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Social Security
Social Security Disability (SSDI) and Supplemental Security Income (SSI) Representation
Social Security Disability (SSDI) and Supplemental Security Income (SSI) Representation
What is Social Security?
We are all familiar with people receiving social security benefits upon reaching retirement age. However, a significant part of the Social Security program is to pay benefits for those who are disabled prior to reaching retirement age. The purpose of the program is to provide benefits in the form of monetary payments as well as health insurance (Medicare or Medicaid) for those who are no longer able to work due to physical or mental disabilities.
What is the process to receive social security benefits?
The first step to receiving social security benefits is to apply through the local Social Security office in your county. Medical records will then be requested by the Social Security Administration and they will make an initial determination based upon the medical information received. If a denial is issued, the applicant may then file a timely appeal for reconsideration. If the Notice of Reconsideration is a denial, a timely Request for Hearing can then be filed by the applicant.
The hearing will take place before an Administrative Law Judge and exhibits will be submitted and testimony will be given. A vocational expert will often testify at the hearing. If a denial is issued as a result of the hearing, further timely appeals may be pursued with the Appeals Council and eventually in federal court. All appeals must be timely filed.
When do I need an attorney?
An attorney may be retained to represent you at any time throughout the process. Our advice is typically to file the Application on your own and, at a minimum, receive the first decision on your own. Obviously, if you receive benefits you will not need representation.
We generally leave it up to the client whether or not they wish to pursue a Reconsideration -- the second decision -- with or without an attorney. Some clients want to increase their chances for success on the second decision and choose to retain an attorney after the first denial. However, the second decision -- the Reconsideration -- is made without a hearing or testimony. Therefore, it is not essential that you retain an attorney before the second decision (Reconsideration) and it is really a matter of personal preference and your financial circumstances.
If the second decision (Reconsideration) is a denial, this is the point at which an attorney should be retained. If a timely appeal is filed, your claim will then be scheduled for a hearing and attorney representation at the hearing can be the difference between winning and losing. It is difficult for attorneys to first get involved in the process after an Administrative Law Judge has issued a ruling. If you intend to retain an attorney, contact us before your hearing is scheduled to allow for enough time to properly prepare your claim.
Will I need to pay an up-front fee for representation?
No. The Fee Agreement used by our office typically does not require any up-front payment. The attorney fee is contingent upon your receiving benefits. In other words, we are paid a fee only in the event that you recover some social security benefits.
What advantage is there to retaining an attorney to represent me in my social security claim?
The fundamental reason for retaining an attorney in social security claims is to significantly improve your chances of winning. While you can go through the entire social security process without representation, an attorney’s knowledge of what Administrative Law Judges want can be extremely beneficial.
An experienced attorney will have knowledge of the Social Security rules and regulations that will be used to decide your case. An experienced attorney will also have a good understanding of what it will take in the form of evidence to win your claim. An attorney will also be able to gather and file your medical records. Additionally, an attorney can request opinions from your physicians that could be the difference between winning and losing. Lastly, your attorney will also help you prepare for testifying at your hearing.
What is the process by which social security decisions are decided?
There is a five-step sequential process used to decide social security claims. These steps are as follows:
- Are you engaged in substantial gainful activity as defined by the Social Security Administration?
- Do you suffer from a severe medical impairment that is expected to last for a continuous period of at least 12 months or death?
- Does your impairment meet one of the Listings as defined by the Social Security Disability Regulations?
- Is the claimant able to perform past relevant work?
- Can the claimant perform any other work (other than past relevant work) that exists in significant numbers in the national economy?
The above sequence of questions is a rough framework that is used in social security claims. However, depending on the type of condition, age, and education of the individual, some or all of these steps may apply to an individual case. Please contact us for details.
Can I apply for social security if I have a very limited work history or have not worked at all?
Yes. However, it is important to understand that if you have not worked at all or have not worked enough to establish sufficient work credits to qualify for Social Security Disability Insurance (SSDI), your claim will be for supplemental Social Security Income (SSI), which is a federal welfare program for the disabled, blind, and those over age 65. In addition to a finding of disability, SSI requirements include significant limitations of income and assets. If an applicant (or their family) exceeds the specific income and asset limitations, SSI may not be payable.
What is the difference between claims for Social Security Disability (SSDI) and Supplemental Security Income (SSI)?
The medical requirements are the same in that the individual must be found to be disabled in both SSDI and SSI. In SSI claims there are additional “non-medical” requirements that must be met and these requirements are in the form of asset and income limitations.