Do I qualify for benefits?
Do you qualify for Social Security Disability benefits? There are several benefit types, including DIB (Disability Insurance Benefits) also called SSD (Social Security Disability), or RSDI (Retirement, Survivors and Disability Insurance), and SSI (Supplemental Security Income). The basic test of disability for all these programs is the same. The question process below will give you an idea of what we will discuss when we meet.
- Are you working and making substantial earnings (SGA)? If so, you do not qualify.
- If you are not working, do you have a “severe impairment” which interferes with your work activity? If not, you do not qualify.
- Is your severe impairment a qualifying disorder or impairment as defined by the SSA? If so, you are “disabled” and may qualify for benefits.
- Does your impairment make you unable to perform your “past relevant work”? If you are able to do your past work you probably will not qualify. If you cannot perform your past work you may qualify.
- Do your impairments keep you from doing any other kind of work? If yes, you are “disabled” according to SSA standards and entitled to receive benefits.
This process can be very complex – one key is persistence. If you have already applied and your claim has been denied, you need to keep going. You need to appeal.
For more information about whether you qualify to receive Social Security benefits, contact Oregon SSD attorney Richard A. Sly.
How long will my SSD case take?
The process of obtaining Social Security Disability income (SSD or SSDI) is complicated and time-consuming. Even with the assistance of a skilled attorney, you are not guaranteed that benefits will be granted. However, the process may be made easier, and go faster, if you have a knowledgeable advocate on your side.
It can be frustrating to know that even though most initial Social Security Disability applications are denied, the process of reviewing the initial application and making a decision can take anywhere from four to six months. In some complex cases, it may take even longer. Unfortunately, this is the way in which the SSD agency operates, and we are at their mercy. Throughout the course of waiting for the initial application to be reviewed, we stay in touch with the SSD administration to ensure that the process is moving forward and report our findings
After receiving a denial of your initial SSD application, we can immediately put together an appeal. However, it is important to note that through the appeals process, it can take anywhere from nine to 30 months for a new decision to be made. We do not let this deter us or our clients. Our firm is committed to seeing the appeal through to the end, no matter how long it takes.
Should I try to work after filing my SSD claim?
When applying for Social Security Disability (SSD) benefits, many individuals wonder if they should attempt to continue working. This is a question that must be answered on a case-by-case basis, as each individual, disability and situation is different. In many cases, it is left up to your doctor to determine if you should be working or not.
The bottom line is: do not compromise your health and safety by working. If you believe you can go to work, and feel up to it, then go to work. If you physically or mentally cannot, then do not attempt it.
“Should I try to work?” Let us discuss it with you during an initial consultation at our office.
One of the most common types of injuries or disabilities that get in the way of work all fall under the category of back injuries. Degenerative disc disease, herniated disc, torn disc, spinal cord and nerve injuries that stem from the back all leave sufferers in extreme pain and unable to perform certain types of tasks. Some back injuries may leave someone unable to stand for an extended period of time; others may not be able to sit for long.
What if I can’t afford a doctor?
When determining the extent of your disability in order to file for Social Security Disability (SSD) benefits, you must be examined by a doctor who can confirm your physical and mental limitations. However, many individuals cannot afford a doctor and therefore do not have the required documentation for the SSD process. They often approach our firm and ask, “What if I can’t afford a doctor?”
Having a doctor’s diagnosis is crucial in obtaining the disability compensation you require. Without it, there is nothing to show that you require disability benefits.
There are some state programs that allow for financial assistance in situations where one cannot afford to be evaluated by a doctor. However, the type and extent of assistance is dependent on the state in which you live. We can review your situation and determine if it may be possible for you to benefit from these programs.
If you cannot afford a doctor but believe your disability may allow you to regain employment at some point, the state of Oregon offers vocational rehabilitation as an alternative to SSD benefits. This way, you are able to deal with your impairment, rehabilitate it as much as possible, develop new job skills and obtain accommodations that allow you to continue to work. If you have attempted this program but come to the realization that your disability is too overwhelming to work, the fact that you attempted to overcome it may have a positive impact on your SSD application from the perspective of the claims evaluators.
What is Supplemental Security Income (SSI)?
Supplemental Security Income (SSI) refers to the benefits paid out by the Social Security Administration (SSA) to people who have limited income and resources and who are:
- Disabled and/or blind adults
- Disabled and/or blind children (i.e., are younger than 18 years old)
- 65 years old or older
- U.S. citizens or nationals or who fall into a certain categories of aliens.
For the purposes of securing SSI benefits, the SSA has created the following specific definitions:
- Limited income refers to the total amount of income a person has from money he has earned from working, from other government (or private) benefits he may receive and from free resources (like food or shelter) he may receive.
- Blindness is specifically defined as having a visual acuity of 20/200 or less in the better eye when corrective lenses are used.
- Disability is uniquely defined depending on the nature of the applicant and his specific condition. For example, the standards for proving a disability for an adult applicant are generally the same as those associated with Social Security disability benefits; however, the SSA has unique standards for SSI versus disability benefits for applicants who are younger than 18 years old.
Additional Requirements for Supplemental Security Income Benefits
Additionally, in order to qualify for SSI benefits, applicants have to:
- Reside in one of the 50 U.S. states, the District of Columbia or the Northern Mariana Islands
- Not be outside of the U.S. for one full calendar month or more (or for 30 consecutive days or more)
- Apply for any other monetary benefits to which they may be entitled (These can include other Social Security benefits, pensions, etc.)
- Complete and submit the necessary application, along with any other requested documentation or evidence
- Comply with any other requirements the SSA has set forth.
Help with your SSI claim
Given all of the requirements the SSA has set forth for obtaining SSI benefits, the application and associated process can be extremely complicated, and one wrong move at any stage of the process can result in:
- Unnecessary, prolonged delays of your case, which can compound any financial burdens you may be dealing with
- An outright denial of your claim.
As a result, if you are in need of Supplemental Security Income benefits, it’s crucial that you work with an experienced lawyer who can facilitate and expedite the process so that you have the best chances of obtaining the benefits you need and deserve.
WHAT IS SOCIAL SECURITY DISABILITY INSURANCE?
Social Security Disability Insurance refers to federal insurance coverage that you have:
- In the event you are disabled and unable to earn a living for at least one year (While people with disabilities that may impact their ability to work for less than one year can receive benefits, these benefits are not provided via Social Security Disability Insurance, which only provides benefits for individuals with long-term disabilities.)
- As long as you have worked for a long enough period of time
- As long as, for the period that you were employed, you paid Social Security taxes.
What You Need to Know About Social Security Disability Benefits
If you qualify for Social Security disability benefits, here’s some important info you need to know:
- In order to prove that you qualify for federal disability benefits, you will need to provide specific medical documentation to the Social Security Administration (SSA). Such documentation, which typically includes various types of medical reports and files, will need to establish (among other things) the nature and severity of your claimed disability.
- Federal disability benefits are generally paid out until you are able to return to work on a regular basis.
- The SSA has some special rules, which are referred to as work incentives, that can provide you with continued benefits and health care coverage to facilitate your transition back to working.
- If you are receiving disability benefits and reach the age of retirement, your disability benefits will automatically become retirement benefits, with the amount of the benefits not changing.
Filing your Federal Disability Benefits Claim
If you are no longer able to earn a living because of a physical condition and/or a mental health impairment, don’t try to file your disability benefits claim with the Social Security Administration on your own. Making even one mistake in the notoriously complicated process can cause your legitimate claim to be delayed or even denied. In fact, about 65 percent of all new claims are denied by the SSA each year.
Instead, optimize your chances of obtaining a favorable outcome to your case by working with an experienced attorney who can help guide you through the Social Security process to help you secure the federal disability benefits you need and deserve.
WHAT IS THE DIFFERENCE BETWEEN SSI AND SSDI?
Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are both forms of financial assistance that the federal government makes available to individuals with specific disabilities as long as they meet certain requirements.
However, despite the fact that SSI and SSDI are both types of federal benefits that are paid on a monthly basis and are administered by the Social Security Administration (SSA), these benefits are different in the following ways:
- People are only eligible for federal disability benefits if they are considered to be “insured,” meaning that they have paid into the system via Social Security taxes for the required amount of time. In contrast, eligibility for SSI benefits is not contingent on applicants’ work history.
- While Social Security taxes fund disability benefits, they do NOT fund SSI benefits. Instead, SSI benefits are financed by personal income taxes, business taxes and other funds managed by the U.S. Treasury.
- While eligibility for SSI requires that applicants have limited income/resources and are disabled, blind and/or at least 65 years old, for federal disability benefits, applicants only need to establish that they have a qualifying long-term disability that prevents them from being able to earn a living.
- Individuals receiving SSI benefits may also be able to obtain Medicaid to cover the costs of their doctors’ bills, prescription medications and other health care needs (depending on the state in which they reside).
- Individuals applying for SSI benefits may be able to use the same application to receive food benefits (again, depending on the state in which they reside).
Applying for SSI or Federal Disability Benefits
Regardless of whether you are applying for SSI or federal disability benefits, the application and approval process for both of these forms of financial assistance are very complicated, and making a mistake at any point along the way can cause:
- A significant delay in the payout of the requested benefits
- A denial of the application
- Additional financial hardships on the applicant.
Given the complexity of the application process, it’s critical that individuals who are applying for SSI or SSDI work with a skilled attorney who:
- Is knowledgeable when it comes to Social Security laws
- Is experienced at compiling SSI and SSDI cases and applications
- Is committed to seeing their case through to a favorable resolution.
WILL MY BENEFIT AMOUNT BE THE SAME FOR THE REST OF MY LIFE?
No. There are a number of factors that can increase the amount of your federal disability benefits or your SSI benefits or that can make it seem as though your benefits have decreased. The following are just some of the factors that may affect the amount of your benefits:
- Cost-of-living adjustments (COLAs): SSI and SSDI benefits generally increase on an annual basis to account for inflation. This increase is known as the cost-of-living adjustment and will depend on the consumer price index, which is calculated by the Bureau of Labor Statistics. For 2014, the COLA has been calculated to be 1.5 percent (meaning that people who receive benefits can expect their benefit amounts to increase by 1.5 percent to account for inflation).
- Medicare premiums: In some cases, it may seem like your benefits have decreased when the cost of healthcare via Medicare premiums increases faster than the cost-of-living adjustments. This means that, despite the fact that you have received a slightly higher amount of benefits due to the COLA, the increase in Medicare premiums has outpaced the COLA, resulting in you taking home less when all of your health care costs have been paid.
- Contributions via Social Security taxes: If you are receiving federal disability benefits and are still working on a restricted basis, the amount of your benefits may increase if and when your earnings increase and you are, as a result, paying more Social Security taxes. In the event that your earnings cause the Social Security Administration to deduct your excess earnings from your benefits, your retirement benefits will ultimately reflect this deduction (and this deduction will likely cause the retirement benefits to increase).
Portland Social Security Disability and SSI Lawyer at the Law Firm of Richard A. Sly
If you are living with a disability, have limited income and/or are unable to work due to your medical condition, don’t try to deal with the Social Security Administration on your own. This system is notoriously complicated and bureaucratic, and even the most minor mistake could result in an outright denial of your legitimate claim.
To give yourself the best chances of obtaining a favorable outcome to your case, you will need the help of an experienced attorney who can help you navigate the Social Security process to help you secure the federal disability benefits you need and deserve.
HOW DO I APPLY FOR DISABILITY BENEFITS?
If you are living with certain physical conditions or mental health impairments and, as a result, are unable to earn a living, you will likely qualify for federal disability benefits, which you will need to apply for with the Social Security Administration (SSA). While you can apply either online (via the SSA’s website) or in person (by making an appointment with your local SSA office), your application will have to include a number of specific documents, some of which include a completed:
- Disability Benefit Application
- Adult (or Child) Disability Report
- Authorization to Disclose Information to the Social Security Administration (also referred to as an SSA Form-827).
Additionally, you will generally have to supply a number of different medical documents and reports to the SSA to verify the nature and severity of your claimed disability, as well as the length of time that you have been living with this disability.
Information You Need to Know When Applying for Disability Benefits
The following is just some of the information that you need to know when applying for federal disability benefits:
- You will need to provide the following information about yourself (and possibly provide the appropriate documentation proving the information):
- Your social security number and age (with documentation proving your age)
- Your doctors (including their names, addresses and contact information)
- Your medical records (including lab reports and test results that may be related to your condition)
- Your work history and federal tax return.
- You will need to provide the following information about the members of your family (and again provide the appropriate proof via official documentation):
- The social security numbers for each family member who may be eligible for disability benefits
- Documentation proving marital status (and any prior marriages if applicable).
- Claims for disability benefits tend to take longer to review and process than other types of Social Security claims. In fact, it generally takes between 3 to 5 months for the SSA to process these claims (however, it can take longer if there has been an influx of applicants seeking federal disability benefits).
- Providing all of the necessary medical documentation and other required paperwork to the SSA upfront will give you better chances of expediting your claim while minimizing the possibility of a denial.
- You will have the best chances of obtaining the maximum possible disability benefits by working with an experienced attorney.
HOW DO THE SSI AND SSDI SYSTEMS WORK?
The Social Security Administration (SSA) oversees various federal benefits, including Supplemental Security Income (SSI) benefits and benefits paid out of Social Security Disability Insurance (SSDI). Such benefits are available to those who are disabled, retired or otherwise qualified because most American workers have paid into the system via their Social Security taxes (or other taxes, like their personal income taxes, business taxes, etc.).
While the qualifications for obtaining these benefits are distinct, the general process associated with obtaining benefits is similar and typically involves the following:
- Completing the necessary applications and forms – The first step in getting a disability benefits or SSI benefits claim started is completing a number of specific forms and filing them with the SSA. While some of the required forms for an SSI benefits claim may include an SSA-8001-F5 form and/or an SSA-827 form, forms associated with disability benefits claims may include a Disability Application form, an Adult Disability Report and an SSA-8001-F5 form.
- Submitting these forms and other necessary documents to the SSA – Once these forms have been completed, the next step in the process will be to submit them to the Social Security Administration – either through their website or in person at your local SSA office (however, you will need to make an appointment ahead of time).At this time (or later if you want to wait for the SSA to make an official request), you will also have to submit other documentation to verify the nature of your medical condition or disability, the severity of this condition, its impacts on your life and the length of time you have been living with it. Documentation to this end typically involves a number of different medical reports.
- Waiting for the claim to be processed – After providing all of the necessary forms and supporting documents to the SSA, you will have to wait for the Administration to review, process and either approve or deny your claim. This can take up to 5 months for disability claims (or even longer if there has been an influx in applications).
- Appealing the SSA if the claim is denied – If your claim is denied, you do not have to accept this denial as the final disposition of your case. Because appeals to the SSA can be even more complicated than the initial application process, it’s important that you work with an experienced attorney to give yourself the best chances of obtaining the benefits you need and deserve.
Portland Social Security Disability and SSI Lawyer at the Law Firm of Richard A. Sly
Richard A. Sly is an experienced Portland Social Security Disability and SSI lawyer who has been committed for more than 30 years to helping his clients:
- Navigate the complexities of the Social Security system
- Build the strongest possible claims
- Have the best chances of obtaining benefits the first time they present their claims
- Mount strong appeals cases in the event their claim has been denied
- Secure the benefits to which they are entitled.
WILL MY BENEFITS CLAIM BE DENIED?
Whether your benefits claim is approved or denied by the Social Security Administration (SSA) will, in short, depend on the circumstances of your case, as well as the specific nature of the application you have submitted. In other words, the SSA may deny your claim for various reasons, which may be medical or non-medical in nature.
Medical Reasons for Claim Denials
The SSA may deny benefits claims for medical reasons that may include (but are not limited to) the facts that:
- The individual is not considered to be disabled or have a qualifying medical condition.
- The alleged disability or medical condition is not severe enough to qualify the individual for benefits.
- The alleged disability or medical condition does not impact a person’s ability to earn a living and/or has not persisted for long enough (i.e., is temporary).
Non-medical Reasons for Claim Denials
When non-medical reasons are the basis of a claim denial, they can include (but are not limited to) any of the following:
- The applicant has not worked for a long enough period of time or paid Social Security taxes (or other taxes) in order to qualify for the specific benefits.
- The applicant has not completed and/or filed the necessary forms with the SSA.
- The applicant has not provided the SSA with the necessary medical documentation to verify his or her medical condition, the severity of the condition, the impacts his condition has had on his abilities and/or the length of time the condition has persisted.
- The medical documents provided to the SSA were not originals or certified copies provided by the issuing office.
Appealing SSA Denials
When the SSA has denied a benefits claim, it’s important that applicants realize that:
- They do not have to accept the SSA’s decision as the final disposition of their case.
- They have the right to file an appeal.
- They will have the best chances of mounting a strong appeal and reversing the SSA’s decision by working with an experienced attorney who will advocate their rights at every stage of the process.
2017 COST OF LIVING ADJUSTMENT (COLA) FOR FEDERAL DISABILITY & SSI BENEFITS
Beneficiaries of federal disability benefits and Supplemental Security Income (SSI) can expect a 0.3 percent Cost of Living Adjustment (COLA) for 2017.
The COLA, which is based on the increase in the Consumer Price Index (CPI-W), is projected to impact more than 65 million Americans, according to the Social Security Administration (SSA).
The following outlines how the 2017 COLA will, on average, increase disability benefits and SSI in 2017 (based on a beneficiary’s circumstances).
|Type of Beneficiary
||2016 Benefits (before COLA)
||2017 Benefits (with COLA)
|Disabled worker with a spouse &
at least one child
|SSI for an individual
|SSI for a couple
Additional Social Security Changes for 2017: What Beneficiaries Need to Know
- Social Security disability thresholds – In 2017, non-blind disability beneficiaries can earn up to $1,170 per month (versus $1,130/mo. in 2016) and still be eligible to receive benefits. Blind beneficiaries will be able to earn up to $1,950/mo. (versus $1,820/mo. in 2016) without compromising their eligibility for benefits. Here, it’s important to understand that earning income may result in a reduction to benefits (and that earning more than the above-noted thresholds can disqualify beneficiaries from being eligible to ongoing receiving benefits).
- SSI resource limits for 2017 – Although there is a COLA for 2017, the resources limits for SSI beneficiaries for 2017 remain unchanged (i.e., they are the same as in 2016). Specifically, these resource limits will remain at $2,000 for individuals and at $3,000 for couples.
- Maximum taxable earnings for 2017 – This year, the maximum taxable earnings have increased by $8,700, rising from $118,500 in 2016 to $127,200 in 2017. The tax rate for Social Security, however, will remain unchanged, staying at 7.65% for employees and 15.30% for self-employed professionals.
A Final Word about the 2017 COLA
While the 2017 COLA increases the amount of benefits that beneficiaries can receive this year, it’s important for beneficiaries to remember (or be aware) that:
- Their cases are subject to regular reviews by the SSA – These reviews are meant to verify that a particular beneficiary still qualifies for federal disability and/or SSI benefits. The frequency of these reviews will depend on the type of benefits being received, as well as other factors (like the health condition of the beneficiary).
- The SSA does not always make the right decision – Unfortunately, officials at the SSA do not always make the proper decision when reviewing claims (for first-time benefit claims, as well as for appeals or existing open cases). This may be due to the fact that they don’t have all of the information they need, they misinterpret the information they do have, etc. The bottom line here is that you should NOT take a denial of benefits as the last word on your claim. If your benefits are denied (or wrongly reduced), it’s best to consult a lawyer who can point out your rights and options.
Need Help Securing Benefits? Contact Portland Disability & SSI Lawyer Richard A. Sly
For experienced help applying for federal disability and/or SSI benefits, contact Portland Disability & SSI Lawyer Richard A. Sly.
Since 1963, Attorney Richard A. Sly has been dedicated to helping his clients navigate the complexities of the SSA so that they can secure the benefits they need and deserve. Skilled at building his clients the strongest possible cases the first time around, Richard Sly is also experienced at pursuing appeals when mistakes or wrong decisions lead to reductions, denials or the termination of benefits.
The bottom line is that, with Richard Sly on your side, you can be sure that you have a seasoned advocate working tirelessly to help you secure the full amount of benefits to which you may be entitled.
Call (503) 406-1471 or email us via the contact form on this page to set up a free, no obligations case evaluation and find out more about:
- What you need to do to position your claim for approval
- How Richard Sly can help you.
Conveniently located in downtown Portland (near public transportation), we serve clients throughout the states of Washington and Oregon.