At Skaar Law we understand that the Social Security Administration’s explanation as to an individual’s eligibility for Social Security benefits, procedures for filing for benefits, and what to expect during the Administration’s processing of an individual’s claim for Social Security Disability benefits is anything but clear. Consequently, we have provided this list of FREQUENTLY ASKED QUESTIONS, which provides plain language answers to all of these common questions. Please call or email us if you have any additional questions after review of the material, and we will answer your questions without charge, even if you are not a client!
The short answer is disabled adults and disabled widows or widowers, divorced spouses, surviving spouses, and children of disabled adults may all be eligible for Social Security Disability (SSDI) Benefits although the requirements vary for each category.
First you must be considered “insured” by the Social Security Administration (SSA). This means that you have worked and paid into the social security system the required amount given your age. If found “insured” there are two basic ways to qualify as “disabled” for SSDI benefits: First Way – If you suffer from an “impairment” (condition) listed in the Social Security “blue book” and meet the criteria listed in the “blue book.” While this may sound simple enough, it is oddly the least likely way to qualify for SSD benefits. Second Way – If you suffer from a medically determinable, mental, physical or combination impairment which may result in death or renders you unable to perform your usual occupation or work relating to your usual occupation for more than 12 continuous months, causing your monthly gross income to fall below about $1300 per month (SGA). This is the most likely way to qualify for Social Security Disability (SSDI) benefits.
There are 3 ways to apply: 1. Best Way – Call your Local Social Security Office and schedule an appointment (preferred) for an interview or walk in to your local office for an interview. (Be prepared to wait if you do not have an appointment). This is the preferred method of applying for benefits because it allows the Social Security Representative to personally see your disability. To prepare yourself with the information needed for the interview, print out and complete the adult starter kit before your interview. 2. Phone Interview – Call the Social Security main number (1-800-772-1213) or calling your Local Social Security Office and give the representative your information over the phone. 3. Internet Application – Go to the Social Security Website, fill out the forms, and attach the requested files.
While the Texas approval rate is obviously based on the facts of each case, approximately 60 percent of initial claims are denied. Additionally, approximately 80 percent of the “reconsiderations” (this is the appeal of the initial denial) are denied. However, over half of hearings before the Administrative Law Judge (this is the appeal from the reconsideration) are approved!
Proper documentation of regular and recent medical treatment will give you the best chance for approval. Proper documentation should include all medical records and statements from your regular doctor, which must be provided for free under Texas law, specifically describing the nature and extent of your impairment, including such things as range of motion, any specific physical and/or mental limitations, the expected duration of the disability, and whether the condition is expected to worsen. Doctor’s statements that merely state that you are disabled are not helpful, as they do not provide any actual evidence of what your impairment entails. Ensure that you always obtain and follow the recommended schedule for all treatments and prescriptions given by your doctors. Additionally, prompt cooperation with all Social Security Administration (SSA) requests, including submission of requested documents and attending appointments, is critical in obtaining approval.
As mentioned previously, you can expect a denial of your initial claim. The next step is to request a reconsideration of your initial denial. The reconsideration must be requested within 60 days of the date of the initial denial or you must reapply (start over again!). Again, you can expect a denial of the reconsideration as the reconsideration is done by the same office as your initial application. The next step is to request a hearing before the Administrative Law Judge. This hearing is your best chance of obtaining benefits and must be requested within 60 days of the date of the denial of your reconsideration or you must start the process over again. If you are denied benefits at the hearing, you can seek review from the Appeals Council (again within 60 days of denial from the Administrative Law Judge). If your are denied benefits at Appeals Council level, then appeals using the Federal Court System, all the way to the United States Supreme Court, may also be available.
No, representation by a lawyer or a non-lawyer representative is not required, as the claimant is allowed to represent himself or herself through the entire process. However, especially at the hearing before the Administrative Law Judge, having representation is strongly recommended, as a representative can serve as an informed professional advocate ensuring the strengths of your case are fully presented and argued. Additionally, a good representative will be able to deal with any expert witnesses the Social Security Administration may use at your hearing. Statistically claimants with representation are approved for benefits far more often than claimants without representation. A representative can also ensure that your rights are protected during the process, presenting the strongest possible case during appeals.
While the actual time each step in the process takes will vary with the facts of each case and the actual office where the claim is filed, here are some typical times for each potential step in the process: Initial Claim – 4 Months Reconsideration (if required) – 4 Months Hearing before the Administrative Law Judge (if required) – 6 Months Some cases may be resolved in less time and many cases in busy areas can take well over 2 years to complete! For this reason claimants must plan ahead financially for what is typically a long wait before receiving benefits. Once approved, there is a manditory five month waiting period before benefits begin.
Things needed for the claim application: Download the Checklist of Items Financial Preparation: As you can see, obtaining Social Security Disability (SSDI) benefits normally will take well over a year and can take over two years in many areas. As a result, it is imperative that as soon as you become impaired, you begin laying out a careful financial plan to you get you through the lengthy process. The ideas listed below should not be considered legal or financial advice, but may serve as useful planning tools. Consider consolidation of debt and avoid additional debt Consider renting out extra rooms in your residence. Consider moving in as a roommate with a friend or relative. Consider using the equity in your residence if needed. Consider obtaining additional checking and credit cards for emergency use only in the future. Consider moving into a less expensive residence. Consider application for financial assistance such as food stamps. Consider contacting your local department of Social Services.
It is very simple, I only get paid if you get paid. I receive a fee for my services only if you are approved for Social Security Benefits. The Social Security Administration is required to approve all fee agreements and limits the representative’s fee to 25% of the backpayment you are owed from the Social Security Administration due to your impairment, with the maximum fee capped at $7200. I charge no upfront or out of pocket fees for expenses and my fee will be automatically deducted from your backpayment when your benefits are approved.