Social Security / Disability FAQs

What do I need to prove in order to obtain social security disability benefits?
Answer: First, you must have an earnings record which establishes that you are eligible for benefits. This is called your “insured status.” Second, you must prove that you are incapable of performing “substantial gainful employment.” There are various standards and regulations which provide guidance for each disability claim. These guidelines take into consideration your age, education, work experience and your physical or mental limitations.

What is supplemental security income?
Answer: This is a program which provides need based assistance for disabled workers. Unlike social security disability benefits, supplemental security income regulations require that you have a limited amount of income in your household and you are also limited to the amount of financial assets which you can hold. Under SSI, you must meet the guidelines for disability and you must additionally prove that you are qualified by virtue of your income and assets.

What fee do I have to pay to a lawyer in order to represent me?
Answer: There is no fee unless we win your case. The fee is based upon a percentage of the money which is awarded to you at the time that you are approved for disability benefits. If your claim is unsuccessful, there is no fee for our services. We only collect if you win!

When will I start receiving benefits?
Answer: There is a five-month “waiting period” before a person can start receiving Social Security Disability benefits. The first day that a person is found to be disabled is called the “onset date”. For example, if a person is injured in a car accident on February 1st of 2009, and his onset date is February 1st of 2009, his benefits will be withheld until July 1st of 2009. Of course, the person must be disabled for a minimum of at least one year. If an individual were to be disabled for exactly one year, then they would receive exactly seven months of benefits, due to the five-month waiting period.

Will I receive disability benefits forever?
Answer: There are two types of Social Security Disability awards. There is an “open award” which will continue until a person reaches full retirement age. Some people face disabilities which are never going to ever improve. Judges will determine whether a disabled person’s case should be reviewed periodically, or whether this would be a waste of time.

A second type of award is called a “closed award”. This involves a situation where an individual eventually recovers from his disabilities. For example, if someone is disabled from a car accident, or a work accident, on February 1st of 2009, and he is totally disabled for more than one year, he would be entitled to disability benefits. However, if he eventually returns to work a year and a half after his car accident, then a judge could issue a “closed award”. The judge could make a finding that the individual was disabled from the time of his “onset”, until the date that he returned to work. We will sometimes represent individuals who have already returned to work by the time they have their Social Security Disability hearing. In these instances, we are trying to convince an Administrative Law Judge that the individual should be awarded closed benefits for a specified period of time.

If I am on sick leave, do I need to wait until my sick leave is exhausted before applying for social security disability benefits?
Answer: You do not have to wait until your sick leave is exhausted before filing for Social Security Disability benefits. The Social Security Administration will consider the onset date as being the date that you first became unable to work. An employer may have a sick leave program which allows you to obtain benefits for a specified period of time. Because the Social Security Administration compiles an earnings record, it may be necessary for you to provide the Social Security Administration with clarification regarding your sick time benefits. It may not be possible for them to determine whether the earnings which are reflected in their file are for earned income, or sick pay. We believe that it is a good policy to obtain documentation from your employer explaining what part of your income constitutes sick pay.

Can I apply for social security disability benefits if I am receiving workers’ compensation benefits?
Answer: You can apply for Social Security Disability benefits, even though you are receiving Workers’ Compensation benefits. Our advice is that you should apply for Social Security Disability benefits as soon as there is an expectation that you may be disabled for more than one year. The Social Security Administration will consider receipt of Workers’ Compensation benefits with respect to the amount of Social Security benefits that you are entitled to receive. There is an offset if the combination of benefits from Workers’ Compensation and Social Security Disability exceeds a certain ceiling. The Social Security Administration will compile information on what is known as your “average current earnings” aka “ACE”. There is a ceiling which is roughly about 80% of what you would earn during your five best years of work. These earnings are indexed for inflation and other factors. While there is a possibility that your Social Security Disability benefits could be reduced, you would still receive some additional income.

Can I apply for social security disability benefits if I am receiving unemployment compensation?
Answer: The answer to this question is that you can file for both. However, there are a number of dangers and pitfalls. Some Social Security Judges feel that you cannot have it both ways. In filing for unemployment, you are stating that you are ready, willing, and able to work. This would contradict your Social Security application in which you are stating that you are unable to work in any capacity because you are completely disabled. Consequently, there is a tactical determination and different schools of thought when it comes to this problem.

There are individuals who will apply for Social Security Disability benefits and will be turned down because the Social Security Administration has made a decision that they are capable of working. These individuals may decide to go the unemployment office and, when they are asked whether they are ready, willing, and able to work, they may be able to state that the Social Security Administration has denied their disability. If these individuals are eventually approved for Social Security Disability, then they must be prepared to reimburse their state’s office for Unemployment Compensation. A determination would need to be made as to whether an offset applies, and there are sometimes criminal charges which could potentially be brought if these individuals collect both Unemployment and Social Security Disability benefits and fail to disclose or reimburse their state’s Unemployment Compensation Fund.

How will social security look at my age in determining whether or not I am disabled?
Answer: The Social Security Administration considers various age categories in making disability determinations. It is assumed that older workers are less adaptable and would have more difficulties in adapting to various types of alternative employment situations. The Social Security Administration states that “[We] will consider your chronological age in combination with your residual functional capacity, education, and work experience.” They indicate that they “will not consider your ability to adjust to other work on the basis of your age alone.” It is the Administration’s position that they will consider “advancing” age “to be an increasingly limiting factor” in a person’s ability to make a work adjustment.

Under Section 404.1563, the Social Security Administration states that individuals who are under the age of 50 are considered to be “younger persons”. They do not believe that being under the age of 50 will seriously affect an individual’s ability to adjust to other work. They will give some consideration to individuals who are between the ages of 45 and 49, versus individuals who are under age 45. Individuals who are between the ages of 50 and 54 are considered to be persons “closely approaching advanced age”. Under these circumstances, the Social Security Administration will consider age as having a negative impact upon your ability to make work place adjustments. For individuals who are 55 years of age and older, they are considered to be persons “of advanced age”. The Administration states that they have special rules for these individuals who are closely approaching retirement age and believes that they are not as adaptable.

How does social security administration look at my education?
Answer: Under the law, the Social Security Administration will consider the amount of education which you have had and will look at “formal schooling, or other training, which contributes to your ability to meet vocational requirements”. They will also consider the amount of time which has passed between receiving your educational training and the time that you became disabled. For example, if an individual attended a secretarial college 25 years ago and has not worked in a secretarial capacity for many years, this training would now be outdated. In today’s age of high-technology and computers, formal training on a manual typewriter with carbon paper would not be of much use. This is an extreme example, but there is an acknowledgement that times have changed and some types of training and education are no longer helpful in the open labor market.

The Social Security Administration looks at several categories when considering an individual’s education. The Social Security Administration will consider someone to be illiterate if they cannot read or write in a simple manner. They will consider a person to be marginally education if they have the equivalent of a sixth grade education or less with respect to reasoning, arithmetic, and language skills. A person with a “limited education” is defined as someone who has a seventh through eleventh grade level of formal education. The final level is for individuals who have a high school education and above and who have the requisite reasoning, arithmetic, and language skills.

How does social security administration look at my work experience?
Answer: The Social Security Administration states that “work experience” means skills and abilities you have acquired through work you have done which shows the type of work you may be expected to do. The Administration considers work experience which has been performed within 15 years prior to the date of your onset. They will also consider whether you have performed that work for a long enough period. For example, if you were hired as a secretary within the last 15 years and you were fired within two weeks of starting because you were considered inadequate, it would be unfair to consider you to have the skills of a secretary.

How does social security administration look at my disabilities in order to determine whether I can do other types of work?
Answer: The Social Security Administration looks at a book which is referred to as the “Dictionary of Occupational Titles”. This book is published by the Department of Labor and it lists virtually every type of job which exists in the national economy. For each of these jobs, the Dictionary of Occupational Titles will have a listing of the physical exertion requirements, as well as the skill and educational requirements. The Administration will attempt to determine the level of physical exertion which you can perform. They define sedentary work as work involving lifting of no more than ten pounds at a time and occasionally carrying light objects. There are also limited requirements for standing and walking. Light work is classified as being able to lift no more than twenty pounds at a time with frequent lifting of no more than ten pounds. It is also assumed that you can walk frequently and you are able to site for a significant time and you have control of your arms and legs.

Medium work is defined as lifting no more than fifty pounds and carrying or lifting objects frequently weighing no more than twenty-five pounds. Heavy work involves lifting no more than 100 pounds and frequently carrying fifty pounds. Finally, there is the classification of very heavy work which involves lifting objects weighing more than 100 pounds and frequently carrying objects that weigh more than fifty pounds.

The Social Security Administration will look at how your past work fits into these categories and will then try to determine whether you are able to perform any past relevant work. If your restrictions do not allow you to perform past relevant work, they will look at whether there was any transferability of skills from your past employment. For example, if you have worked in the past as a roofer, then perhaps there would be transferability if there are job openings for someone who can prepare roofing bids. Sometimes a job which is heavy or very heavy in nature can have transferability where estimates can be performed or customer service can be provided by individuals because of their knowledge. The Social Security Administration notes that there are degrees of transferability ranging from jobs which involves close similarities to jobs which are isolated and unique. The Social Security Administration will limit their determination of transferability of skills for persons of advanced age.

How does social security look at skill requirements?
Answer: The Social Security Administration considers whether the work that you have done was “unskilled, semi-skilled, or skilled”. Unskilled work involves little or no judgment. These are jobs which are common and can be done with very little training. Semi-skilled work requires more complexity and sometimes more attention, or even more coordination and dexterity. Skilled work involves employment which requires a person to use judgments in order to deal with more complex problems. Skilled work may also involve dealing with people and working with situations which involve precision.

If I am approved for social security benefits, how far will they go back in looking at my back pay?
Answer: Disability insurance applications cannot begin until five months have passed from the date that an individual becomes disabled. There is a limitation in that benefits cannot be paid for more than one year prior to the date of the claim. This is another reason why you should file your application as soon as possible as you could be limited in how far back your benefits will go.

If I am denied, how long will it take before I get a hearing?
Answer: Efforts are presently being made to clear up a substantial backlog which has occurred in the Social Security system. There have been a number of judges and personnel who have been hired and we hope that this will make an impact on the time that it takes to get a hearing. A study was done by the Social Security Administration on 7/2/09. The study indicated that the St. Louis office had a processing time of 476 days and the Creve Coeur office had a processing time of 524 days. In mid-2008, the national average had reached 541 days. Of course, this is only a snapshot of the past, and it is uncertain as to whether this will hold true for future cases. In 2008, most initial applications received a decision within approximately four months.

If I am approved for social security benefits will I receive medicare?
Answer: If you are approved for any kind of Social Security Disability benefits, other than SSI, you will be entitled to Medicare benefits after approximately two years. If you are approved for Supplemental Security Income benefits, then you will be eligible for Medicaid and, it is possible, that you may receive both Medicare and Medicaid.

How much will it cost for me to hire an attorney?
Answer: There is no upfront fee to hire an attorney to represent you in a Social Security Disability claim. In addition, if your claim is unsuccessful, you will not owe your attorney any fee whatsoever. If your claim is successful, then the attorney’s fees are normally 25% of the amount of benefits which are owed to you between the onset date of your disability and the date of your favorable decision. Attorney’s fees are capped by the Social Security Administration. As of 2009, attorney’s fees could not exceed $6,000.00, regardless of the amount of benefits which are owed to you.