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![]() Social Security Disability Information The
following information is intended as general information, and not as
legal advice specific to your case. There are many variables
which may affect your eligibility for benefits. Those
possibilities are far too numerous to address here, as no website can
be a substitute for legal advice specific to your needs.
What types of benefits are available? There are two primary types of benefits available from the federal government to individuals who are unable to work: Social Security Disability Insurance benefits (SSDI) and Supplemental Security Income benefits. SSDI benefits are based upon credits earned from your payroll deductions while you were working. Roughly speaking, a person must have worked consistently for 5 out of the last 10 years to have enough credits to receive benefits. SSI is a needs-based program for those who have not earned enough credits for SSDI benefits or who have earned only enough for a small SSDI benefit. There are strict limits on household income and other resources under the SSI program. Some people are eligible to receive benefits under both programs. The definition of disability is the same under both programs. What is the definition of disabled? The Social Security Administration defines disability 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 has lasted or can be expected to last for continuous period of not less than 12 months." How do I apply for benefits? In order to apply for either SSDI or SSI benefits, you must file your application with the Social Security Administration. SSA makes this process fairly easy. You can file your application online by clicking here. You may also call SSA toll-free at 1-800-772-1213. They will schedule a time for a claims representative to call you back for an interview. A third option is to call or visit your local Social Security field office, which you can locate here. What are the steps in the process? After you file your initial application, your disability claim will be decided by the Disability Determination Services (DDS) office in your state. They will obtain medical records, and doctors who work for the state will evaluate your condition. Many people who are actually disabled are denied at this level. Next, you can appeal and file for "Reconsideration." The claim will again be reviewed by DDS. Not surprisingly, most people are denied again at reconsideration. After this, you can request a hearing before an Administrative Law Judge (ALJ). This is where most people who are denied initially are awarded benefits. A lawyer who is experienced in Social Security Disability law will work to make sure that the ALJ has all of the information necessary to maximize your possibility of success. If your claim is denied by the ALJ, there is another level of appeal within the Social Security Administration, the Appeals Council. The Appeals Council is located near Washington, DC. They do not conduct another hearing, but rather review the record in your case. Finally, claimants who are denied at the AC level can file a complaint in United States District Court and have the claim decided by the federal court system. Attorney Paul Silich handles appeals at all of these levels. Does my doctor have a say in the process? Many people are disappointed when their disability claim is denied despite the fact that their long-time family doctor wrote a note saying that they are disabled. Unfortunately, it is not this simple. While Social Security rules provide that a treating physician's opinion is controlling in some circumstances, several requirements must be met. Your lawyer can work with your doctor to ensure that his or her opinion is in the proper form and supported by the proper evidence so that it is more likely to be accepted by SSA. Will I receive medical benefits? People who are eligible for SSDI or SSI benefits will also qualify for medical benefits, which vary depending on which program is involved. If you receive SSDI benefits, you will qualify for Medicare. Medicare Part A is free and pays for hospital benefits. Medicare Part B requires payment of a premium on your part and pays for physician and other charges. The amount of the premium changes every year and is deducted from your SSDI benefit. If you receive both SSDI an SSI, you may qualify to have your Part B premium paid by your state. If you are receiving SSI, you will be eligible for "Title 19" covervage, which is also known as Medicaid. Can I work while applying for benefits? Social Security Disability and SSI are programs generally designed for people who are unable to work at a level defined as "substantial gainful activity." Both programs have income limits which will be an absolute disqualification from benefits. A Social Security Disability attorney can advise you about these limits. While it is possible to work part time and still have your claim approved, generally people working part time will have a more difficult time having their claim approved. Once someone is receiving benefits, there are also strict income limits of which you need to be aware. Do I need a lawyer for my claim? While it is not necessary to have lawyer represent you in your claim, a lawyer who practices in Social Security Law can do several things to help your claim proceed successfully and obtain the benefits you deserve. A lawyer will help you navigate the multiple forms that are required by SSA and make sure that your appeals are filed in a timely manner. A lawyer will work with your treating doctors to develop their opinions concerning your disability. It is generally not enough for your doctor to write a note saying you are disabled. In addition, your lawyer will work to prepare you for your hearing before an administrative law judge and make sure your benefits are calculated correctly. How much are attorney fees and costs? Attorney Paul Silich charges attorney fees only if your claim is successful and you are awarded benefits. Attorney fees are generally 25% of your past-due benefits, up to a maximum charge of $5,300.00. This cap will increase to $6,000.00 for cases decided after June, 2009. In addition to attorney fees, you would be responsible for reimbursing your lawyer for out of pocket costs which were spent to develop your case. The most common costs are for medical records. Sometimes, it is helpful to your claim to have you evaluated and obtain a report from another doctor or other expert. You would be responsible for those costs, but they generally increase the likelihood of your claim succeeding. |
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A Social Security Disability and Workers' Compensation law firm located in Dubuque County, Iowa. Lawyer serving clients throughout Eastern Iowa and Northwest Illinois, including Cedar Rapids, Clinton, Dubuque, Davenport, Dubuque, Waterloo, Galena, and Freeport. Information provided on this website is intended only as general information, not specific legal advice. No attorney-client relationship is established until a written representation agreement is executed. An Iowa and Illinois Social Security Disability, SSI and workers' compensation attorney. |