What is Social Security?
Social Security is a major part of most people’s lives. One in six Americans receives a Social Security benefit, and about 98% of all workers are in jobs covered by Social Security. In 1940, only slightly more than 122,000 people received monthly Social Security benefits; today, more than 49 million people receive them. The SSI program provides income support to more than 7 million people.
The original Social Security law was passed in 1935 and amended in 1939. Payment of monthly benefits began in the beginning of 1940. In 1950, the law was changed again, this time to allow for cost of living adjustments (COLAS). The disability program was instituted in 1954, and that program was broadened in subsequent years.
Today, Social Security offers retirement and survivors’ benefits as well as disability benefits. The Administration also provides Supplemental Security Income benefits for those who are elderly, blind, and/or disabled and have not accrued retirement benefits.
What Types of Disability Payments are Available to Me through Social Security?
One of the first things people ask about when they contact our firm is what Social Security disability programs they qualify for. The two main programs are Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI).
Both programs provide financial support for individuals who are unable to work because of a physical or mental illness. SSDI provides financial support for individuals who have spent most of their lives working, but are now unable to work because of a disability or illness. SSI provides support for people who have hardly or never worked or paid taxes into the system, and also have financial need. The standard for disability for both programs is the same, but there are different eligibility standards.
How Do I Find Out if I’m Eligible for Benefits?
In order to get Social Security Disability benefits, you have to have enough quarters paid into the system (meaning, enough paid work history during which you paid Social Security taxes), particularly during the last ten years. (You can earn up to four quarters of coverage in a calendar year.) Supplemental Security Income benefits are also based on need, which means that your income or the family income in your household must be below a certain monthly amount for you to qualify.
You May Qualify for Both, One or The Other, or Neither
If you have enough quarters paid into the system to be eligible for Social Security Disability and you have no income and no family income in your household, it is likely that when you apply for disability benefits, they will take an application for you for SSI, too.
If you have even modest assets or family income in your household, they will likely only take an application for you for Social Security Disability.
If you do not have enough quarters of coverage (enough paid work during which you paid Social Security taxes) during the last ten years, then you will likely only be eligible for SSI (Supplemental Security Income) benefits.
Sometimes people fall into a gap because they have not earned enough quarters to be eligible for Social Security Disability and their working spouse makes too much money for them to qualify for SSI. Under this circumstance, even if you have very severe health issues that keep you from working, you are not eligible for either of the disability programs.
Applying for Social Security Disability
Normally, we do not assist people in the application stage, although we are available to do that if you are unable to submit an application on your own. Applications can be completed online if you have access to a computer, or you can pick one up at your local Social Security office, or call and ask them to send you an application packet.
The application process involves you giving the Social Security Administration all available information on your educational background, your work background, and what health conditions you claim affect and limit your ability to work. The Social Security Administration defines work as “gainful employment.”
Describing Your Medical History
When you give Social Security the information on your healthcare, make sure you give names and addresses of all the doctors, and/or clinics, and/or hospitals you have seen since the date you are alleging you became disabled. Your Disability Onset Date is the date you were no longer able to be gainfully employed as a result of your health.
Make sure you list all of your health problems, not just the most major ones which are most affecting your ability to work. It may be possible to prove that you are disabled based on one particular condition, or, in many cases, your disability may be based on a combination of a number of conditions. These should include conditions that affect your physical health and any conditions which affect your mental health.
The more documentation you have about your health problems, the better your chances are of success.
Note that it is helpful to give the Social Security Administration your medical records if you have them or were able to obtain them, but it is not essential. As long as you give them accurate names and addresses and periods of time when you saw specific doctors or facilities, they will order the records.
Describing Your Work Background
When it comes to describing your work experience, always accentuate the most physical aspects of your work. For instance, let’s say you have worked in a convenience store as a manager or a supervisor.
Most people tend to want to emphasize the higher-level nature of these positions, yet our experience shows us that in these kinds of positions the “manager or supervisor” often stocks, cleans, loads, is up on their feet walking or standing for most of their shift, and has to fill in shifts for other employees. It is important that you identify all of the physical and mental demands of the work that you have done in the past. This is how the Social Security Administration will classify your past, relevant work. This is often an essential question that will affect the ultimate success or failure of your claim.
What Is A Disability-Listed Impairment And How Does That Affect Me?
How does the Social Security Administration decide what constitutes a disability? It keeps a list of illnesses and health conditions that it considers serious enough to potentially prevent people from working. These are known as “disability listed impairments.” If you can prove that you have one of these conditions (or equivalent findings) and that your symptoms are severe enough, you should qualify for disability. Generally, the people who are awarded benefits on application without the need for a lengthy appeal process will meet one of these listings.
The listings are divided into various body systems, as follows:
- Musculosketal System
- Special Senses in Speech
- Respiratory System
- Cardiovascular System
- Digestive System
- Genital Urinary System
- Lymphatic System
- Endocrine System
- Multiple Body Systems
- Mental Disorders
- Neoplastic Disease, Malignant
- Immune System
Symptoms, Not Just Diagnosis
Even if your condition is a listed impairment, your symptom severity is very important. Oftentimes, when people call us about being denied for disability benefits, they simply state their diagnosis. Here’s the reality: a diagnosis alone (unless it is fatal in the short term) does not automatically get you disability.
For example, people are often surprised that simply having insulin-dependent diabetes does not quality them for disability. However, being an insulin-dependent diabetic will not automatically get you disability benefits. What’s more important is the symptoms you have as a result of the diabetes.
There are many insulin dependent diabetics who are able to function relatively normally as long as they keep track of their blood sugar, take their insulin as prescribed, and follow a diabetic diet. On the other hand, diabetes can progress to the point where it affects your ability to see (retinopathy) and to use your hands or feet (neuropathy). It can even result in the amputation of a limb. It is at this stage that diabetes will more likely qualify as a disability.
Speaking of amputation, here’s another example: Having lost one of your four limbs does not automatically qualify you as having a listed impairment. In order to have an automatic finding of disability, you would have to be missing two limbs.
Overall, the medical listings have very detailed and strict requirements. Even if you do have a particular condition (for example, some loss of sight or loss of hearing) your situation must meet the administration’s particular guidelines in order to qualify you for disability.
What If I Don’t Meet A Listed Impairment?
If you do not meet the requirements of a Listed Impairment, there are a number of factors that affect your disability claim. These include your age, how far you went in school, your prior work experience, and the documented medical conditions that you have.
The Social Security Administration is required to look at both the physical and mental demands of work. The physical demands of work are divided into four categories (heavy, medium, light, and sedentary). The bottom line is that the older you are, the less educated you are, and the more physically demanding your prior work was, the greater your chances are of receiving benefits.
Ultimately, though, the most important factor in proving your entitlement to benefits is the medical evidence. After all, we can assume that every person who applies for disability believes that they are unable to work. This is why your medical treatment, and what doctors say about your condition and how it impacts you, is the single most important factor in determining if you are likely to be successful.
Will the Social Security Administration Send Me to One of Their Doctors?
The Social Security Administration does not send everyone to be evaluated by the physicians which they employ for this purpose. They are also not required to do so. They tend to do this more in cases where you do not have your own medical evidence, usually due to a lack of insurance or lack of access to adequate health care. This is a problem for many people.
The medical evaluations which the Social Security Administration will send you to are often brief and not very comprehensive. It is rare that these evaluations actually help your case, although in a small percentage of cases they can be helpful. These examinations usually do not involve the kinds of testing (MRIs, blood work, electrocardiograms, etc.) that are likely to confirm the existence of serious medical impairments. Additionally, these doctors are only seeing you one time, and may not even be qualified in the particular specialty which covers your health problem. For example, the doctors the Social Security Administration sends you to for spinal problems (back and neck pain) are generally not orthopedic or neurosurgical specialists, but general physicians.
These doctors do a large number of these evaluations for which they are paid modest sums of money.
The doctor that Social Security sent you to (called a Consultative Evaluator) usually won’t tell you anything about their findings and they won’t give you the medical records or report they generate as a result of their examination. They consider your records to be owned by the Social Security Administration, as they are the ones who paid for the evaluation.
You will, however, have an opportunity to see what those doctors wrote in their reports later on in the disability process, particularly if you have a legal representative.
My Disability Application was Denied! Now What?
There can be up to five stages in the Social Security process if you are denied. This includes four levels of appeal. All appeals generally require a formal response within 60 days of the denial.
The first appeal (after being denied on application) is called Reconsideration. Like all requests and forms associated with this process, it must be submitted in a timely manner (within 60 days). Most people who are denied on their initial application are also denied on their Request for Reconsideration.
This is because most of the time the medical evidence used to make the original decision has not changed.
Once you have been denied the second time (on Reconsideration), you have 60 days to ask for a hearing before an Administrative Law Judge. This is the stage at which you stand the best chance of succeeding in your claim for benefits, especially if you have the help of an experienced Social Security lawyer.
The hearings are held before an Administrative Law Judge, either in person or by video conference. At the hearing you will have an opportunity to testify, and you may have an attorney or other representative to assist you.
How Long Does the Appeals Process Last?
When you first apply for benefits, after you have either given Social Security all of your medical records or they have requested records from the doctors and hospitals you have listed, you will often get a decision within a few months. If you are denied and ask for Reconsideration, that also can take another few months. And if you are denied on Reconsideration and ask for a hearing before an Administrative Law Judge, you will generally wait one to two years to get a hearing.
What this actually means is that the entire process–from when you first apply to when you actually get a hearing and then a hearing decision–will likely take two years or longer. This is extraordinarily difficult, since Social Security applicants are generally not working much, if at all, and have little or no income. Without additional support, such as family help or savings, this presents extreme hardship for people. Unfortunately, though, this is true for most people. Therefore, claiming hardship rarely results in a faster resolution of your claim.
If you are denied by the Administrative Law Judge, you have another right of appeal before the Appeals Council. This appeal can also take another six months to a year and a half. If you are then denied by the Appeals Council, you still have a right to file a lawsuit in federal court. This is a complex and lengthy process.
What is The Hearing Like?
The hearing is before an Administrative Law Judge who is generally well versed in Social Security law; the more diligent ones will have familiarized themselves with the evidence in your case before the hearing. At the hearing, you will be sworn in, and questioned by your lawyer, the judge or both. The purpose of your testimony is to give you an opportunity to express how your health problems affect your daily life and your ability to function in the areas that would be required of you in order to be gainfully employed.
Often, the judge will also have a Vocational Expert on hand to testify. He or she can classify your past relevant work and identify other jobs which may exist that you may be able to do, depending on what the judge concludes your limitations are. The judge can also call a Medical Expert to testify. This is someone who reviews your records and gives their opinion about the degree of your impairments and limitations.You may also call other witnesses at your hearing, such as family and other people who know you and know how your condition affects you. In our experience, such witnesses are not very effective.
Why You Should Hire a Disability Lawyer
When people apply for benefits from the government, they are usually at a tough place in their lives. They have had a serious medical problem and are unable to work. People reach out asking for help. However, instead of finding the help they need, the government turns them down, saying the medical condition does not qualify or denying their claim for some other reason.
If that is the situation you are in, it is important to work with experienced Social Security disability attorneys. At the Goldberg Law Office, we understand the financial, emotional and physical stress people are going through, and we strive to help however we can.
We know it can be frustrating to wait for answers, so when clients contact us, we always provide the prompt answers individuals need. We work with a team of assistants, so there is always someone who can answer your questions. However, because we understand the delicate nature of the topic, if you would like to speak directly with the lawyer handling your case, you can do that.
In most situations, when individuals contact us, they have already been turned down by the government. Once we begin working with clients, we do all the appeals work. We often handle Social Security Disability Insurance (SSDI) cases for one to two years, or for as long as it takes to resolve the case.
During the appeals process, we prepare cases to be resolved in a judicial hearing. This includes presenting your case to an Administrative Law Judge and becoming familiar with every detail of the case. We know the Appeals Courts can be frightening for clients, so we explain the process in great detail so our clients know what to expect at each step of the process.
Why You Need a Lawyer, Not Just a “Representative”
The Social Security Administration defines a “representative” as anyone that you hire to represent your interests in your disability case and to advocate on your behalf. Unfortunately, Social Security does not make a distinction as to whether or not your representative is a lawyer. Typically, non-lawyer representatives charge the same 25% contingency fee that lawyer representatives do.
Many times when someone contacts a “Social Security Disability Representative Group” they are not aware that the person assigned to their case is not a lawyer. Remember, you can hire an experienced disability lawyer, like us, for the same fee that you would pay a non-lawyer. The statutes or laws which govern the disability process and your rights are extensive and complex. Lawyers are trained in both interpreting laws and in advocating on clients’ behalf. Hiring an expert is in your best interest. We know how to win a disability case.
How We Charge to Represent People In Disability Cases
The Social Security Administration allows and routinely approves our simple fee agreement for 25% of any past due benefits that you are entitled to. This is a contingent fee, which means that we only get paid if we win your case. If we don’t win your case, you do not owe us anything.
In addition to the fee, if we win your case, you will owe us for any out-of-pocket expenses that we incurred in your case. These are primarily the cost of ordering your medical records, copying, faxing, etc. In most successful disability cases, the result of our efforts is the recovery of many thousands of dollars (sometimes tens of thousands of dollars) in back benefits for our clients. The out-of-pocket costs in these cases is rarely more than $200 to $500.
Our Experience in Disability Cases
Goldberg Law Office opened in the fall of 1986, which means that we have been representing North Central Florida’s injured and disabled for the last twenty-eight years. Martin Goldberg, the senior attorney in the firm, has been handling disability cases for thirty-four years. Our representation has resulted in over a thousand individuals and families getting the financial support and medical care they desperately needed.
In our experience, not only do you have to know and understand the law and know and understand the different styles and inclinations of the various law judges who hear these cases, but you also have to be very knowledgeable about a whole range of medical conditions. We have represented people with musculoskeletal problems, eyesight and hearing problems, breathing problems, cardiac problems, digestive problems, neurological problems, malignant disease problems, immune system disorders, mental health problems, and pretty much every condition, illness or injury that is part of the human experience.
Finally, your disability lawyer should be sensitive to the extraordinary health and financial problems that cause people to have to apply for disability in the first place. We know how difficult these problems are, and we know the importance of having a fully qualified advocate in your corner along with a dedicated staff of people who will make their very best efforts on your behalf.
Contact Experienced Gainesville Social Security Benefits Attorneys
If you have already been denied Social Security benefits, or if you are thinking of applying, we can help make sure your application has the information it needs to get through the system successfully. Learn more about the representation we provide by contacting us online or calling (352) 376-1200 to schedule your free initial consultation.