Social Security Disability Insurance
The Social Security disability insurance program awards benefits to individuals who are unable to engage in substantial gainful employment under the criteria of the Social Security Law. In order to qualify for benefits one must have worked 20 quarters of the last 40 quarters prior to the date of onset of disability (check this). Essentially you must have been employed for five of the last ten years.
Social Security Disability Insurance (“SSDI”) differs from Supplemental Social Security income (“SSI”). SSI is a program for those who are disabled and who may not qualify as a result of insufficient work history.
In either case (SSDI or SSI) the criteria for disability are the same. Applications can be filed by going to a local Social Security Administration (“SSA”) Office, online or by telephone (1-800-772-1213). Initial applications are screened by the New York State Department of Social Services, Office of Disability Determinations. In some cases if the medical evidence meets certain criteria under the Social Security Rules & Regulations ("the listings") benefits are awarded without the necessity of a hearing. However, in most cases disability is denied at this level and it is necessary for an applicant to file a request for a hearing before an Administrative Law Judge. The request for such a hearing must be made within 60 days of the date of the Notice of Disapproval.
If disapproved for benefits at the initial stage, it is often as a result of insufficient medical evidence having been submitted in order to allow a Favorable Decision. Our offices will review the SSA file to determine what evidence was presented. We will then follow up to gather additional evidence, if available. We will also seek to have a Residual Functional Capacity Evaluation completed by treating physicians in order to make available to the fact finders medical evidence in a clear and concise fashion - invaluable in obtaining a favorable result. In some cases, even after disapproval, we can assist in obtaining a Favorable Decision without waiting for the Appeal to be heard by requesting an "on the record decision" based upon additional medical records which we gather and submit to the SSA.
It is crucial to have sufficient medical records documenting physical and mental limitations in order to allow the reviewing agency to determine disability. Our staff is experienced in reviewing medical evidence to determine if you will be successful in the event of Appeal or advising what additional evidence need be obtained in order to be successful.
In almost all cases, no fee will be payable unless we are successful in handling your file in obtaining benefits due you.
In many instances the Administrative Law Judge that hears your Appeal will obtain the services of a Vocational Expert who will testify whether an individual with limitations can perform past relevant work or any jobs which are available in the economy. Cross-examination of such experts by a skilled attorney can often times make the difference between a successful Appeal and an Unfavorable Decision.
SSA reviews all applications for disability insurance and determines whether an individual qualifies. While the SSA maintains a list of impairments that will automatically qualify one for benefits, it is also possible to qualify in other ways. It is important that SSA is provided with accurate up-to-date medical evidence. Our offices undertake the task of ensuring that each application and/or appeal is replete with sufficient and favorable medical evidence. We will also personally appear with the individual at any appeals hearing to safeguard that person's rights.
In order for SSA to fairly evaluate a claim, it is crucial that all relevant information is presented. SSA will require from your medical provider information involving your particular condition, how long that condition has persisted, current treatment plans, frequency of treatment and what effect your condition has had on your ability to work.
More specifically SSA will inquire into work-related limitations. These include your ability to walk, sit, stand, lift, carry, and if applicable concentrate. Through all of this, it is important to remember that your doctor(s) does not decide if you are disabled as with Workers' Compensation; it Social Security that makes this decision. That is why it becomes so important to have quality and experienced representation.
Social Security Disability Areas include:
- Initial Evaluation/Application