FAQ Social Security Disability
Q: Who is considered disabled and qualifies for Social Security Disability according to the Social Security Administration?
A: If you have a medical condition, you may be considered disabled if:
(1) You can no longer perform the work you performed in your old job;
(2) You cannot adjust to new work because of your medical condition; and
(3) Your disability lasts or is expected to last for a year or more or will result in death.
Q: Does Social Security provide short-term or temporary disability benefits?
A: No. Social Security only provides benefits for medical conditions lasting for a year or more.
Q: What is Social Security Disability Insurance (SSDI)?
A: SSDI is one of two programs that provides benefits based on disability. Payments under this plan are based on the prior work of the claimant that was reported to the Social Security Administration. A claimant must earn substantial credits based on taxable work in order to qualify for SSDI. The amount of the payment is based on the claimant’s earnings record.
Q: How are credits earned and how do they affect eligibility for SSDI?
A: One credit is earned for approximately every $1,000 a worker earns. However, a worker cannot earn more than four credits per year. In order to qualify for SSDI, a claimant needs to have earned 20 credits over a 10 year period. However, if the claimant is under age 24, he or she needs to have earned six credits over a three year period, and if the claimant is between the ages of 24 and 31, he or she needs to have credits for half of the time between age 21 and the age at which he or she becomes disabled.
Q: What is Supplemental Security Income(SSI)?
A: SSI is the other of the two programs that provide benefits based on disability. SSI benefits are payable based on financial need instead of the prior work of the claimant. Children and adults may be eligible to receive SSI benefits based on limited income and resources, living arrangements, and disability.
Q: What does a disabled individual need to do in order to apply for Social Security disability benefits?
A: The individual can either visit his or her local Social Security office or apply online at the Social Security Administration’s website.
Q: What does the Social Security Administration consider when a disability claim is filed?
A: The Social Security Administration will look at the following:
(1) the type of disability;
(2) the claimant’s medical records;
(3) the claimant’s work record;
(4) the claimant’s financial need (for SSI); and
(5) any other information that may be relevant to the claim.
Q: How long does it take to receive a response from the Social Security Administration once a disability claim is filed?
A: It usually takes three to five months to receive an initial decision in a disability case.
Q: What options does a claimant have if the disability claim is denied?
A: The claimant can either drop the claim or file a request for reconsideration within 60 days of the date of denial.
Q: How long does it take to receive a response to the request for reconsideration from the Social Security Administration?
A: It usually takes around four to six months to receive a response to the request for reconsideration.
Q: What options does a claimant have if the request for reconsideration results in another denial?
A: The claimant can either drop the claim or file a request for a hearing in front of an administrative law judge within 60 days of the denial.
Q: How long does it usually take to receive a hearing?
A: In most cases, the waiting period will be approximately 16 to 18 months. However, waiting times may be longer or shorter depending on which office is handling the claim.
Q: How long does it usually take to receive a decision after an administrative hearing?
A: It usually takes three to nine months to receive a decision after an administrative hearing.
Q: What if the claim is denied at the hearing level?
A: The claimant has 60 days to file an appeal to the Appeals Council. The claimant must submit a request for review of the hearing decision with either the local office or the Appeals Council.
Q: Does a claimant have to be represented by an attorney in a disability case?
A: No. A claimant can represent himself or herself at all stages of the process. A claimant may also be represented by a non-attorney.
Q: What are the benefits of being represented by an attorney in a disability case?
A: The attorney will be much more familiar with the process than the claimant. The attorney can complete and file all necessary paperwork and request and submit all necessary records.
Q: Is there a waiting period for receiving Social Security benefits?
A: Yes. Social Security benefits will not be paid for the first five months of the disability. If benefits are awarded, they will begin to accrue during the sixth month of the disability. However, benefits will not accrue for more than twelve months before the claimant filed for Social Security. If the claimant became disabled more than twelve months before he or she applied for Social Security, the benefits may begin to accrue twelve months before the claimant filed for Social Security. Therefore, Social Security benefits begin to accrue either five months after the onset of the disability or twelve months before the Social Security application is filed, whichever is later.
Q: How are past accrued benefits paid after Social Security disability benefits are awarded?
A: If more than a year of back benefits are to be paid, the back benefits will likely be paid in two or three installments six months apart. The first two installments will each pay for one year of back benefits. The third installment will pay any remaining amount due.
Q: How are monthly Social Security disability benefits calculated?
A: In calculating SSDI benefits, the Social Security Administration considers factors including earnings, FICA taxes paid, age of claimant, and date of disability. SSI benefits are calculated based on income, marital status, and living arrangement. The Social Security Administration uses a complicated formula to figure out the amount of benefits, so the amount is not predictable with accuracy.
Q: When does a disabled individual become eligible for Medicare?
A: The disabled individual is considered to be eligible for Medicare 24 months after the date of eligibility for disability benefits.
Q: How do workers’ compensation benefits affect disability benefits?
A: Workers’ compensation benefits will reduce disability benefits. A disabled individual cannot earn more than 80 percent of his or her average earnings at the time of disability once workers’ compensation benefits and disability benefits are combined.