SOCIAL SECURITY DISABILITY BENEFITS

Most Americans do not realize that they are covered by a disability insurance plan. The plan is operated by the federal government. Each time a worker receives a pay check, approximately 20% of the Social Security taxes deducted are paid into the federal government's Social Security Disability Insurance plan.

In order to be eligible for these benefits, you must have paid in sufficient payroll taxes in 20 of the last 40 calendar quarters. In other words, you must have worked for approximately half of the last ten years.

Social Security Disability is not a welfare program. There are no restrictions relating to your wealth or income from sources other than work.

Social Security Disability benefits range between $300 .00 and $1,800.00 per month. After a recipient of disability benefits has been disabled for 29 months, he or she receives Medicare coverage.

SUPPLEMENTAL SECURITY INCOME ( SSI)

There is another program operated by the federal government which provides monthly income benefits to poor people who are disabled. The program is called Supplemental Security Income or SSI.

The maximum SSI benefit is about $600.00 per month. This benefit is reduced by the amount of any other income received by the disabled person. This is more of a welfare program and it is only available to people with minimal assets. Persons who qualify for SSI benefits also qualify for Medicaid or Title 19 medical coverage.

QUALIFYING FOR BENEFITS

An individual is considered to be disabled and eligible for benefits only if his or her physical or mental impairment or impairments are of such severity that the person is unable to do his or her previous work and cannot, considering the person's age, education and work experience, do any other kind of substantial gainful work which is available in the national economy. The question is not whether the person could get hired to do the job, but whether the person could perform the job on a regular and sustained basis.

If a person has a physical or mental impairment or impairments which prevent the person from working, the condition must be such that it will last at least 12 months or is expected to result in death.

The Social Security Administration has prepared a "listing of impairments" of qualifying medical conditions. If a person is not working and has one of the "listed impairments" , the person qualifies for disability benefits.

Many people do not have a listed impairment, but are still disabled and are unable to work. These people are eligible for benefits if they are unable to perform their past relevant work, and because of a medically documented physical or mental impairment, are unable to do any other types of work which are available in significant numbers in the national economy. In making this determination, consideration is given to the person's age, education and work experience. There is an age bias in the rules for determining disability. As a person gets older (beginning at age 50), it becomes easier to prove the person is disabled. For people under age 50, it is difficult to establish disability in many cases.

HOW TO OBTAIN BENEFITS

In order to apply for disability benefits, a person must contact their local Social Security Administration Office. An applicant is then required to complete a rather lengthy application and provide information regarding their medical condition, health care providers, work experience and other matters. Approximately 40% of those who apply for disability benefits have their application approved.

For the 60% of those applicants denied, they are advised that they can request reconsideration of their application, if they disagree with the denial. Approximately 17% of those whose initial applications are denied are granted benefits after requesting reconsideration of their case.

For those whose request for reconsideration is denied, there is an opportunity to appeal the denial reconsideration, by requesting a hearing before an administrative law judge.

In a hearing before an administrative law judge, a person is entitled to present all evidence which supports a claim for benefits. Administrative law judges are independent from the Social Security Administration and are not bound by the previous denials of benefits. Just over 60% of those who request hearings before an administrative law judge are granted benefits.

A person who loses a hearing before an administrative law judge does have the right to file an additional appeal to a body known as the Appeals Council. Very few of those who file appeals with the Appeals Council are successful.

A person who loses an appeal to the Appeals Council has a right to further file an appeal in Federal Court. Less than 1% of all claims filed are reviewed in Federal Court.

SHOULD I HIRE AN ATTORNEY

We generally recommend that people file their initial application on their own. When a person files an application, the Social Security Administration gathers the person's medical records. This is done at no expense to the applicant. The approval rate on initial applications is low, and only the most severely disabled people are granted benefits. Those who are able to obtain benefits at this stage are so disabled that they do not need an attorney to help prove their case.

We also generally advise clients to request reconsideration on their own. When reconsideration is requested, the government again obtains updated medical records for the applicant, at no cost to the applicant. Since only 17% of reconsideration requests are granted, only the obviously disabled people obtain benefits at this stage. These people do not need a lawyer.

In most cases, a disabled person will benefit greatly from having a lawyer represent them for a hearing before an administrative law judge. An experienced attorney can review the medical evidence and determine whether there is sufficient evidence to prove a case. A skilled attorney is also able to obtain additional medical evidence to help prove the case. By having doctors write additional reports, or, in come cases, order additional tests, the attorney provides additional medical evidence to prove a case, which evidence was not in the Social Security file previously.

At the Griffin Law Center, we have had successful results in approximately 95% of the Social Security disability claims we have handled.

ATTORNEY'S FEES

Clients are only charged attorney's fees if we are successful in obtaining disability benefits. The fees are 25% of the benefits the Social Security Administration owes the client. Normally, the maximum fee charged is $5,300.00. The client is also responsible for reimbursing our firm for any costs incurred in the handling of the case.