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Social Security Disability Basis: Common Questions from Social Security Disability Applicants

I have severe medical problems.  Are my medical problems enough to qualify for disability?

This can be a complex question.  Most attorneys who evaluate Social Security Disability Claims start with your age.  The reason is simple. As worker's age, the regulations enacted by Social Security are designed to make it less difficult to qualify for disability.  Generally, some, but not many people have an easier time securing benefits when they turn age 45. However, at 45 it does not become significantly easier unless the disability is extreme and other contributing factors like the inability to read and/or write are present.  Once a person reaches the age of 50, it becomes easier. If have a severe medical problem and that medical problem prevents you from performing even easy sit down type work, you may have a good chance of qualifying for benefits. At age 55 and 60, qualifying is even easier.  In some circumstances, even if you can still perform light or medium level work, you may qualify.

Age is only a starting point.  Even if you under age 45 or 50, you do not have to be bedridden to obtain in order to obtain benefits.  If you are unable to perform work you have done in the past 15 years and medical documentation supports that you cannot perform other jobs that exist, you may be able to qualify.

The unfortunate reality is that many workers are truly unable to work, but have a hard time qualifying for disability.  If you are truly unable to work, particularly if you have a physician that supports your inability to work and will document the inability, appealing any denials you receive from the Social Security Administration and seek a hearing before an administrative law judge.  Even after a judge has heard your case, you can appeal to another level. It may be helpful at some point during the process to talk to a lawyer to help.


What is the process for initiating a Social Security Disability Claim?

You have three options:

  1. By telephone
  2. In person
  3. Online

For many people, applying online is the easiest way to apply.  If you are able to access and use the internet go to www.socialsecurity.gov/applyfordisability/adult.htm. Not only can you apply, but you can provide support documents and reports required by the Social Security Administration.

If you would prefer to call the Social Security Administration to start an application or to appear in person to apply, call the Social Security Administration at 1-800-772-1213. When you call, you will be given a time to receive a call to apply or the ability to schedule an in person time at the local Social Security Office.  If you complete a Social Security Disability Application on the phone, the completed application will be sent to you in the mail to sign and return to the Social Security Administration.

Here are some tips when you apply:

  1. The strongest Social Security Disability applications come from applicants who have received consistent medical treatment for their condition.  Make sure you have a list of names and contact information for all medical providers who have treated you for your medical condition or conditions. While uncommon, some people with severe and chronic medical problems do not receive medical treatment because they do not believe that any medical treatment they have received has helped them and have stopped treating because of lack of progress. For a Social Security applicant, this is a mistake.  We cannot emphasize strongly enough: Records for Medical treatment are, far an away, the most important evidence that you are disabled. It is important to note as well that, once you give Social Security, all of your medical treatment information, the SSA will request your medical records
  2. Be HONEST with the Social Security Administration.  Try not to overstate or exaggerate your problems. At the same time, be clear about the significant impact your medical condition has on your ability to function and your ability to work.
  3. If you run into any issues, contact a lawyer. Some lawyers will give you direction to help you complete your application and some may offer to represent you in all aspects of your claim.  (See below)
  4. Make sure to pay attention to all documents you receive from the Social Security Administration.  If you receive a “denial” from the Administration, you must appeal the denial within 60 days. If you do not, you will need to complete an new application.

What are Social Security Disability Appeals and how do I appeal?

In most circumstances there are 3 potential appeals when your case is being handled by the Social Security Administration. (some states are a little different) If your initial claim is denied, you can ask for “reconsideration”. This is the first appeal. If “reconsideration” is denied, you can “Request a Hearing”.  This is appeal number two. At this stage, you can present your case before an Administrative Law Judge. If an Administrative Law Judge denies your case, you can appeal to the “Appeals Council”. This is the third and final potential appeal within the Social Security Administration.  If you exhaust these appeals, you can sue the Social Security Administration in Federal Court which has its own procedures and appeal processes.

There are several ways that you can appeal if you are denied on your initial claim or at reconsideration.

  1. You can call the Social Security Administration and ask for your appeal to be for your appeal to be handled by phone and mail.
  2. You can appear at the local Social Security office to appeal your claim.  If you do this, make sure to take the denial letter with you. Also, make sure that the person you talk to with the Administration gives you written confirmation of your appeal.
  3. You can send in an appeal online. Go to https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp. If you do this, you will have the ability to print and receive a receipt for the appeal.

Do attorneys represent Social Security Applicants? 

Many lawyers practice Social Security Disability law.  If a lawyer is necessary for your case, there is not necessarily a specific time that is best to obtain a lawyer. Each case is different.  On the one hand, an argument can be made to not get a lawyer until a hearing is requested. For people who are able to navigate all of the documents, obtain and submit medical records and communicate with the Social Security Administration, this may not be a bad option. However, sometimes people find that filling out forms, obtaining medical records and communicating with the Social Security Administration during the initial claim period and during Reconsideration is daunting, particularly if they are suffering from chronic medical conditions.  In this scenario, lawyers have different entry points. Some lawyers will offer to help from the very beginning, some will not represent individuals until a hearing has been requested.

While our firm does not file initial applications, we can direct you to law firms that handle initial.  In very select cases, we will get involved after the initial denial is issues by Social Security.

We often receive requests to assist claimants at the Reconsideration stage of a claim. We handle these requests carefully and accept select cases in this scenario.  One of our considerations is whether you will be or have already been out of work for 12 consecutive months as required by the law. Sometimes, we will ask that the applicant obtain additional medical records for us to review before making a decision.

We only help in Social Security Cases on a “contingency” basis.  This means that the Social Security Disability Applicants that we represent only pay us a fee if they win Social Security Disability benefits. Ordinarily, our fee is 25% of back due benefits with a maximum amount set by the Social Security Administration of $6,000.00. This number is set by the Social Security Administration and can change at any time.  In summary, our fee us 25% of any benefits due to you from the “onset date” (the date Social Security finds that you became disabled through the date on which the finding is made. , currently $6,000.00. In addition, we pay for medical records and other records up front. You will be expected to pay us back for our expenses to the fee, you will be expected to pay the expense sof gathering medical records, obtaining medical opinion letters, etc.

This article is only a basic overview of Social Security Disability.  Please do not hesitate to contact our office if you have additional questions!

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