How to Appeal a Social Security Disability Denial

November 17th, 2007, 9:37 am

If an individual applies for Social Security disability insurance and is denied there is an appeal process they can through in order for reconsideration of their application. If an individual wishes to appeal the Social Security Administration’s decision regarding their application for disability insurance they can do so, however they must make their request in writing within 60 days from the date they received Social Security’s denial letter. The Social Security Administration assumes that the individual receives their letter five days after the date posted on the letter, unless an individual can show them they received it later. There are generally three or four levels of appeals; the first being reconsideration, second is a hearing by and administrative law judge, third is a review by appeals council and lastly is a federal court review. When the Social Security Administration sends an individual their letter about their decision on their claim they give them instructions on how to appeal the decision.

The first level of appeals is reconsideration. Reconsideration is a complete review of the individual’s application by someone who didn’t take place in the first decision. The individual at the Social Security Administration reviewing the application will look at any evidence submitted when the original application was sent in and also any new evidence. Most of reconsideration reviews are done without the individual present, however if the individual is appealing a decision that they are no longer eligible for disability insurance because their condition has improved, they can meet with a Social Security representative to explain to them why they believe they still have a disability.

The second level of appeals is a hearing by an administrative law judge. If an individual disagrees with the reconsideration decision, they may ask for a hearing. The administrative law judge conducting the hearing is one who had no part in the first decision or the reconsideration decision in the individual’s case. The hearing is held usually within 75 miles of the individual’s home, and the administrative judge notifies the individual of the time and place of the hearing. The individual and their representative (if they have one) may come to the hearing to explain their case to the judge in person; they may look at the information in their file and give any new information that they have. In order for the administrative law judge to make his/her decision they will question the individual and their witnesses they bring to the hearing. Other witnesses such as medical and vocational experts may also give the judge information at the hearing. The individual or representative then also may question the witnesses. It is usually to the individuals advantage if they attend their hearing, however if they chose not to do so they must notify the Social Security Administration in writing that they don’t want to attend. In some situations they hearing may be held as a video conference rather than in person. The individual will be notified ahead of time if this is the case. A video conference is often more convenient for the individual, it also is usually faster to schedule a video conference than an in-person hearing. Lastly the video conference may also make it closer to their home so it would make it easier for the individual to have witnesses and others accompany them. Unless the administrative law judge believes that the individual presence is needed to decide the case he or she will make their decision based on all the information in the individual’s case and that’s including any new information. Lastly when the administrative law judge has reached their decision the individual will be sent a letter and a copy of the administrative law judge’s decision.

The third level of appeal in denial of Social Security disability benefits is an appeals council. This level of appeal happens when the individual doesn’t agree with the hearing’s decision they make ask for a review by the Social Security’s Appeals Council. The Appeals Council looks at all requests for review, they can however deny a request if they believe that the decision of the hearing was correct. If the Appeals Council decides to review the individual’s case it will either decide the individuals case itself or it will return it to an administrative law judge for further review. If the Appeals Council denies the individuals request for a review they will send the individual a letter explaining the denial, if the Appeals Council makes a decision on the case the individual will be sent a copy of the Appeals Council’s decision, and lastly if the Appeals Council returns the case to an administrative law judge for further review the individual will receive a letter and a copy of the order for further review from the Appeals Council.

The last level of appeals is federal court. If the individual disagrees with the decision of the Appeals Council or the Appeals Council denied request for a review of their case, the individual may file a law suit in a federal district court. The letter that the Social Security Administration sends to the individual explaining about the Appeals Council’s action will also have information regarding how to ask a court to look at the individual’s case.

An individual may still be eligible to receive disability insurance while the Social Security Administration makes a decision on their appeal if, the individual is appealing a decision that they can no longer get Social Security disability benefits because their medical condition is not disabling or, if the individual is appealing the Social Security Administration’s decision that they are no longer eligible for SSI payments or that their SSI payments may be reduced or suspended. If the individual wishes to continue receiving benefits they must notify the Social Security Administration within ten days of receiving the administration’s letter. If the individuals appeal is turned down they might be required to pay back any money they were not eligible to receive.

An individual appealing a Social Security disability denial has the right to have a representative help them in their appeals process. The Social Security Administration offers free help with the appeals process however the individual may also opt to have a lawyer, a friend or someone else to help them. The Social Security Administration will work with the individuals representative in all the steps to appeal, the representative can act for the individual in most Social Security matters and will also receive copies of any decisions made about the individuals claim. The representative however cannot collect any fees from the individual without prior permission of the Social Security Administration. Rules about representation can be found on the Social Security Administration’s website. http://www.ssa.gov/pubs/10075.html

In order to contact the Social Security Administration for further information regarding a denial of disability insurance their website at www.ssa.gov is a very useful resource of information they also have a number of things the individual can do online. The individual can also contact the Social Security Administration directly by calling them at 1-800-772-1213.

This article was written by Ashely

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How Social Security Benefits Help the Disabled

November 17th, 2007, 9:34 am

The Social Security Administration pays disability benefits in two different ways. The first way is through the Social Security disability insurance and the second one is through the Supplemental Security Income (SSI) Program.For information about disabilities programs for children please refer to http://www.socialsecurity.gov/pubs/10026.html.

Social Security pays benefits to people who can’t work because they have a medical condition that is expected to last at least one year or result in death. The federal law requires such strict definition of disability, while some other programs give individuals benefits who have a partial-disability or have short-term disability, Social Security doesn’t. An individual must meet certain earnings requirements in order to be eligible for benefits. Individuals must meet two different earnings tests to be eligible for disability benefits. The first test is a “recent work” test which is based on the individual’s age at the time they became disabled and the second test a “duration of work” test to show that they worked long enough under Social Security. An individual should apply for disability benefits as soon as they become disabled because it can take a long time to process the application for disability benefits. It typically takes about 3 to 5 months. After the application is sent the Social Security Administration will review their application and make sure they meet some basic requirements for benefits such as whether they worked long enough to qualify and they will evaluate any current work activities. If these requirements are met then they will then send your application to the Disability Determination Services office in their state. This agency makes the decision for the SSA, they use their doctors and disability specialists to ask their doctor information about their condition, all facts in their case will be considered. They will also use evidence from any hospital, doctor’s office, clinics or institutions that the individual has been treated in order to obtain all other information. http://www.socialsecurity.gov/pubs/10029.html#part1 this link will provide information pertaining to the rules for the “recent work test” and also examples of work need for the “duration of work” test. Lastly individuals will also be able to find out what questions are considered in order to make the decision in which whether or not an individual receives disability benefits.

The Supplemental Security Income program http://www.socialsecurity.gov/pubs/11000.html makes monthly payments for individuals with low income and few resources who are also disabled. They also make monthly payments for individuals who are 65 and older and individuals who are blind. In order to be eligible to obtain SSI benefits, the eligibility is based on income and resources which are the things an individual owns. According to the Social Security Administrations income is defined as money you receive such as wages, Social Security benefits, and pensions. Income can also include such things as food and shelter. The amount of income an individual can receive each month and still get SSI depends partly on where the individual lives. In order to obtain information pertaining to how much an individual will receive based on the state they live in, they should call the Social Security Administration at 1-800-772-1213. Social Security doesn’t count all of an individual’s income when deciding whether or not they qualify for SSI benefits. Things that Social Security doesn’t count are; the first $20 a month of most income an individual receives, the first $65 a month an individual earns from working, and half the amount over $65, food stamps, shelter they receive from a nonprofit organization(s) and lastly most home energy assistance. If an individual is married the Social Security Administration also includes a part of their spouse’s income and resources when deciding whether they qualify for SSI, and if an individual is under the age of 18 the SSA includes part of their parent’s income and resources and if an individual is a sponsored noncitizen they may include their sponsor’s income and resources. If the individual is a student then some of the wages or scholarships they receive may not count. If an individual is disabled but works Social Security doesn’t count wages an individual uses to pay for items or services that may help them work, for example if an individual buys a wheelchair to be able to work, Social Security doesn’t count those expenses when deciding whether they qualify for SSI benefits. Social Security also doesn’t count any wages a blind individual uses for work expenses, for example transportation to and from work are not included in determining eligibility for SSI. Lastly, if an individual is disabled or blind some of the income they use or save for training or to buy things they need to work may not be counted. Resources that are counted in determining eligibility for SSI benefits are; real estate, bank accounts, cash, stocks and bonds. An individual may be able to get SSI benefits if their resources are worth no more than $2000, and a couple may get benefits if their resources are worth no more than $3000. Also if an individual owns property that they are trying to sell, they may be able to get SSI while they are trying to sell it. Social Security does not count the following in determining an individual’s eligibility for benefits. First the home they live in and the land it’s on, life insurance policies with a face value of $1,500 or less, an individuals car (usually), burial plots for an individual and members of their immediate family and lastly up to $1,500 in burial funds for the individual and up to $1,500 in burial funds for their spouse. Other rules that an individual must meet for eligibility are; to obtain SSI they must live in the U.S. or the Northern Mariana Islands and be a U.S. citizen or national. In some cases, noncitizen residents can qualify for SSI. For more information on qualifications for noncitizens please visit the website http://www.socialsecurity.gov/pubs/10026.html . For the rest of the rules an individual must meet in order to be eligible for SSI benefits please visit http://www.socialsecurity.gov/pubs/11000.html#part2 .

It should be noted that the basic SSI amount is the same nationwide however many states add to the basic benefit. In order to find out whether an individuals state adds extra benefits call the Social Security Administration. Lastly the Social Security Administration manages the SSI program however even though Social Security manages the program, SSI is not paid for by Social Security taxes. SSI benefits are paid for by the U.S. Treasury general funds, not the Social Security trust funds.

This article as written by Ashley Gurdon, a Suffolk University student and intern for the employment lawyers at Goldstein and Clegg, LLC

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How to Apply for Social Security Benefits

November 17th, 2007, 9:33 am

In order to apply for any Social Security benefits one must find out if, first they qualify for the benefits they are wishing to receive. There are various options one has to determine if they would be eligible. One such way would be to contact an attorney who handles social security filings. Another option is take an online eligibility test at https://secure.ssa.gov/apps7/best/benefits/. The test is called B.E.S.T.- Benefit Eligibility Screening Tool. The test is not an application for benefits and it doesn’t give you an estimate of benefit amounts, ask you for your name, or social security number and lastly it doesn’t access your personal Social Security records.You can apply for Social Security benefits online however you can’t apply for all aspects of Social Security benefits online. Online you may apply for retirement, disability and spouse’s benefits. You are also able to restart an incomplete application and check the status of a claim at: https://s044a90.ssa.gov/apps6z/ISBA/main.html .You are not allowed to use the internet application if you are applying for Supplemental Security Income (SSI) benefits, however you can begin the process of applying for SSI disability for an adult of child by completing an online disability report. http://www.socialsecurity.gov/applyfordisability/ An individual cannot apply online for benefits for children, benefits as a surviving spouse, lump sum death payments and lastly apply for Medicare coverage only. Instead of applying online for the listed items above the individual must call toll free at 1-800-772-1213, and for the deaf and hard of hearing the TTY number is 1-800-325-0778. Applicants can also apply by mail or in person at any Social Security office. However they must first make an appointment in order to apply for benefits. The application process can sometimes be complex and confusing, as such, it is sometimes helpful to seek the services of an attorney. By law, an attorney can only receive a fee for SSI or SSDI benefits after you are receiving funds, and in most cases the attorney only receives a percent of the benefits you were do in the past, but not any money due in the future.

Some things that an individual would need to take into consideration when applying for these benefits are; an individual must be ready to supply the information needed in order to approve an application for benefits. The Social Security Administration also may ask the individual to provide certain documents to show that they are eligible and to assist in the decision of how much the benefits should be. http://www.ssa.gov/r&m2.htm . If an individual is considering having direct deposit they must also bring their bank information in order for the process to be started. It should be noted that if an individual has filed for Social Security disability benefits and have been denied the benefits within the last 60 days they are not to use the internet application to file an appeal. If an individual is unsure whether or not they are still within the appeal period they should call the Social Security Administrations toll free number to acquire assistance before completing the internet application. An individual is also entitled to choose a representative in order to assist them with business regarding Social Security. The Social Security Administration would work with the representative as they would work with the individual. For more information about the right to representation for Social Security, please review the Social Security Administration’s publication regarding representation. http://www.socialsecurity.gov/pubs/10075.html

This article as written by Ashley Gurdon, a Suffolk University student and intern for the employment lawyers at Goldstein and Clegg, LLC

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Introduction to Social Security Benefits

November 17th, 2007, 9:31 am

The Social Security Administration can provide benefits in three different categories, they include; when you retire, if you become disabled, and lastly when you die. Information about Social Security benefits can be found on the Social Security Administration’s website at http://www.ssa.gov.The age to receive full retirement benefits has been 65 for many years now however for people born after 1938 it is gradually increasing until it reaches the age of 67 for people born after 1959. An individual may start receiving retirement benefits as early as age 62, however if an individual decides to receive benefits starting at age 62 then their benefits are reduced a fraction of a percent for each month before your full retirement age. To find out how much an individual would lose if they retire at age 62 please click on this link http://www.socialsecurity.gov/retire2/agereduction.htm. An individual has the choice to retire between the age of 62 and the full retirement age. An Individual qualifies for Social Security benefits by earning Social Security credits when they work in a job and pay Social Security taxes. The credits are based on the amount of the individual’s earnings and their work history is what determines their eligibility for retirement, disability and survivor’s benefits when an individual dies. For the year 2007 an individual receives one credit for $1,000 of earnings, up to the maximum of four credits per year. Each year the amount of earnings needed to receive credits increases slightly as the average earnings level increases. The credits earned remain on the individual’s Social Security record even if they change jobs or are without earnings for a while. There are special rules that apply for Social Security coverage for certain types of work. If an individual is self-employed then they earn the same amount of credits as employees however special rules apply if they have net earnings of less than $400. For individuals in the military they earn credits the same way civilians do however there is an opportunity to get additional credits under certain conditions. There are also special rules that apply to individuals that have jobs that include; domestic work, farm work or individuals that work for the church or church-controlled organizations that don’t pay Social Security taxes. There are also types of work that don’t count toward Social Security. Most federal employees hired before 1984, because since January 1, 1983 all federal employees have paid the Medicare hospital insurance part of the Social Security Tax. Others who are affected by this are railroad workers who have more than 10 years of service. Employees of some state and local governments chose not to participate in Social Security also don’t qualify and lastly children younger than the age of 21 who do household chores for a parent. An individual also may choose to delay retirement benefits. If this is the case their benefits will be increased by a certain percentage depending on the year they were born and the increase will be added automatically from the time they reach full retirement age until the time they decide to retire or until they reach age 70, whichever comes first. One last thing to consider about retirement benefits is if an individual works and gets benefits. An individuals earnings in or after the month they reach full retirement age will not reduce their Social Security benefits however their benefits will be reduced if their earnings exceed certain limits for the months before they reach full retirement age. If an individual works and starts receiving benefits before full retirement age then $1 in benefits will be deducted for each $2 in earnings they have above the annual limit. In 2007 the limit is $12,960. In the year that the individual reaches full retirement age then their benefits will be reduced $1 for every $3 they earn over a different annual limit, for 2007 its $34,440, until the month they reach their full retirement age. Once the individual reaches their full retirement age they can keep working and their Social Security benefits won’t be reduced no matter how much they earn.

Another helpful benefit that the Social Security Administration offers is disability benefits. The Social Security Administration pays disability benefits in two different ways, one being through the Social Security disability program insurance, the second one is through the Supplemental Security Income (SSI) program. To find information regarding the SSI disabilities program please click on the link provided. http://www.socialsecurity.gov/pubs/11000.html. For information about disabilities programs for children please refer to http://www.socialsecurity.gov/pubs/10026.html. Social Security pays benefits to people who can’t work because they have a medical condition that is expected to last at least one year or result in death. The federal law requires such strict definition of disability, while some other programs give individuals benefits who have a partial-disability or have short-term disability, Social Security doesn’t. An individual must meet certain earnings requirements in order to be eligible for benefits. Individuals must meet two different earnings tests to be eligible for disability benefits. The first test is a “recent work” test which is based on the individual’s age at the time they became disabled and the second test a “duration of work” test to show that they worked long enough under Social Security. An individual should apply for disability benefits as soon as they become disabled because it can take a long time to process the application for disability benefits. It typically takes about 3 to 5 months. After the application is sent the Social Security Administration will review their application and make sure they meet some basic requirements for benefits such as whether they worked long enough to qualify and they will evaluate any current work activities. If these requirements are met then they will then send your application to the Disability Determination Services office in their state. This agency makes the decision for the SSA, they use their doctors and disability specialists to ask their doctor information about their condition, all facts in their case will be considered. They will also use evidence from any hospital, doctor’s office, clinics or institutions that the individual has been treated in order to obtain all other information.

http://www.socialsecurity.gov/pubs/10029.html#part1this link will provide information pertaining to the rules for the “recent work test” and also examples of work need for the “duration of work” test. Lastly individuals will also be able to find out what questions are considered in order to make the decision in which whether or not an individual receives disability benefits.

Lastly another option that the Social Security Administration offers is Survivor’s benefits. People usually only consider Social Security as paying retirement benefits however some of the Social Security taxes that individuals pay go towards providing survivors insurance for workers and their families. The value of the survivors insurance the individual has under Social Security is probably more than the value of their individual life insurance. As an individual works and pays Social Security taxes they earn credits toward their Social Security benefits. The number of years and individual needs to work depends on the age of the individual when they die. The younger a person is the fewer the years they need to have worked, but no one needs to work more than 10 years in order to be eligible for Social Security benefits. Under a special rule if an individual has only worked for a year and a half in the three years just before death, benefits can be paid to individuals and their spouses who are caring for the children. Those who are eligible for survivor’s benefits include; the individual’s widow/widower at age 65 if they were born before January 1, 1940 or at age 67. Reduced widow benefits can be obtained as early as age 60. The individual’s widow or widower can receive benefits at any age if he/she takes care of their child who is eligible to a child’s benefit and is age 16 or younger or who is disabled. An individual’s unmarried children who are under age 18 or 19 if they are attending elementary or secondary education full time. Their children can get benefits at any age if they were disabled before age 22 and remain disabled. Under certain circumstances benefits could also be paid to stepchildren, grandchildren, or adopted children. Dependent parents may also receive benefits if they are 62 or older. If an individual was divorced their former spouse is eligible if they are 60 and older and if their marriage lasted longer than 10 years. If an individual’s former spouse doesn’t meet the age requirement or length-of-marriage requirement but are caring for his/her child under the age of 16 they can still be entitled.

This article as written by Ashley Gurdon, a Suffolk University student and intern for the employment lawyers at Goldstein and Clegg, LLC

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