Ideally You Should Have Already Been Out Of Work For Five Months Or More When You Apply For Ssdi
If you work up until the day you submit your disability benefits application, the SSA will almost certainly reject it. Thats because you must prove that you cannot work directly as a result of your disability to qualify for benefits. In some cases, you can show that it was difficult to work full-time because of your disability. But for the most part, spending the last five months unemployed because youre disabled seems to be the sweet spot. The SSA will also ask you:
- Whether your medical condition caused you to cease working at your previous job
- If you had to reduce hours before leaving work altogether
- Whether your employer had to provide special help in order for you to complete your routine job tasks
If you have an especially complicated claim, ask a Social Security attorney to review your application before submitting it. Lawyers often know disability secrets that apply to someone in your specific situation that you wouldnt find anywhere online.
IMPORTANT: Did you have an unexpected/abrupt accident or illness? If a sudden disability makes working obviously impossible on a short-term basis, you may be exempted from the five-month rule. The SSA will estimate how long your inability to work should last based on your medical diagnosis. If its one year or longer, you may still qualify for disability benefits.
How Common Is It For Beneficiaries To Return To Work
Both Disability Insurance and Supplemental Security provide incentives for beneficiaries to work. Disability Insurance beneficiaries are encouraged to work up to their full capacity and can earn an unlimited amount for up to 12 months without losing any benefits. Beneficiaries who work for more than 12 months and have earnings above the substantial gainful activity level cease to receive a monthly benefit. If at any point in the next five years their condition worsens and they are not able to continue working above the substantial gainful activity level, however, they are eligible for expedited reinstatement of their benefits. This means they do not need to repeat the entire, and typically lengthy, disability-determination process that they initially went through to qualify for benefits.
Supplemental Security beneficiaries who are able to work are encouraged to do so as well. Their benefits are reduced based on their earningsafter the first $85 of earnings each month, which is not counted against the benefitbut by only $1 for every $2 of earnings. Beneficiaries who are able to do some work will therefore always be better off with both earnings and a reduced benefit than just the benefit alone.
How Can The Social Security Disability Programs Be Improved To Increase Economic Security And Work Opportunities For Beneficiaries
Disability Insurance and Supplemental Security increase economic security for millions of disabled workers. For beneficiaries whose conditions improve, the programs also provide important incentives and supports for returning to work. Still, the programs could be further strengthened to increase disabled workers economic security and provide a more seamless transition for those who are able to return to work.
Modernize Supplemental Security
The value of Supplemental Security benefits has eroded considerably since the programs inception in 1972, as the programs income exclusions and asset limits have not kept pace with inflation and living standards. The current maximum benefit is equivalent to just three-quarters of the also-outdated federal poverty line for a single person. The general income exclusion and earned income exclusion have never been increased. To address this erosion, H.R. 1601, the Supplemental Security Restoration Act, sponsored by Rep. Raul Grijalva and introduced in Congress in April 2013, would increase the monthly maximum benefit to $937, which is 100 percent of the current federal poverty line, and would increase the general income disregard to $110 per month and the earned income disregard to $357 a month. Increasing the income exclusions and indexing them to inflation going forward would restore the monthly benefit amount to its intended value and significantly increase beneficiaries economic security.
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Approval Rates For Denials
Social Security disability applications face an overwhelming 70% denial rate upon initial evaluation. That is a huge number but it is based upon several very different factors, such as applying for a condition that does not meet the criteria or lack of proper medical documentation.
Fortunately, the Social Security disability benefits program offers a comprehensive set of appeals guidelines that have a great success rate.
When you appeal a decision, the understanding at that point is that you truly believe you qualify for disability benefits. You might go back and review your medical documentation to ensure that you have provided everything that the SSA needs to make an informed decision.
In some cases, new information has presented itself since you initially filed, and this new information can help to make your case even stronger.
The reality, though, is that your initial request for reconsideration goes back to the SSA so this appeal level only has an average success rate of 13.8%.
The best chance for a successful appeal comes at the disability hearing level, where you have the chance to speak with an administrative judge about your condition. You are able to bring witnesses who can support and corroborate your claims. There is an average success rate of 62% at this stage.
The two remaining levels are the Appeals Council and taking the case to federal court. The Appeals Council approval rate is about 13% and only 40% of federal court cases receive favorable decisions.
How Does A Person Qualify For Ssi
In addition to meeting the disability criteria , an SSI enrollee must meet several non-medical criteria, including having a low income. SSA has complex rules for determining financial eligibility. In general, income is anything received in cash, earned or unearned, that can be used to meet a persons need for food or shelter.17 Income is countable except for some limited amounts that are disregarded.18 Income also includes in kind support, such as any food or shelter provided or paid by another person. In kind support generally is valued at one-third of the maximum federal benefit amount.19 SSA also deems a portion of income from a persons spouse or parent/step-parent as countable income.20 To financially qualify for SSI, a persons countable income cannot exceed the maximum federal benefit rate , and the amount of SSI that a person actually receives is the maximum federal rate reduced by the amount of their countable income.21 These rules apply to SSI enrollees of all ages.
Figure 4: SSI Disability Determination Process for Adults
Figure 5: Disability and SSI Status of Nonelderly Adults with Medicaid, 2019
Figure 6: SSI Application Allowance Rate for Medical Decisions by Adjudicative Level, 2018
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Does Everyone Get Denied Disability First Time
No, it is a myth that all disability claims are denied the first time around. The Social Security Administration has no regulation, policy, or formula that influences the disability system in such a way that most initial applications for Social Security disability benefits are automatically denied .
The Basics About Disability Benefits
The SSDI program pays benefits to you and certain if you are insured. This means that you worked long enough and recently enough – and paid Social Security taxes on your earnings. The program pays benefits to adults and children with disabilities who have limited income and resources.
While these two programs are different, the medical requirements are the same. If you meet the non-medical requirements, monthly benefits are paid if you have a medical condition expected to last at least one year or result in death.
You Must Be Disabled Due To A Bona
Your disabling condition must be a legitimate medical condition diagnosed by medical professionals and supported with medical evidence. For example, a person without a medical diagnosis is unlikely to secure disability benefits. Similarly a person claiming disability due to rheumatoid arthritis for whom diagnostic and laboratory tests do not support this diagnosis will likely be denied disability benefits.
Medical evidence also needs to support the severity of the disability alleged. One claiming disability due to a back impairment with multiple levels of severe stenosis on radiography is much more likely to be approved for disability than one with radiographic evidence of only mild degenerative disease of the spine.
Your Right To An Administrative Law Judge Hearing And Appeals Council Review Of Your Social Security Case
70-10281, ICN 469055,
If you are eligible for Social Security or Supplemental Security Income Benefits, we want to make sure that you get them on time and in the right amount. After we decide whether or not you are eligible for benefits, or that we will stop your benefits, or change the amount, we send you a letter explaining our decision. If you do not agree with our decision, you have the right to appeal it. When you ask for an appeal, Social Security may review the entire decision, including those parts which were favorable to you.
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How Long Will It Take For Ssa To Pay Me
As a rule, it takes one to two months for back benefits to be paid and monthly benefits to begin in a Social Security disability case in which no SSI application was ever filed.
But these are only general rules. In some cases, it takes as long as 3 months for back benefits to be paid. When it takes more than 90 days for back benefits to be paid in a Social Security disability case, it may mean that there has been a bureaucratic mix-up somewhere in the system. In that case it will be necessary to take some sort of action to deal with the delayed benefits.
If 90 days pass from the date of the decision and I am still not paid my back benefits, is there anything that can be done to speed up payment?
It is possible that your attorney may be able to do something if you are not paid after 90 days. Be sure to telephone your attorney to explain that you havent gotten paid after about three months. It may be necessary at that point to contact the payment center.
Lack Of Hard Medical Evidence
Many Social Security Disability claims are denied due to a lack of solid medical evidence. If you want to qualify for disability benefits you will need to prove that you are unable to work due to your disabling condition.
In order to succeed in this, you must have medical records that show your disability has interfered with your ability to perform work activity.
For example, you may be seeing your doctor every month for severe back pain but if your doctor has not documented how that back pain interferes with your ability to work, your claim for Social Security Disability may be denied.
Many people assume that Social Security will send them to doctors who will gather the evidence needed to qualify and approve a claim for Social Security Disability benefits. This isn’t the case. Even if you are sent for medical exam by the Social Security office, it may not be enough to prove your disability.
The medical records kept by your primary care physicians are what will be most important in determining the success of your claim for Social Security Disability benefits. Because of this, it is very important that you discuss how your disability is impacting your work life with your physician.
Doctor’s notes excusing you from work or records suggesting a modified work schedule should be included with your medical files if possible. If you were working prior to filing for disability and had to miss time from work due to the disability, keep record of just how much time was lost.
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Types Of Back Payments
Back payments are paid for the months between the date you applied for disability benefits and the date you were approved for benefits. Due to the number of people that are applying for disability benefits and the time it takes to process your application, there is usually a long delay between your disability application date and approval date. And for Social Security Disability Insurance benefits, there is five-month waiting period, so you are only eligible to receive back pay for any delay beyond the waiting period .
Another type of back payment that may be available to individuals who are receiving SSDI benefits are retroactive benefits. Retroactive benefits are paid for the months between when you became disabled and when you applied for Social Security Disability benefits. These are benefits that you were eligible for and would have received if you had applied for benefits earlier.
How Are Back Payments Made
If you are approved for SSDI only, you’ll most likely receive one lump-sum payment for the entire amount of your backpayments.
If you are approved for SSI, or SSI and SSDI, the rules are different. Social Security generally pays the past-due benefits for SSI or combined SSI/SSDI in three equal installment payments that are separated by six months each. However, you are eligible for larger first and second installments if you need funds for necessities or to pay off debts for necessities. Or, you may be eligible for one lump-sum payment if you are not expected to live past the next 12 months or you are no longer eligible for SSI benefits at the time you receive your backpay . For more information, read our article on lump-sum payments of backpay.
To learn more about disability backpay in general, see Disability Secret’s section on Social Security disability backpay.
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The Facts On Social Security Disability Insurance And Supplemental Security Income For Workers With Disabilities
Social Security Disability Insurance and Supplemental Security Income provide critical lifelines for the roughly 12 million people with disabilities in the United States.
- Shawn Fremstad
- Rebecca Vallas
Nearly one out of every six working-age Americans29.5 million peoplehas a disability, making them much more likely to experience economic hardship than people without disabilities. Many people with disabilities are able to work, although they face greater challenges finding work than people without disabilities. But many individuals with severe and long-lasting disabilities have no or only limited capacity to work and are particularly vulnerable to economic hardship.
For roughly 12 million people with disabilities, Social Security Disability Insurance and Supplemental Security Income, both core components of our nations Social Security system, provide critical lifelines. The modest but vital assistance that Disability Insurance and Supplemental Security provide makes it possible for individuals with severe disabilities and health conditions to live independently, keep a roof over their heads and food on the table, and pay for needed, often life-sustaining medications and other basic expenses.
Getting The Help You Need
The Florida disability application process has its challenges, but receiving the SSDI or SSI benefits youre entitled to can be accomplished more easily with a disability advocate at your side. Our advocates know how to cut through the red tape to help get your disability application approved if its not, well go to work to ensure a fast appeal process. At Disability Experts of Florida, we have over 100 years of combined experience navigating the Sunshine States application process and have helped thousands receive the disability benefits they deserve. We can help you too.
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Take Steps To Protect Your Back Pay And Retroactive Pay Today
Once you are approved for Social Security disability back pay or retroactive pay, then you will typically receive the money that is owed to you in one lump sum unless you are also eligible for Supplemental Security Income in which case the rules differ. No interest will be paid on back pay or retroactive pay benefits.
Back pay and retroactive pay can be important to your financial future. Therefore, it is important that you contact an experienced Social Security disability lawyer as soon as possible. Our lawyers can help you gather the right evidence and make persuasive arguments so that you get the full amount of back pay and retroactive benefits that you deserve. Contact us today via this website or by phone to find out more about what we can do for you and how we can help you get the fair amount of Social Security disability benefits that you have earned. Contact Us by filling out a form or call us at 508-283-5500.
The Social Security Administration Recognizes Your Condition As Disabling
Eligibility for social security disability benefits requires either that the disability lasts, or is expected to last, 12 months or longer, or will result in your death. This means that disability benefits are paid only for long-term disability short-term disability does not qualify.
The Social Security Administration Blue Book lists more than 100 medical conditions the SSA considers disabling. Each condition has specific criteria applicants must meet, through medical evidence, to prove their disability. Being able to meet these criteria doesnt guarantee that the SSA will rule that you are disabled enough to receive disability benefits. Some people can meet a listings criteria from a medical standpoint yet, either through workplace accommodations, treatment, or an ability to adapt to or work through any pain, still be able to work. But meeting the criteria for a specific listing increases your chances of approval.
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