SSDI & SSI SOCIAL SECURITY
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Social Security Disability Insurance

Social Security Disability Insurance (“SSDI”) provides benefits to disabled or blind persons who are “insured” by workers’ contributions to the Social Security trust fund. These contributions are based on your earnings (or those of your spouse or parents) as required by the Federal Insurance Contributions Act (FICA). Title II of the Social Security Act authorizes SSDI benefits. Your dependents may also be eligible for benefits from your earnings record.  If you are awarded Social Security Disability benefits, you will be eligible to receive Medicare twenty-four months after the first month for which you are paid.

Supplemental Security Income

Supplemental Security Income (“SSI”) provides cash assistance payments to aged, blind, and disabled persons (including children) who have limited income and resources.  If you are a Florida resident and eligible to receive Supplemental Security Income payments, you are also eligible for Medicaid. As long as you receive Supplemental Security Income, you do not have to file a separate application for Medicaid.

The Social Security Act defines disability for anyone over 18 years of age as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. There are different rules for blindness and children.

The Social Security Regulations outline a five-step, sequential evaluation process to determine whether a claimant is disabled:

(1)   Whether the claimant is currently engaged in substantial gainful activity;

(2)   Whether the claimant has a severe impairment or combination of impairments;

(3)   Whether the impairment meets or equals the severity of the specified impairments in the Listing of Impairments;

(4)   Based on a residual functional capacity (“RFC”) assessment, whether the claimant can perform any of his or her past relevant work despite the impairment; and

(5)   Whether there are significant numbers of jobs in the national economy that the claimant can perform given the claimant’s RFC, age, education, and work experience.

See Phillips v. Barnhart, 357 F.3d 1232, 1237-39 (11th Cir. 2004); 20 C.F.R. §§ 404.1520(a)(4)(i)-(v), 416.920(a)(4)(i)-(v).

Step 1: Application

The Social Security Administration administers the Social Security Disability and Supplemental Security Income programs. You contact the Social Security office serving your area to start the process. You can find out which office serves your area by calling information or going to the Social Security Website at www.SocialSecurity.gov.  You can apply in person, over the phone, or online.  Applying online is usually the quickest.  You can apply online by going to: https://www.ssa.gov/applyfordisability/

Disability Determination Process: Social Security has a contract with a State office, the Division of Disability Determinations, to evaluate each case and make a determination as to whether or not the claimant is disabled. After you complete the application process, Social Security sends your file to the State disability office. They may request more information from you regarding your disability, and will obtain copies of the medical records from your health care providers. They may want you to see one of their doctors. If you can get the information they need from your own treating doctor instead of going to an examination by a new doctor, it is usually in your interest to do so. Your doctor already knows your case, and has access to the testing and treatment which has already been provided. The Social Security doctor may not be able to identify your problem at a brief one-time exam. An opinion by one of these doctors that your impairment would not prevent you from working could mean that you will not receive your disability benefits.

After obtaining the information they need, the State disability determination office will make a recommended decision to Social Security. The length of time it takes to get to this point depends how long it takes the Social Security office to complete the application, and send your file to the State disability office which varies substantially from office to office. It also depends on how long it takes your medical providers to send your records, and how quickly the State office staff perform their responsibilities. According to the Division of Disability Determinations Office in Orlando, the average time spent on a case in their office at the initial level is 85 days.

If the State disability office recommends that your claim be approved, Social Security will review the case and send a Notice to you. They will then make sure that you meet all of the other non-disability requirements for eligibility and process your payment. The State office recommends most cases be denied. If a recommendation of denial is made, Social Security will send you a denial notice. If your claim is denied, you have sixty days from the date you receive the denial to appeal. Social Security assumes you receive the notice within five days of the date on it unless you can prove otherwise. You file an appeal by completing and submitting a Request for Reconsideration with two Social Security releases, and a Disability Report on a form supplied by Social Security.

You can check the status of your claim or get other information by opening a “My Social Security Account” at: https://www.ssa.gov/myaccount/

Step 2: Reconsideration

If you file a Request for Reconsideration with Social Security, your file will be sent back to the State disability office. They will obtain any updated information and another determination will be made by another claim examiner. Again, the amount of time it takes depends on how quickly the Social Security staff, State office staff, you, and your doctors do what is needed. The average time would be approximately three or four months. Any given case could take more or less time.

If a recommendation for approval is made, the file will be returned to Social Security. After a review, a Notice will be sent to you, and the process will begin to make sure you meet all other eligibility criteria and determine the amount of your benefits. Again, the State office recommends most cases be denied. If your claim is denied, you have sixty days from the date you receive the denial to appeal. Social Security assumes you receive the notice within five days of the date on it unless you can prove otherwise. You file an appeal by completing and submitting a Request for Hearing with two Social Security releases, and a Disability Report on a form supplied by Social Security.

Step 3: Hearing

Although your results may vary, most people who appeal their case to an Administrative Law Judge are found disabled. The problem is that it generally takes more than a year before a case is even assigned to a judge. It could take two or more months after that before the hearing is scheduled, and two or more months after that to receive the written decision.

Step 4: Appeals Council

Administrative Law Judge decisions can be appealed to the Appeals Council. Detail as to where and when the appeal must be filed will be included with the Judge’s decision. It often takes more than a year after you file your appeal before the Appeals Council issues a decision.  Sometimes it is less.

Step 5: Federal Court

Claims that are denied by the Appeals Council can be appealed to the United States District Court. More details are included with the notice sent by the Appeals Council.

We are here to help.

If you are disabled and unable to do the work you once did, call Richard A. Culbertson at (407) 894-0888 or contact us online for a free initial consultation.  We look forward to hearing from you.

Disclaimer: The following is general information only. The Social Security Act and related regulations, rulings and case law should be used or cited as authority for the Social Security disability programs.

At Culbertson Law Group, P.L.L.C., we handle most disability cases on a contingency fee basis. This means you do not have to pay us any attorney fees at the time we start working on your case. If you are not awarded retroactive benefits, you do not have to pay us any attorney fees. If we are successful, and you are paid retroactive benefits, the attorney fee would be a fee equal to 25% of the past-due benefits resulting from the claim, or, if less, the maximum dollar amount allowed pursuant to section 206(a)(2)(2) of the Social Security Act based on the date the Social Security Administration approves the fee agreement.

In appropriate cases, we may agree to accept a case on an hourly or flat fee basis. At Culbertson Law Group, P.L.L.C., we do not charge for incidental expenses such as postage, long distance phone calls, or mileage. We will not charge you for any costs associated with your case unless we discuss the matter with you first.

Need To Apply?

If you have already filed for social security disability online or by mailing in forms, you can now seek representation. If you have been denied at the initial level of Social Security, the following required forms can either be filled out online, over the phone, or at the office: CLICK HERE TO VISIT OUR RESOURCES PAGE

Still Have Questions?

Don’t be shy, give us a call! If you are disabled and unable to do the work you once did, call Richard A. Culbertson at (407) 894-0888 or click the button below for a free initial consultation. We look forward to hearing from you. CLICK HERE TO CONTACT OUR OFFICE