Jennifer C. Jaff, Esq, Executive Director of Advocacy for Patients with Chronic Illness, Inc.
Reprinted with Permission.
We get a lot of questions about Social Security disability. The most common question we get is whether there’s any way to speed up the process. The truth is that, if you’re denied at the initial application stage — and 70 percent of people are denied at the start — you are going to wait close to a year in most of the country to get a hearing, and in some parts of the country, you will have to seek reconsideration first. The system is terribly back-logged. In some cases, a Senator or Congressman’s inquiry about the status of your case may help break a logjam, but other than that, we know of no way to speed up the process.
Hopefully, though, even if we can’t speed things up, we can help you understand the system a little better.
There are two forms of Social Security disability — Social Security Disability Income (SSDI), for which you have to have earned a total of 40 work credits (typically, forty three-month quarters, or a total of 10 years) with 20 of those occurring in the most recent 10 years; and Supplemental Security Income (SSI), which you can get even if you’ve never worked, but only if you have little or no income. There are people — for example, women who haven’t worked in years because they chose to raise kids full-time, but who have more than poverty level income — who do not qualify for either, even if they are otherwise disabled. Usually, if you are denied SSDI because you don’t have enough work credits, or if you are denied SSI because you have too much income, the only reason to appeal would be if you believe Social Security got the facts wrong. Most people, though, are denied because Social Security doesn’t agree that their illness is disabling.
The disability determination is pretty much the same for both types of assistance, SSDI and SSI. You have to be unable to perform any job in the economy — think the most light duty, sedentary job you can imagine. It’s not enough that you are unable to keep working at the job you had when you became disabled; you have to be unable to perform ANY job. For a child, disability occurs when you have a severe impairment that is reasonably expected to result in death or to last for a continuous period no shorter than 12 months.
In most states, if you get SSI, you are automatically eligible for Medicaid. If you get SSDI, you become eligible for Medicare after two years. SSI typically pays a monthly amount that is less than what you would get under SSDI, but the value of Medicaid cannot be overstated.
If your application is denied, it’s important that you appeal rather than giving up and starting over. When you win, Social Security often pays you a lump sum that covers the period from the date of your application (and sometimes earlier) to the date when you win. If you give up and start over again, you may lose some of that retroactive benefit.
It’s also very important, if your application is denied, to get a lawyer. Lawyers who do Social Security disability appeals don’t get paid unless they win, and the amount they are paid is the lesser of 25% of that retroactive lump sum or $6000 (the amount changes every year to adjust for inflation). Because lawyers who handle Social Security appeals can be hired without coming up with cash up front, Advocacy for Patients does not do Social Security appeals — we focus on doing the things you can’t get anywhere else. If you don’t know an attorney, you can call us and see if we have anybody on our referral list, or you can call the National Organization of Social Security Claimants’ Representatives at 1-800-431-2804. They also have a great set of FAQs here that we find very helpful.
Although the percentage of people who win at the initial application stage is low, roughly half of the people who appeal win. So don’t give up; get yourself a lawyer and appeal.
Finally, I think the best advice I have for people who are applying for Social Security disability is to keep a diary for a little while before you fill out the application and/or before your appeal hearing. It will help you gather your thoughts, be precise and detailed. Be explicit and detailed when you describe your daily life.
That’s just the tip of the iceberg. In addition to the NOSSCR FAQs I linked to above, the Social Security Administration’s website is pretty user friendly. You can find answers to most of your questions there. If you run into a problem, you know where to find us!
Visit the Advocacy for Patients with Chronic Illness, Inc.’s website: http://www.advocacyforpatients.org