About SSI & SSDI
What Every Lawyer Should Know About Social Security Disability
There are lots of different types of lawyers in the world, and if you’re a disability attorney, awesome! You probably already know everything there is to know about Social Security Disability benefits. But if disability isn’t your specialty, maybe you’re wondering what’s involved in this particular niche of law.
And lucky for you, I’m about to run you through the disability law basics that every lawyer out there should know, especially if you ever encounter a client looking to apply for Social Security Disability. Here goes nothing:
The Two Types of Disability Claims
All disability claims are overseen by the Social Security Administration (SSA) and have the same medical eligibility requirements, but there are still two main camps of that these claims fall into:
Social Security Disability (SSD or SSDI)— Disability insurance is a program available to people with a work history. If they’ve worked for at least five out of the last ten years and contributed to the Social Security fund, this is where their disability benefits will be coming from. This program’s beneficiaries usually receive Medicare coverage along with their benefits.
Supplemental Security Income (SSI)—This type of claim is based on financial need rather than work history. Essentially a government assistance program, SSI is for people with disabilities who have less than $2,000 of assets (or $3,000 for a couple) and a very limited monthly income. SSI beneficiaries usually receive Medicaid with their benefits and often qualify for additional benefits like food stamps.
The Qualifications
If a claimant fits into one of the two financial buckets above, next they need to pass the SSA’s medical and vocational qualifications for disability. To qualify for SSDI or SSI, a person must be totally disabled and unable to be gainfully employed. This is an all or nothing program, but a claimant doesn’t have to be permanently disabled to qualify. Generally the SSA will grant benefits to anyone who is going to be disabled for a minimum of 12 months. Once a claimant passes the medical and vocational qualifications, they have to pass all five steps of the disability determination process.
The Five-Step Disability Determination Process
Step 1: Is the person engaging in substantial gainful activity? According to the SSA, a person who’s working and earning at least $1,090 a month is engaged in gainful activity. This person is not eligible for benefits.
Step 2: Does the claimant have a severe impairment? A severe impairment is one that will prevent a claimant from working either physically or mentally for at least 12 months or result in their death.
Step 3: Does the claimant have an impairment or combination of impairments that meets or medically equals a listed impairment? This stage is where a disability attorney’s skills come into play the most since there is a very exact formula of severity and symptoms needed to convince an administrative law judge that a claimant should be granted benefits. You can view the SSA’s complete list of medical conditions and symptoms that qualify for disability benefits on their website.
Step 4: Can the claimant perform his or her past relevant work? This question is usually answered based on evidence from the claimant’s treating doctor, a medical expert hired by the SSA, and the claimant’s personal testimony.
Step 5: Is there any other work in the national economy, given the claimant’s age, education, past relevant work, and residual functional capacity, that the claimant could perform? The SSA will often bring a vocational expert to the hearing to present evidence on this point. It’s the disability attorney’s job to rebut this evidence.
The Procedural Stages
A claimant can be declared lawfully disabled and granted disability benefits at any point in the application process, but the complete five-step process of a disability case includes:
1. Initial Application
2. Reconsideration
3. ALJ Hearing
4. Appeals Council
5. Federal Court
If a claim gets denied in any of these stages, a claimant has a 60-day time limit to appeal and move on to the next stage. Every lawyer should realize that time is of the essence in a disability case, so it’s important not to delay one of these cases. If a claimant’s deadline passes, they have to start the entire process over again and will lose their original filing date, which decides how much disability back pay they receive. So if someone comes to you saying they’ve been denied for disability, be sure to answer their questions in a timely fashion.
Good Questions to Ask if You’re Planning to Refer a Disability Claimant
- What’s your full name as listed on your Social Security Administration paperwork?
- Are you married? Do you have any dependents under 18?
- What’s your level of education? Have you worked five of the last 10 years?
- What is your Date Last Insured (DLI) when you are eligible to start receiving benefits?
- Have you applied for disability benefits before? When were you last denied? Do you have a copy of your last letter of denial?
- Have you attempted to return to work since your disability began? (Get dates worked and amounts earned)
- What is your current monthly income? Are you receiving any form of government assistance such as food stamps or unemployment?
- Who is your treating doctor? Has he or she restricted your work or the amount you can lift in any way?
- Can you afford ongoing medical treatment?
- Are you receiving long-term or short-term disability benefits from private insurance?
- Are there any third parties such as friends or neighbors who can corroborate your restrictions on daily activities?
- Are you an honorably discharged veteran with a potential service-connected disability?
For even more information about Social Security Disability, check out the SSA’s official website at ssa.gov. And if you’re interested in more blog posts like this one, check our post on the top 10 reasons to work with a disability attorney.
About SSI & SSDI
SSDI or SSI: What Makes These Programs Different?
If you are disabled, you can receive help from the government in the form of SSDI or SSI. These two programs help disabled citizens pay for their basic needs. However, the two have different criteria for who to award money to and what you might be eligible for.
SSDI (Social Security Disability Insurance) is an entitlement program that you can access if you have worked before and paid into Social Security retirement benefits. The program allows you to access those benefits early because you have become disabled. SSI (Social Security Income) is for people who are in special financial need and are disabled. Because this program is funded completely by general taxes, there are stringent requirements that one must fulfill in order to receive it.
Here are some of the main differences between SSDI and SSI:
SSDI
- Funded through payroll taxes.
- Available to qualified people who have worked for a certain number of years and contributed to the Social Security trust fund through FICA Social Security taxes.
- Earned after receiving a certain number of “work credits.”
- Eligible for Medicare only after receiving SSDI for two years.
- No maximum asset amount requirements.
- Must be disabled for a five-month waiting period before receiving benefits.
- Spouse and children (over the age of 18) are eligible for partial dependent “auxiliary benefits.”
- Must be younger than 65 to qualify.
SSI
- Funded by general fund taxes.
- Based on financial need.
- Awarded according to low income and low assets—does not deal with work history.
- Can receive Medicaid if eligible for SSI.
- Must have assets less than $2,000 (if single) or $3,000 (if a couple), excluding certain items like primary residence.
- Can receive benefits instantly once approved.
- No dependent benefits.
- Must be blind, disabled, or 65 or older to qualify.
What Do They Have in Common?
SSDI and SSI are both for people who are disabled or blind. However, the eligibility is different when it comes to how old you are. If you are over 65, you can apply for SSI and receive it if your needs match the requirements. SSDI does not cover non-disabled seniors. Those who are not disabled and over the age of 65 are qualified to receive Social Security retirement benefits.
Both programs provide benefits that help take care of your basic needs. Because SSI is a needs-based program, it provides the similar benefit amounts for everyone enrolled. The amount provided by SSI is flexible, meaning you can receive any amount up to the maximum dependent on your need.
On the other hand, SSDI is an entitlement program. Benefits vary according to formulas that the Social Security Administration uses to calculate your specific benefits. The best place to get an estimate of your SSDI benefits is on your Social Security statement. You can see this statement by creating an account on the Social Security Administration’s official website. You can also learn about your Social Security status and other important information at this site.
Even though both the SSI and the SSDI are administered through the Social Security Administration, they have very different application processes. To apply for SSDI, go to the SSA’s online application and follow instructions. SSI is a more difficult process, so we recommend applying at your local Social Security office or on the phone.
About SSI & SSDI
6 Different Types of Service Animals
Did you know that today is National Dog Day? Every August 26, Americans everywhere celebrate the special dogs in their lives. And today we thought we’d celebrate the holiday by talking about service animals.
Animals can help those in need in many ways. A therapy dog is a companion animal that improves mental health by providing assistance to someone with a psychiatric disability, such as post traumatic stress disorder. But these trained dogs can be much more than just a comfort pet.
According to the ADA, a service animal is any animal that provides assistance to a person with a disability. Unlike an emotional support animal for PTSD, service animals also perform tasks to help their owner function normally. This can be anything from supporting them while they walk, retrieving items they drop, or even reminding them to take medication. Traditionally, when we think of a service animal we think of guide dogs for the blind, and for good reason. According to the National Organization on Disability, the vast majority of all services animals are dogs.
1. Miniature horses—This type of service animal has been on the rise in popularity since they’re a great choice for someone with a mobility impairment who needs physical support to walk. Many people who are blind use a miniature horse instead of a guide dog, and there’s actually an entire Guide Horse Foundation for this very purpose. Apparently the miniature horse is really good at its job. The species is naturally cautious, mild-mannered, and sharp-eyed, all of which make for a great assistance animal. And on top of all that, miniature horses can live for up to 30 years. That’s five to seven times longer than your average service dog.But there are actually all kinds of animals that assist people with disabilities. To give you an idea of the variety, here are six animals other than dogs that you probably had no idea could be an awesome service animal:
2. Ferrets—Another unlikely service animal, ferrets have the natural advantages of being easy-going, highly social, and easily transportable. Ferrets make great emotional support animals since they enjoy burrowing close to their owners, which can be extremely comforting to people needing emotional support. But ferrets make great service animals too. These critters are known for alerting their owners when they’re about to experience a seizure, and ferrets can also be trained to wake someone up, remind their owner to take medication, and even interrupt harmful behaviors. Not bad, ferrets.
3. Boa Constrictors—This creature might not be the first animal you’d choose to keep in your home, but they actually make great service animals. These snakes are known for helping patients with bipolar disorder, obsessive compulsive disorder, and panic disorders, and there are even cases when these snakes can be used to prevent medical emergencies. One man in Washington has a friendly boa that will squeeze him more tightly when it senses he’s about to have a seizure, giving him enough time to take his medication or go to a safer location until his seizure passes.
4. Parrots—This is a popular animal for treating psychiatric disorders, namely because many species of parrot have the ability to talk to their owners and deescalate them in stressful situations (something a psychiatric service dog can’t do). A great example of this a man named Jim Eggers from St. Louis who relies on his service parrot, Sadie. The parrot has been trained to repeat the mantra, “It’s OK, Jim. Calm down, Jim. You’re all right, Jim. I’m here, Jim” to calm Jim down whenever she senses he’s about to have a violent episode. Jim used to say the mantra to himself, but now with Sadie’s help he can pre-empt episodes even before they start. Sadie is also trained to alert Jim when someone comes to the door and when he leaves the faucet running.
5. Potbelly pigs—Both highly intelligent and mild-mannered, potbellied pigs can be trained to do all the same functions as the traditional service dog. The only difference is that they’re far cleaner than dogs and also don’t shed as much. Sounds like a good bargain. Plus this particular species is known for being good with kids. Lois Brady from California takes her service pig Buttercup to schools to visit children on the autism spectrum. Since most children don’t have any preconceived ideas about pigs, Brady has found that fewer students are afraid of Buttercup than of a big dog. The pig’s gentle nature also come in handy when he encounters students with aggressive tendencies that would probably make a dog turn around and attack.
6. Capuchin Monkeys—Another very exotic service animal choice is the capuchin monkey. These little helpers are native to South America and weigh about 6 to 10 pounds. Capuchins are especially talented at grasping and retrieving, which makes them invaluable companions for quadriplegics and other disabilities that affect fine motor skills. These monkey can perform nearly any specific task: bringing water, fetching phones, performing basic chores, opening doors, and even feeding someone. There’s an entire organization in Boston called Monkey Helpers that trains little capuchins to be the hands for people who can’t use their own.
Want to read more about service animals? Check out our blog post on how to register a service animal.
About SSI & SSDI
Social Security Updates for July 2015
Like any government institution, Social Security is always changing. If you’re interested in what’s happening in Congress right now, here’s a peek at some current 2015 legislation regarding Social Security:
Ensuring Access to Clinical Trials Act of 2015 (July 16)
This bill allows people receiving Supplemental Security Income (SSI) benefits to participate in clinical trials freely. Because many of these individuals have rare diseases or disabling conditions, they’re often eligible to participate in paid clinical trials. Congress passed a bill in 2009 excluding this compensation from SSI, but the bill was set to expire in October of 2015. The Ensuring Access to Clinical Trials Act of 2015 will effectively remove the expiration date and allow these people to continue participating in clinical trials without the danger of losing their benefits. The bill passed through the Senate with unanimous consent and will now move to the House for further consideration.
Federal Improper Payments Coordination Act of 2015 (July 28)
This bill is designed to grant federal U.S. agencies access to the SSA’s death records through the Do Not Pay (DNP) Initiative in an attempt to prevent and recover improper or duplicate payments. The SSA already shares its death records for research and statistical purposes, but this bill will be improving the sharing and use of the SSA’s data in order to prevent fraud. The bill passed through the Senate with unanimous consent and will now move to the House for further consideration. You can visit the SSA’s website to read more about this bill.
2015 Trustees Report
Every year the Social Security Board of Trustees releases its annual report to Congress. As usual the report showed a surplus of Social Security funds, a nearly $25 billion surplus so far this year. But the board is still projecting that the Social Security Disability Insurance Trust Fund will be depleted in late 2016. Not surprisingly they’re encouraging lawmakers to at least temporarily increase resources to meet the current disability financial needs before 2016. Otherwise disability benefits will need to be cut by 20 percent.
In the past Congress has rebalanced Social Security’s funds to ward off shortfalls, but expansion of the program is another popular option that might occur. Or abolition of the program altogether. How Congress plans to respond remains to be seen, but the Social Security Trustees seem to be in agreement that whatever Congress decides to do, they should do it fast.
Check out the SSA’s website to read the full synopsis of the Trustees Report.
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