Bala Cynwyd, PA Disability (SSDI) Lawyer
While many of us look forward to retiring one day, it is safe to say that many people can expect a premature retirement due to illness or an injury that renders the worker disabled. Unfortunately, according to the Social Security Administration, approximately 30 percent of workers will become disabled at some point during their career prior to reaching retirement age. In recognition of the fact that even hard-working people can sometimes have a run of bad luck, Congress created programs to provide financial assistance in order to help workers who become permanently disabled.
Working with an experienced Social Security benefits attorney can help you understand a process that is often complex and highly technical. With a lawyer from Young Marr & Associates handling your application, you will have the peace of mind that comes with the experience of a seasoned Social Security attorney. To schedule a free and confidential consultation, call us at (215) 515-2954.
What Types of Social Security Benefits Exist?
Unfortunately suffering from a severe illness or injury that limits the things you are able to do does not make your bills and obligations stop. All too often people delay taking action and find themselves in a precarious financial position that is complicated by the long process of applying for SSDI benefits. However, it does not have to be that way. The Social Security Administration administers two distinct benefits programs designed to assist people with disabilities:
- Social Security Disability Insurance (SSDI) funded by payroll taxes
- Supplemental Security Income (SSI) funded by the general tax fund
SSDI is an insurance program funded under the Federal Insurance Contributions Act (FICA). Under SSDI, financial support is available for workers with a record of the accumulated credits needed to qualify for the SSDI program. A qualifying SSDI applicant will receive an average of $1,234 and up to $2,861 per month. In general, the older a worker is at the time of disability, the greater the number of work credits he or she will need to qualify. However, age alone is not qualifying eligibility. There are multiple requirements described below.
Eligibility for SSI doesn’t depend on credits but on other qualifications. In contrast, SSI is a needs-based program for low-income individuals who have the accumulated credits needed to qualify for Social Security Disability Insurance. Monthly SSI payments are based on a Federal Benefit Rate, and the average is $771 for individuals and $1,157 for couples. Your attorney can help you ascertain how much you can expect to receive based on the pre-set guidelines for these calculations. Over time, your award is subject to adjustment based on inflation rates.
Moreover, your attorney can help you determine if there are other sources of assistance you are eligible to receive. With respect to medical needs, you can rely on Medicare and Medicaid. Medicaid is health insurance based on income alone. Medicare is a national health insurance available for people after they become 65 years old. However, you are eligible to receive Medicare after receiving SSDI for two years.
SSDI Applications on Behalf of Family Members
You can file an application on behalf of family members who are disabled and don’t qualify for SSDI. Coverage includes your:
- Children—including stepchildren and adopted children—as long as the disability began before the child turned 22 years old
- Spouses (ex-spouses included)
- Grandchildren (as long as the grandparents are the primary caretakers)
The FICA credits accumulated by the insured will serve as the basis for family applications. Your attorney can provide you more information on how this is typically determined.
Children under 22 years old must meet SSDI’s definition of disabled, but there are additional elements considered in the evaluation process. The application requirements are the same as for adults in terms of the medical information required and the length of the process. With the guidance of an experienced attorney, your disabled child can receive the financial assistance necessary to provide for him or her.
Over time, these applications are subject to close scrutiny, but the award is generally available as long as the child remains unmarried. The award is subject to review when the applicant gets married, at which point the applicant can rely on the insured spouse’s FICA record.
How the Social Security Administration Evaluates Claims
Your application is subject to a rigorous analysis. Your medical records, physical evaluations, income, and work history are subject to close scrutiny based on Social Security standards. A Social Security disability attorney who understands the process and requirements can help improve your chances of a favorable determination.
Experience with the process can help to anticipate problems with the claim and correct them through appropriate measures. Anticipation of problems is helpful in submitting SSDI applications due to the long length of the application process and the typically common expectation that the evaluation process is subject to various levels of review.
With an overall average wait time of 15.3 months, most SSDI applicants agree that patience is needed throughout the process. Even if you feel as though you understand the laws and regulations, applications are often rejected depending on findings on the medical records as well as the different circumstances of most applicants.
If an application is denied after the initial review, the next step is filing a reconsideration. The average waiting period for a reconsideration is 103 days. The time required can depend on factors such as whether additional medical records were submitted or if the claim examiners ask for an examination by a Social Security physician.
Don’t Risk Your Benefits Without a Lawyer at the Disability Hearing
If the application is denied during reconsideration, the next level of review is with an administrative law judge (ALJ). Most SSDI applicants have to wait a long time before their case is presented to a judge who will then hear testimony and analyze if the claims examiner’s review is consistent with Social Security Administration standards. Government surveys show that as much as 42 percent applicants can end up waiting over a year to receive a hearing date.
The administrative law hearing is extremely important because judges often hear testimony about the findings in your file. While these hearings are not held in a court of law, the procedure is best handled by an attorney who can verify the credibility and training of witnesses certifying that you don’t meet Social Security’s criteria for disability payments. While the setting is not technically a court of law, the procedures are imbued with the same evidentiary rules and guarantees of an official court hearing.
Your Right to Appeal After a Disability Hearing
Subsequent to the hearing, you can file an appeal with the Social Security Appeals Council or at a U.S. Federal District Court. The Social Security Appeals Council doesn’t review all applications, while a federal court reviews every appeal.
At the federal district level, you are not allowed to provide additional information. Your lawyer will provide a legal document establishing why you’re entitled to SSDI as a matter of law. Your application is reviewed under the legal standard of “preponderance of the evidence.” This means that the federal judge will determine if the decision to deny the application was warranted and if all evidence received adequate weight throughout evaluation process.
Compassionate Allowance Exception
The Compassionate Allowance Exception allow SSDI claims examiners to identify situations where certain diseases call for a streamlined review. These are typically diseases such as cancer, terminal conditions, and ailments known to cause extreme disabilities. Your attorney can guide you as to the requirements if you qualify for a compassionate allowance.
Your Claim’s 5-Step Process Analysis
The Social Security guidelines for SSDI applications involve a case-by-case analysis of your medical and work history. While every application is different, there are specific requirements every application has to meet. The 5-step process analysis is summarized as follows:
1. Is There a Substantial Gainful Activity?
A substantial gainful activity, or SGA, is any work or other activity that you are able to do to gain income. An SGA typically includes work that is mentally or physically taxing in some way. If income from your SGA exceeds the maximum amount as defined by the SSA, you will be ineligible for benefits. Your application is ineligible if you earn more $1,220 or more every month.
2. Is Your Impairment Considered Severe?
You must have an impairment that is considered severe by the SSA. A severe impairment limits the things that you are able to do. Your impairment has to cause limitations that most people consider disabling and include either one or a combination of the following conditions:
- Impaired senses or speech
- Digestive problems
- Genitourinary disorders
- Cardiovascular disease
- Endocrine disorders
- Hematological disorders
- Skin disorders
- Respiratory disorders
- Congenital disorders that affect multiple body systems
- Neurological disorders
- Severe mental illness
- Autoimmune disorders
Medical conditions frequently involve impairments of more than one of the disorders and systems listed above. These applications can appear confusing and convoluted to disability claims examiners because it’s likely to include reviews and diagnoses by multiple physicians.
A qualified disability attorney can help you prepare a strong application without providing excessive or repetitive documentation that can hurt your chances of being approved. Similarly, there are instances when doctors’ letters and opinions alone are insufficient to establish your impairment without supporting medical tests and other records.
3. Is Your Condition Listed?
The SSA has listed a number of medical conditions that it considers to be so severe that they automatically qualify. There is a registry known as the Blue Book containing this list.
Even if your condition is not listed, you can still satisfy this requirement if you can prove the condition is medically equivalent. When a condition is not listed, your application must contain information on your impairment or impairments sufficient to show that your ailment is as disabling and debilitating as other listed conditions.
4. What is your Residual Functional Capacity?
Your residual functional capacity, or RFC, refers to the things that you are still able to do despite your severe impairment. If your RFC is considered to be too limited for the work you previously performed, you may proceed to the next step. Your vocational skills are then reviewed by an expert who determines if you are capable of working in another capacity, with proper accommodations. Under Social Security standards, capacities are assigned grades or levels of activity you can perform. If you are found to meet the RFC criteria, you’re not considered disabled.
5. Can you perform other work?
With your education, experience, age, and training in mind, the SSA then determines if alternate employment is available in your region. Once you’re deemed eligible, your file is subject to periodic review to determine if you are still eligible.
Experienced Bala Cynwyd Social Security Disability Attorneys Fighting for Your Rights
SSDI lawyers are prohibited from charging excessive fees for legal representation throughout the process of applying for disability benefits. There is a consensus that most SSDI applicants are seeking much-needed disability income and are in a vulnerable position due to their disability. Your fees are only charged if the application is successful. Moreover, there are fee amount restrictions and limitations your attorney can explain at greater length during your free consultation.
When it comes to experience in handling SSDI applications, our accomplished attorneys have a proven track record of successful SSDI applications. Lawyers at the disability law practice of Young Marr & Associates have an extensive SSDI advocacy background, including lawyers who used to work for the Social Security Administration itself. To learn more about how we can help you through this difficult process, call us at (215) 515-2954 today. We offer free and private consultations.