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.

If your Social Security Disability application is reviewed by a Social Security disability examiner or an Administrative Law Judge they will use three basic criteria to determine if you are disabled. First, do you have a mental or physical condition that is substantiated through medical documentation? Second, is your condition so severe that it prevents you from performing substantial gainful activity? Third, is your mental or physical health condition expected to last for at least 12 months or result in your death?

The disability examiner will specifically use what the Social Security Administration calls the Sequential Evaluation Process to determine if you are disabled.

STEP 1: Are you working?

If a claimant is working and the Social Security Administration determines it is “substantial work” the Social Security Disability claim is automatically denied without a review of the claimant’s mental or physical health condition.

STEP 2: Do you have a severe impairment?

If a claimant’s condition is not severe and does not affect their functional ability to work the claimant is denied Social Security Disability benefits.

STEP 3: Does the impairment equal or exceed an impairment listed in the guidelines?

The Social Security Administration has a list of impairments which they consider severe and if a claimant’s condition equals or exceeds the listing the claimant is automatically awarded Social Security Disability benefits.

Now you may be curious about the question of functional capacity to perform work and how it is factored into the Social Security Disability decision. Until Step 4 of the sequential analysis, functional work capacity is not considered, but at Step 4 it is the most important consideration that the disability examiner will consider when awarding disability benefits.

STEP 4: Are you able to do your past employment?

The disability examiner will review all of the relevant jobs a claimant has performed over the past 15 years and determine if the claimant has enough “residual work capacity” to perform their past job or a similar job. If the disability examiner determines you are not substantially limited by your mental or physical health condition and you can perform past work, you will be denied Social Security Disability benefits.

STEP 5: Is there any other lighter work you can do?

The disability examiner will assess a claimant’s physical abilities which include the nature and extent of the claimant’s limitations and their ability to work a job on a continuing and regular basis. Physical limitations can include the inability to: sit, stand, walk, lift, carry, push, pull, stoop, reach, crouch or manipulate objects. The mental abilities of the claimant are also evaluated including their inability to: understand, remember, carry out instructions, respond to supervisors or adapt to a work setting.

The Social Security Administration does not decide disability based on functional capacity alone in fact, there are a variety of vocational factors which are also considered such as a claimant’s age, educational level and work history. The most important consideration for claimants, however, is not what type of disability they have been diagnosed with but whether or not their condition(s) are severe and leave them with so little residual functional capacity to work that the claimant is unable to perform substantial gainful activity.

The Social Security Administration (SSA) estimates 3 out of 10 Americans may become disabled prior to retirement age. Not everyone who is unable to work is considered “disabled” by the Social Security Administration. If the Social Security Administration determines you are disabled you may be able to qualify for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Each of these disability benefit programs is administered the United States federal government and require claimants to meet very specific qualifications.

Social Security Disability Insurance

Social Security Disability Insurance or SSDI is offered to disabled workers who have contributed to the Social Security Trust Fund through their employment taxes and have earned enough work credits to qualify. The number of work credits needed to qualify for SSDI may vary, but most workers over the age of 30 will need 40 work credits. Most claimants working full-time can accrue up to four credits per year. In addition to accumulating work credits, SSDI claimants must be determined disabled by the Social Security Administration.

How do you know if you are disabled? Claimants must have a physical or mental impairment which is considered severe and which does not allow them to work for at least 12 months or is expected to result in their death. The Social Security Administration (SSA) will review a claimants medical records, and using their evaluation process, will determine if the claimant is able to perform their current job or any other job in the regional economy given their age, educational background and work experience.

Social Security Disability Insurance requirements:

• Determined disabled by the Social Security Administration.
• Disabled prior to your full retirement age
• Disabled for at least 12 months or your disability is expected to result in death
• Legally allowed to work in the United States
• A United State’s citizen
• If you are 31 or older you must have paid payroll taxes and worked for 5 of the last 10 years.  If you are younger than 31 there may other qualifications.

Supplemental Security Income

Supplemental Security Income, the second disability program administered by the federal government, is for the disabled, blind or aged who are disabled and have limited income and resources. Claimants who are attempting to qualify for SSI disability benefits must meet the same criteria as SSDI applicants. Claimants must be found medically disabled, either physically or mentally, with a disability which is so severe they will not be able to work for at least 12 months.

Supplemental Security Income, unlike Social Security Disability Insurance, is a “needs based” program, and claimants do not have to accumulate work credits to qualify. Claimants must, however, meet non-disability qualifications and have limited resources and income. Resource and income limits are established by the Social Security Administration and can include: stocks, bonds, cars, houses, bank accounts, trust funds and pensions. It is important to discuss your resources and income with a Social Security Disability lawyer to determine if you are eligible to file for Supplemental Security Income benefits. Claimants who do not meet the income and resource qualification will not be awarded Supplemental Security Income benefits regardless of their mental or physical disabilities.

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.

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.

Has it been weeks since you attended your Social Security Disability Hearing and presented evidence for your Social Security Disability claim? Maybe you are wondering if you have been approved for Social Security Disability benefits. No doubt you are frustrated. You may have thought you would receive your benefit notice at the hearing. Maybe the Administrative Law Judge gave you some indication you would receive benefits, but you have waited weeks or months and you have not received payment.

So how long will you have to wait to receive your Social Security Disability hearing decision? Like other processes within the Social Security Administration, the answer is not clear-cut. It may depend on the number of cases assigned to the Administrative Law Judge or how many Social Security Disability Insurance or Supplemental Security Income cases are assigned to your Social Security Disability hearing office.

Most Social Security Disability hearing decisions are made with in 45 to 90 days after the Social Security Disability hearing. If you have not received your Social Security Disability hearing notice after this time you can contact the Social Security Administration, your hearing office or your Social Security Disability lawyer for more information.

Do Denials take longer than Approvals?

Denials and approvals both take a long time to process. There is some evidence to suggest the longer it takes to process a claim the greater chance it will be a denial, but this is not always the case. In fact, many Administrative Law Judges will have all of their decisions written by a decision writer which increases the amount of time it takes to process Social Security Disability decisions including denials and approvals.

If you are waiting for a Social Security Disability hearing decision, do not be discouraged. If you are awarded Social Security Disability Insurance or Supplemental Security Income benefits you are near the end of the Social Security Disability process. If you are denied Social Security Disability benefits, it may be time for you to regroup and consider what you can do differently if you decide to apply for Social Security Disability benefits a second time.

To determine if a claimant is disabled, the disability examiner will review relevant work they have performed in the past 15 years. Claimants who can not perform their current job may be able to retrain for other types of employment. Disability examiners will make this determination by evaluating a claimant’s age, education, work history and their mental and physical residual functional limitations.

Overview Of The Social Security Disability Claim Process

The Social Security Administration maintains a listing of common impairments called the Listing of Impairments. If a claimant does not immediately meet a listing (which automatically allows a claimant to receive disability benefits) the claimant’s residual functional capacity can become more important than the actual impairment. Vocational guidelines have been created to help disability examiners make uniform, standardized decisions about a claimant’s disabling health conditions. Claimants may be limited to sedentary, light, medium, heavy or very heavy work based on their residual functional capacity. Older claimants may have more difficulty adjusting to new employment, and therefore, have a greater chance of receiving benefits than younger employees using the vocational guidelines.

How is the disability decision made?

The first step in the disability determination process is for the disability examiner to determine if a claimant can perform the work they have done in the past. Claimants must provide a detailed description of their past jobs. Detailed physical requirements should be provided by the claimant including the amount of time they were required to sit, stand or walk and the amount of weight they had to frequently lift. Jobs are matched against similar jobs identified in the Dictionary of Occupational Titles, which is a handbook for jobs maintained by the Social Security Administration. The disability examiners evaluate the job requirements for each past job and compare this information to the residual functional capacity information identified in the claimant’s medical files or the residual functional capacity forms (RFC Forms) provided by the claimant’s physicians.

Claimants whose mental or physical residual functional capacity makes it impossible to perform their past work may be able to be retrained to perform another job available in the regional economy. The question of other jobs which may be performed by the disability claimant most frequently arises at the Administrative hearing level when the vocational expert has a list of other job which they claim the claimant may be able to perform given their current limitations. Claimants who have hired an experienced Social Security Disability attorney will hopefully be able to evaluate these “other jobs” and present evidence which proves the claimant does not have sufficient residual functional capacity to perform the suggested work.

The term “denied to other work” may be used by the Social Security Administration to mean that they have denied Social Security Disability benefits based on their evidence that even if a claimant can not perform their old job, they should be able to retrain for new employment based on their residual functional capacity, age, work skills and education level.

How do you win a Social Security Disability benefits? You must prove not only that you can not do your old job, but you can not do any other job available in the regional economy. Social Security Disability lawyers can help you gather relevant medical records to prove your Social Security Disability claim. Residual functional capacity forms, which are completed by a claimant’s doctor, outline the claimant’s physical and mental limitations. These forms are one of the best pieces of medical evidence which can be provided to the Social Security Administration to prove the claimant is unable to work other jobs and keep the SSA from denying a claimant with the reason they are “denied to other work”.

Substantial Gainful Activity

The Social Security Administration defines “substantial gainful activity” as doing any type of mental or physical activity which is “substantial”. Work is considered substantial if the non-blind applicant makes a gross income of $1,000 per month (for 2010), and the blind applicant makes a gross income of $1,640 per month (for 2010).

Activity or work does not have to be performed full-time to be substantial. When claimants consider “work” or “gainful activity” they might think of a full-time job that they do 40 hours per week, but activity can be gainful under the Social Security Administration’s definition if it meets any of the following Social Security Administration’s criteria:

·         Any work performed or done for pay or profit.

·         Work which normally receives pay or profit

·         Work which is intended for profit even if profit is not realized

After a claimant applies for Social Security Disability their application is sent to the disability examiner who will review their application to determine if their mental or physical health condition is severe enough to receive disability benefits. Claimants working above the pre-defined SGA level will have their Social Security Disability application denied by the Social Security Administration before it is sent to the disability examiner, and the disability examiner will not have a chance to evaluate the severity of the mental or physical health condition.

Claimants often are not healthy enough to work full-time and often seek Social Security Disability benefits for short-term or partial disability payments. Unfortunately, Social Security Disability benefits are only for claimants who have a mental or physical health condition which is expected to last for at least 12 months or result in death. Claimants who need Social Security Disability benefits should not expect to work at a level which can support themselves or their family.

The idea of substantial gainful activity is not only factored into the decision at the Social Security Disability application level and Social Security disability appeal’s process but also for every review for continuing an applicant’s Social Security Disability benefits.  Any claimant who currently receives Social Security Disability benefits and is considering returning to work in any part-time capacity should contact the Social Security Administration. Regulations and income rules can change. Returning to work and making more than the allowable income amount can jeopardize the claimant’s rights to continue receiving Social Security Disability benefits. Talk to a Social Security Disability lawyer for more information about your rights to work.

Social Security Disability Insurance

Claimants who have worked and paid sufficient Social Security taxes may be “insured” and covered by Social Security Disability Insurance. Claimants will earn “work credits” for work and must generally have 40 work credits to qualify for Social Security Disability benefits. Younger claimants may need fewer credits. Claimants must also:

• Be a worker, the surviving divorced spouse, a worker’s widow or widower or the worker’s child with disabilities. Childhood disability beneficiaries must be unmarried, age 18 or over and must have been determined disabled prior to 22.
• Complete a Social Security Disability application.
• Be determined either mentally or physically disabled by the Social Security Administration.
• Not be working or performing any type of work at a substantial level.

Supplemental Security Income

Social Security Disability claimants who have not worked and do not have sufficient work credits to be considered insured can not qualify for Social Security Disability Insurance, they may, however, be able to qualify for Supplemental Security Income or SSI. SSI was created to help claimants who have limited income and resources. To meet the eligibility requirements for Supplemental Security Income a claimant must:

• Have resources and income which are below the federally mandated amount.
• Be considered a United State’s citizen or meet the non-citizen requirements.
• Be determined disabled or blind by the Social Security Administration.
• Complete a Supplemental Security Income application and submit it to the Social Security Administration.
• Be a resident of the 50 States, District of Columbia, or Northern Mariana Islands.
• Not be performing substantial gainful activity. The SGA amount varies depending on a claimant’s disability status. Blind individuals are allowed to make higher earnings than a non-blind claimant.

If you have questions regarding your Social Security Disability eligibility, contact the Social Security Administration or visit their website at www.ssa.gov. The Social Security Administration has a useful website that can answer most of your Social Security Disability questions. Social Security Disability claimants who have stopped working due to a physical or mental health conditions may be considered disabled if their physical or mental health condition is expected to last at least 12 months or result in their death. Social Security Disability claimants may also contact a Social Security Disability lawyer for more information. Disability lawyers specialize in winning Social Security Disability Insurance and Supplemental Security Income benefits for their clients everyday.

The Social Security Administration has ten administrative regional offices located across the United States. Each regional office has responsibilities to manage a network of Social Security Administration Field Offices in its region. Each regional office also has a Disability Qualify Branch which requests Social Security Disability cases which it will analyze and perform quality reviews.

In 1998, the Social Security Administration formed the Office of Central Operations by merging several offices together. Currently, the Office of Central Operations is located in Baltimore, Maryland, and is responsible for establishing and maintaining earnings records for workers, processing Title II disability claims for claimants who are under 54 years of age and live in the United States (The Office of Disability Operations) and international Title II claims for claimants who reside outside of the United States (The Office of International Operations).

The Social Security Administration also has a Federal Records Center which maintains all paper records. The Federal Records Center is the final repository for all of the records for disability claims.

In addition to all of the locations listed above, the Social Security Administration also has six Program Service Centers which are located regionally around the United States. There are Program Service Centers in the following cities: Jamaica, NY, Philadelphia, PA, Birmingham, AL, Chicago, IL, Richmond, CA, and Kansas City, MO. Each Program Service Center represents a region of the country and is responsible for processing disability claims, disability appeals, maintaining records and processing Title II claims.

Each of these service centers is run by dedicated Social Security employees who are working hard to process applications, evaluate a claimant’s personal information, review medical files, analyze earnings data and get the information to the next location to help the Social Security Administration make a disability determination for you, the disability claimant.

Does it take a long time to process Social Security Disability claims? Yes, but there are thousands of Social Security Disability applicants just like you who are waiting for their Social Security Disability benefits. It is easy to get discouraged. Talk to a Social Security Disability lawyer about what you information you need to increase your chances of having your disability application approved.