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Does SSI Pay Back Pay?

Tuesday, October 18th, 2011

If you are disabled and find yourself with limited income and resources, you may be eligible for Supplemental Security Income, or SSI, from Social Security.  SSI is a federal program that provides coverage for people 65 and older through monthly payments, as well as covering people who are blind or have become disabled.

Eligibility for SSI depends largely on two factors: your income and your resources.  Income refers to money you get as wages from a job, other Social Security benefits and any retirement or pension fund payments you receive.  Resources refer to things you own such as real estate, cash on hand, stocks and bonds you own, and money in bank accounts.

SSI benefits can be paid retroactively, going back to the date you originally filed your claim, if approved. If you are approved for this retroactive pay, you will be paid in installments, rather than getting one lump sum check.  Many people have reported they have had payments deposited into their bank accounts even before the official notice they are getting them arrives. Usually, a claimant will receive their first payment around 60 days of approval.

How far back your back pay goes depends mostly on two factors: How long your claim has been pending, and the date determined for the onset, or beginning of your disability. For SSI claims, you will receive installments equal to three months of the maximum SSI benefit you’re due when your claim is processed. Six months from your first installment you are issued another three months’ worth, and at the year mark the final installment is paid.

Although there is a five month waiting period on Social Security Disability Insurance claims, which means that after you’ve been approved the SSA effectively eliminates your first five months of benefits. There is not a waiting period for SSI benefits.

In 2006 President Bush signed the Deficit Reduction Act, requiring that past due SSI benefits that exceed three times the maximum monthly benefit (the federal benefit rate plus the state supplementary payment amount, if it applies) payable to claimants must be paid in up to three installments, six months apart. The law also limits the amount of the first two installments to three times the maximum monthly benefit.  The rest owed to you would be paid in the third installment.

The amounts paid in the installments may be increased in certain cases, such as when an individual has outstanding debt relating to food, shelter, clothing, or has certain medical needs. A qualified and experience Social Security disability attorney can help you make sense of the requirements, and help you get the money you need.

If, for some reason your claim for SSI benefits is rejected, you have 60 days to file an appeal. If you are then approved, the beginning of the back payments will be retroactive to the date you filed your first claim. If you don’t file an appeal within 60 days and refile a claim, the back payments will begin based on the second filing date, discounting the initial filing date altogether.


Denied at a Disability Hearing

Thursday, February 24th, 2011

Claimants denied Social Security Disability benefits at the Administrative Hearing level have already been denied once or twice at the application level and the reconsideration level (unless this level was omitted). At this point most claimants are very discouraged and maybe even angry.

If this sounds like how you feel, you are not alone. It is estimated that up to 60% of Social Security Disability claimants who go to a Social Security Disability hearing, and are not represented by a Social Security Disability lawyer, will have their Social Security Insurance Disability Insurance or Supplemental Security Income benefits denied.

So what should you do next? Should you file a new Social Security Disability application and begin the fight all over again or should you attempt to file another appeal with the Appeals Council in the last step of the Social Security Disability appeals process? Let’s talk about your options.

Appealing to the Appeals Council

If you decide you would like to appeal the Administrative Hearing Decision to the Administrative Appeals Judge you will have 60 days from the date you receive the notice of denial to ask for any type of appeal. The Social Security Administration will assume you have received the denial notice within 5 days from the date they have mailed it, unless you can prove otherwise.

The Appeals Council has the right to refuse to review your case. They do look at all requests for reviews, but if they decide the hearing decision was accurate, they may deny the request for review. If the Appeals Council decides to review your case they can do one of two things 1) they may review the case themselves or 2) send your case back to the Administrative Law Judge who initially reviewed the Social Security Disability case and made the denial decision. The Appeals Council, if they decide to review your Social Security Disability case, may evaluate all of the issues of your case and will send you a copy of their final decision.

What happens if the Appeals Council denies your claim or they refuse to review your Social Security Disability claim? Filing a civil suit in the federal district court is the last step to challenge the federal government’s denial of your Social Security Disability claim. If you decide to file a claim to evaluate the judicial review of the Social Security Administration’s denial decision the Social Security Administration will be responsible for putting together the record for the SSD claim for the court. The Social Security Administration will provide all the documents and evidence they reviewed to make their decision. Claimants will be charged for filing a case in federal court. If you choose to file an appeal with the Appeals Council, get ready to wait. According to the Social Security Administration’s statistics their average processing time for Appeals Council cases can be up to 260 days.

Applying for Social Security Disability Benefits a Second Time

If you have been denied Social Security Disability benefits at the Administrative Hearing level you may decide to simply re-file and start the process a second time. This is not ideal, but many Social Security Disability lawyers will tell you it is your best chance for receiving Social Security Disability benefits. How do you improve your chances for approval a second time?

  • Get consistent medical care and find a physician who will support your Social Security disability case. Ideally, your physician will provide RFC or residual functional capacity forms which specifically outline your physical or mental limitations.
  • Get copies of your medical records, including records from recent appointments and provide these medical records to the Social Security Administration when you reapply for SSDI or SSI benefits.
  • Answer all Social Security Administration letters and calls as quickly as possible and attend all required medical exams. Do not let deadlines pass. Failure to appeal either the application denial or reconsideration denial may force you to start the process again.
  • Contact a Social Security Disability lawyer for help. Social Security Disability attorneys help hundreds of claimants a year and understand the Social Security Disability process. SSDI and SSI lawyers understand how to prove you are unable to perform any type of job.
  • Be patient. Kind and courteous. Claimants who are easy to work with have a better chance of getting the help they need.

How can I get Social Security Disability if I haven’t worked or I have not worked in a long time?

Wednesday, February 16th, 2011

Disability benefits are administered by the Federal government through two different disability programs: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). The Social Security Disability Insurance program is offered to workers who have worked and paid employment taxes, earned “work credits” and are considered insured. Supplemental Security Income is paid to disabled, blind or aged claimants who have limited income and resources.

Can you be denied benefits, if you have worked but it has been a long time? You may be denied Social Security Disability Insurance if you have worked for many years, you stop working and too much time has elapsed since your last day of work. How does this happen? Workers may be insured through a certain date, which the Social Security Administration calls their DLI or date last insured. If you stop working and do not pay any more employment taxes at some point in time your date last insured will pass and you will no longer be insured.

This is a tough situation, but it happens all too often. For this reason it is important to file for Social Security Disability as soon as you become disabled with a mental or physical health condition which you believe will last for at least 12 months or may result in your death. The Social Security Administration can answer questions regarding your date last insured.

So if your date last insured has past you have several options. If you are able to return to work you may be able to earn enough work credits to qualify for Social Security Disability Insurance in the future, but if you have a serious disabling health condition this is probably not possible. Another option is to apply for Supplemental Security Income benefits.

Supplemental Security Income payments are monthly benefits paid to the aged, blind or disabled. You do not have to have earned work credits or have paid employment taxes to qualify. Supplemental Security Income recipients must be determined disabled by the Social Security Administration, and they must have limited income and resources. Income can include wages, Social Security benefits, pensions, food and shelter. Resources can include real estate, bank accounts, cash, stocks and bonds. In 2010, the Social Security Administration allows you to have no more than $2,000 in resources if you are single and $3,000 if you are married. The Social Security Administration does make exemptions for certain types of property and other resources such as one car, your primary home, life insurance of $1,500 or less, and burial plots.

So if you have not worked or if it has been several years since you have worked and your date of last insured has passed, your best option is to see if you can qualify for Supplemental Security Income benefits.

Disability Decision

Wednesday, September 15th, 2010

If you have applied for Social Security Disability Insurance or Supplemental Security Income, chances are you have been sick for several months, unable to work and may be facing financial hardships. You may have expected to receive your benefits immediately and did not realize most claimants wait months or even years to receive their Social Security Disability benefits. Claimants who file their Social Security Disability applications and receive SSD benefits immediately are, unfortunately, the exception.

All dates for disability decisions provided by the Social Security Administration are simply estimates. The Social Security Administration does have a legal obligation to meet any of their outlined decision dates. Why the delay in decision making? This is a great question, and there are several legitimate reasons:

·         Disability examiners who are reviewing Social Security Disability applications may have to wait months to receive all of your medical records which they must have to make a determination of disability for your Social Security Disability claim. Claimants who have not seen a doctor recently will likely have to be examined by a consultative examiner to prove they are still disabled. Getting consultative examinations scheduled, getting the results back to the examiner and having the examiner review the results all takes time. Why do the disability examiners care about the consultative examinations? These exams are frequently needed to provide the DDS examiner with more definitive information about a claimant’s disabling health condition and allow them to finalize their disability decision and close a claimant’s SSD case.

·         The number of Social Security Disability applications filed each year has substantially grown, and there are simply not enough disability examiners to review the claims quickly.

·         Claimants fail to provide complete information about their medical history, work history or other relevant personal data, and the Social Security Administration must spend valuable time researching and requesting any missing information.

·         Claimants who are denied Social Security Disability benefits and delay requesting any of their Social Security Disability appeals can also substantially add to their wait time. Claimants have 60 days to request, not only the reconsideration, but also the administrative hearing. Waiting the full 60 days to make the appeals can delay the claimant from receiving benefits for up to 4 months.

·         Most claimants who have appealed their Social Security Disability decision will wait the most time for their hearing to be scheduled with an Administrative Law Judge. The amount of time can vary greatly depending on where the claimant lives. Some claimant’s Social Security Disability hearings are scheduled immediately; others wait up to two years to have their hearings scheduled.

Expediting the Disability Decision

Can the claimant do anything to expedite their Social Security Disability decision? Yes, claimants can gather medical records for the disability examiner and their Social Security Disability lawyer, or at the very least, make sure the examiner gets all of the medical records they have in their possession. Claimants can provide accurate and detailed information on their Social Security Disability application. Claimants can return phone calls and answer letters as quickly as possible and finally, claimants can file all Social Security Disability appeals as soon as the denial letters are received.

Hiring a Social Security Disability lawyer may also help claimants get approved for Social Security Disability. Evidence has shown that hiring a Social Security Disability lawyer can increase a claimant’s chances for approval at every stage of the Social Security Disability process.

How Can You Prove a Social Security Disability Case?

Monday, August 23rd, 2010

Do you suffer from a physical or mental health condition which is considered severe? Are you unable to work? If your condition is expected to last at least 12 months or result in death you may be able to receive Social Security Disability benefits.

Some applicants assume getting Social Security Disability benefits is as simple as producing a doctor’s note which states they are disabled. If only it were that simple. Unfortunately, the process can be cumbersome and complex. Claimants may be denied Social Security Disability benefits multiple times before they are eventually approved.

How can you prove you are disabled and unable to work? You must get medical care and accumulate medical records which can prove your condition. Many claimants do not have a job or medical insurance thus making it nearly impossible to get good medical records. Unfortunately, without medical records claimants filing for Social Security Disability benefits are unable to prove to the Social Security Disability Determination Services (DDS) that they are disabled and will be denied Social Security Disability benefits.

What can a claimant do if they do not have medical documentation for their condition? This question is asked everyday, “How do I see the doctor if I do not have any money?” It can be difficult, but it is not impossible. If you have ever had medical coverage and seen a doctor for the conditions you are filing for you may be able to establish your alleged onset date. Current medical records may be obtained by visiting free local clinics in your area, and claimants may be able to request the same doctor for each visit to establish a doctor/client relationship. Visiting an emergency room would also be a last resort for diagnosing a condition.

Claimants who file for Social Security Disability Insurance or Supplement Security Income benefits without medical records may be sent for consultative exams by the disability examiner who is reviewing their Social Security Disability claim. Social Security Disability claims have been won based on the recommendations of the consultative examiners, but this is unlikely to occur if the claimant’s condition does not meet or equal a listing found on the Social Security Administration’s List of Impairments. Consultative examiners are not offering treatment for claimants but rather simply identifying impairments. Their ability to diagnosis a claimant will be limited by their lack of historical medical information and their lack of a patient/doctor relationship.

What if you have solid medical evidence of your severe medical condition but Social Security Disability benefits have still been denied? What else can you do? Winning Social Security Disability benefits may be as simple as hiring a competent Social Security Disability lawyer to plead your Social Security Disability case. Social Security Disability attorneys can review all of your medical records, gather residual functional capacity forms from your doctor and argue your case before the Administrative Law Judge at your Social Security Disability hearing.

A solid diagnosis, complete medical records, evidence establishing you are unable to work at your current job or be retrained for any other job is just the first step in the Social Security Disability process. It is time to talk to a Social Security Disability attorney and put the finishing touches on your Social Security Disability claim.

Requirements for Disability Benefits

Wednesday, August 11th, 2010

The United States Federal government has created two benefit programs for individuals who are unable to work. The first program, Social Security Disability Insurance (SSDI), was created in 1956 as an expansion of the Federal Insurance Contributions Act (FICA). SSDI was created as “insurance” for disabled workers who were not able to work due to a mental or physical health condition. Employees now pay taxes each pay period to fund the SSDI program. Employees who become disabled and they have contributed enough in taxes, may receive Social Security Disability Insurance benefits.

Requirement for Social Security Disability Insurance

How do disabled employees qualify for Social Security Disability Insurance? “Work credits” must be accrued by working and paying employment taxes. The amount of work credits needed for each employee will vary, but most workers over the age of 30 will need at least 40 work credits. Credits can accrue at a rate of 4 credits per year.

Employees must also be determined disabled by the Social Security Administration (SSA). Unfortunately, the disability determination process is a bit more complicated than bringing a doctor’s note to the SSA. Qualifying mental and physical impairments must be considered severe and be expected to last at least 12 months or result in death. Social Security Disability Insurance is not awarded for short-term disabilities or partial disabilities.

Widows, widowers, dependants (under the age of 18) and disabled dependants (over the age of 18 who were determined disabled prior to the age of 22) of an insured worker may also receive Social Security Disability Insurance.

Full Criteria for SSDI Benefits

  • The Social Security Administration must determine you are disabled.
  • You must be disabled prior to your full retirement age.
  • Your disability must be expected to last least 12 months or be expected to result in your death.
  • You must be legally allowed to work in the United States.
  • You must be a United States’ citizen.
  • If you are 31 years of age or older you must have paid payroll taxes and worked for 5 of the last 10 years.  If you are younger than 31 years of age there are other qualifications.

Requirements for Supplemental Security Income Benefits

Before 1972, most disability benefits for the aged and blind were managed at the state level. The Social Security Administration, in an effort to standardize care, created the Supplemental Security Income program. Unlike Social Security Disability Insurance, to qualify for SSI benefits the claimant does not have to earn work credits or contribute toward payroll taxes. They must, however, be aged (65 years or older), blind or disabled and have limited income and resources. Limited resources is defined as having liquid assets (stocks, bonds, extra cars, cash) which are less than $2,000 (for an individual) and $3,000 (for a couple).

Determining a claimant is disabled is similar for both the SSI and the SSDI program. Claimants may not be engaged in substantial gainful activity which in 2010 is making more than $1,000 per month for a non-blind disabled individual.

Full Criteria for Supplemental Security Income benefits:

  • Claimants may receive SSI benefits if they are aged (over the age of 65) and have limited income and resources.
  • Have a Social Security Disability blindness which is defined as vision of 20/200 or less with corrective procedures.  Claimants may also qualify if they have severe limitations on their peripheral vision such as a visual field of 20 degrees or less.
  • Disabled claimants must be determined disabled by the Social Security Administration which means their mental or physical condition must last at least 12 months or be expected to result in death. The claimant may also not be allowed to engage in substantial gainful activity.
  • Claimants can not be a fugitive felon.
  • Claimants can not be in prison.
  • Claimants must be a United States’ citizen.
  • Claimants can not leave the United States for extended periods of time.
  • Claimants can not reduce their income or resources in an attempt to qualify for SSI benefits.




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