufficiency.

The best thing to do is discuss your condition either with a disability lawyer or your health care doctor for more information about your condition and whether or not it meets a listing. What if it does not meet a listing? Can you still win either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI)? Yes, but it will be more difficult.

Getting disability benefits for Scaroidosis through a medical vocational allowance

Claimants whose condition is not severe enough to meet a listing will have a more difficult time winning SSDI or SSI benefits. They will have to prove that their condition does not leave them enough residual capacity to perform their current job, previous jobs or retrain for new work.

To prove this the claimant should focus on determining what work functions they can no longer perform.

• How long can you walk? Stand? Sit?
• Can you push and pull? Carry weight?
• Do you need to take frequent breaks from work?
• Do you have to see a doctor several times per week?

With enough limitations to perform work, a claimant may be able to prove that they cannot maintain a normal work schedule and that their condition severely impacts their ability to concentrate, and maintain a normal work pace.

Lung Cancer and Social Security Disability Benefits

Lung cancer is caused by abnormal growth of the cells in the lungs. Often if lung cells begin to grow and divide in an uncontrolled division, the proliferation of the cells may eventually form a tumor. Lung tumors generally start in the walls of the bronchi airways. Up to 20 different types of cancerous tumors have been identified that start in the lung itself.

Lung cancer is one of the leading causes of death in the United States, but research indicates that it is one of the most preventable types, often caused by smoking cigarettes.

Diagnosing Lung Cancer

Many lung cancer patients have no idea they have lung cancer and exhibit no signs or symptoms. The lung cancer may only be identified after a chest x-ray. Other lung cancer patients exhibit a wide range of symptoms which can include:

• Coughing
• Fatigue
• Unexplained weight loss
• Respiratory infections
• Wheezing and shortness of breath
• Coughing up blood
• Pain in the chest

Unfortunately, lung cancer can spread to other parts of the body, especially the bones, liver and brain. If the lung cancer has spread to the liver the individual may have yellow skin and eyes. Bone cancer can cause pain and brain cancer can cause loss of vision or weakness on one side of the body.

Qualifying for Social Security Disability Benefits for Lung Cancer

If you have been diagnosed with lung cancer there are two ways you can win Social Security Disability Benefits: meeting a listing on the SSA Listing of Impairments (Blue Book) or proving through a medical vocational allowance that you do not have enough residual capacity to work.

To meet a listing for lung cancer you must prove, through valid medical evidence, that your chronic pulmonary insufficiency meets the SSA “listing”, which is a list of symptoms for your disease that the SSA assumes are so severe that you cannot perform substantial work.

Lung cancer is evaluated under Section 3.0 Respiratory System, listing 3.02 Chronic Pulmonary Insufficiency and it has three parts:

Part A. Chronic pulmonary disease – the severity is evaluated by spirometric testing

Part B. Chronic restrictive ventilator disease – the severity is evaluated by spirometric testing of restrictive pulmonary disease

Part C. Chronic impairment of gas exchange – the SSA evaluates if you have chronic impairment of gas exchange due to clinically documented pulmonary disease.

The Social Security Administration will first consider whether your condition is so severe that it is expected to last for at least 12 continuous months. SSDI (Social Security Disability Insurance) and SSI (Supplemental Security Income) are considered permanent disability programs and do not pay benefits for short-term conditions.

Next, the SSA will determine how effectively your lungs can oxygenate blood and remove waste such as carbon dioxide from your body. The SSA acknowledges that if your lungs can not carry out these basic functions then you would not have the capacity to perform even the least rigorous work (sedentary work).

Hiring a Social Security Disability Lawyer

For more information about the specific levels of testing that must be done, you can review the SSA Blue Book under Section 3.0 Respiratory System. If your condition does not meet or exceed a listing this does not mean that you cannot win benefits, but you may need to talk to a disability lawyer about the information you need to prove that you cannot work.

I have never worked. Will this stop me from getting disability?

The Federal Government provides monthly cash assistance through two disability programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

Social Security Disability Insurance (SSDI)

Social Security Disability Insurance provides disability payments to employees who have a severe health condition which is expected to last for at least 12 continuous months and does not allow the employee to continue to perform work at a “substantial level.”

In addition to the medical criteria established by the Social Security Administration (SSA), employees must have worked and paid payroll taxes to be considered “insured” by the SSA. The number of work credits which must be accumulated by disabled workers to qualify for SSDI has been determined by the Social Security Administration and can vary based on claimant’s age when they become disabled. Most employees will need 20-40 work credits to qualify for Social Security Disability Insurance.

What if you have not worked and you have not accumulated enough work credits for SSDI? Does this make you ineligible for SSDI benefits? Yes, employees who have not worked or paid enough in employment taxes will be denied SSDI benefits, regardless of the severity of their current mental or physical health condition.

I have not worked, what are my disability options?

Supplemental Security Income (SSI)

If you have not worked your only option will be to apply for Supplemental Security Income (SSI). Supplemental Security Income is provided to the blind, disabled or aged (65 years or older who are not “insured” but who need cash assistance to meet their minimum monthly expenses.

This sounds great, but unfortunately many people will not qualify for SSI because it is a “needs based” program and is only provided to claimants who have VERY limited income and resources and who meet additional non-economic considerations.

What do I do if I do not qualify for SSI or SSDI?

Unfortunately, if you do not qualify for SSDI or SSI you have limited options. Some claimants who lack only a few work credits for SSDI may attempt to return to work for a short time to acquire more work credits. Workers can receive one credit for each $1,120 of earnings, up to the maximum of four credits per year (in 2011). So, for example, if you only lack four credits, if you make enough money, you might only have to work another year.

What if you cannot work? Unfortunately, you may have to wait until your resource and income limits are below the allowable limits. To get SSI, your countable resources must not be worth more than $2,000 for an individual or $3,000 for a couple. However, according to the SSA, you may be able to get conditional payments if you agree to sell some of your countable resources. Contact the SSA at 1-800-772-1213 or a disability lawyer for more information if you are considering this option.