Strategies To Qualify For Benefits And Get Money Faster
Many people find applying for Social Security Disability benefits or Supplemental Security Income to be among the most frustrating of all experiences. As any disability attorney or SSI lawyer will tell you, frequently those who legitimately qualify for assistance are unfairly or wrongly denied. Statistics reveal that 60 to 70 percent of claims nationwide are refused. In these instances, obtaining benefits becomes a long, drawn-out affair that can span years.
Fortunately, there are ways to speed up the process by sidestepping common pitfalls that cause delays. Additionally, there are methods to present your case in the best possible light. These are principles that have shown themselves to be effective over many years in a vast number of cases. You’ll find them all clearly explained in this report.
Whether you’re applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), the strategies that work are the same. That’s because other than work history and financial requirements, the disability qualification process for both programs is identical. Competent Social Security Disability attorneys or SSI lawyers are familiar with these techniques and use them on a regular basis.
Please know that these methods for winning your case are not legal advice. The process of becoming eligible for benefits can be quite complicated, and you’ll be best served by finding proper legal representation. The ideas and concepts that follow are intended to assist you in having a productive discussion with your lawyer and in understanding your case clearly.
Additionally, this discussion is geared for applicants who are applying for benefits in New York, New Jersey and Connecticut. While the techniques are generally relevant in all states, you’ll have to consult an SSDI/SSI attorney in your locale to determine how they apply to your specific situation.
As long as you keep those qualifiers in mind, read on to discover how to get your benefits as quickly as possible.
Understand Your Rights
To get your Social Security Disability or SSI benefit award as quickly as possible, it’s best to start by clearly understanding the rules governing eligibility. Here’s a concise overview of what you’re entitled to.
There are two branches of Social Security law that apply to disability benefits. The first is Social Security Disability Insurance, or SSDI regulations, which apply to applicants with an established work history. The second is SSI or Supplemental Security Income, which encompasses claimants who, under current rules, are considered to be at a poverty level.
To qualify for Social Security Disability benefits, you need to have worked for 40 quarters, or 10 years, including five of the past 10 years. There are exceptions for younger people. If you are in your 20s or early 30s, you may be eligible with a shorter work history. An SSDI/SSI lawyer can advise you on these particular distinctions.
To qualify for SSI or Supplemental Security Income benefits, there are no specific work history requirements. Since this program is for the impoverished, however, you cannot have assets in excess of $2,000 for an individual or $3,000 for a family. Assets include cash, investments, real estate you own beyond your primary residence and vehicles other than your main transportation. The cash value of any life insurance policies and other assets can count as well.
With either Social Security Disability or SSI, you cannot earn more than $1,170 per month and still be eligible for benefits. This is the “substantial gainful activity” amount, assigned by the Social Security Administration (SSA). The SGA amount is usually slightly increased each year to keep up with the cost of living. If you earn more than this, Social Security considers you to be able to earn enough through employment to be disqualified for benefits, even if you’re disabled. Also, keep in mind that this is a “gross” figure, not net after taxes and deductions.
Other than these distinctions, the disability requirements for both programs are the same. You have to be disabled with a condition that has lasted or is expected to last 12 months. During this time, you have to be incapable of working at any job in the national economy on a full-time basis. If you can’t work at a full-time job on a sustained basis and meet all other requirements, you’re entitled to benefits.
Note that you do not have to wait 12 months after your disability starts to apply for benefits. Once you’re ill or injured, you can apply immediately and get the process started.
With Social Security Disability, the dollar amount of benefits you get is roughly the same amount you would receive at full retirement age. You can go online at www.ssa.gov to find out what your monthly benefit amount would be if you’re found to be disabled, or call SSA directly at 800-772-1213.
With Supplemental Security Income, you receive a fixed amount. The amount you receive for SSI varies by state and living arrangements, among other factors, but is generally less than $900 per month.
Even though Social Security Disability and SSI are federal programs, once you apply, the initial determination on your application is made by the state. SSI is partially funded by New York state and is administered by the Office of Temporary and Disability Assistance.
Hire An SSDI/SSI Lawyer To Represent You
The process of qualifying can be complicated, time-consuming and frustrating. There are hundreds of exceedingly complex rules and regulations. A competent Social Security Disability and SSI attorney who practices primarily in this area will have a working knowledge of these and be able to use them to your best advantage. It’s similar to going to a specialist when you have a serious medical condition. The physician with in-depth expertise is most suited to give you the best treatment.
Some law firms employ non-attorney representatives to handle their SSDI and SSI cases. You’ll need to evaluate whether these individuals will be as effective in obtaining your benefits as a lawyer would be. Similarly, at some firms, most of the work on your case will be done by support personnel who have only paralegal or secretarial training. When you’re choosing a firm, it pays to ask questions about who will actually do the work on your file and represent you at Social Security’s Office of Hearings Operations. Your benefits award depends on the knowledge, experience and skill level of these people.
Additionally, there’s a lot of paperwork involved in the process from initial application through appeal. Many claimants fill out the forms improperly and fail to submit them in a timely manner. Either of these errors can have serious consequences. At the very least, you’ll suffer a delay of months. In some cases, mistakes can actually result in the dismissal of your claim. You can avoid this difficulty with a disability attorney’s help.
SSDI/SSI lawyers usually work on a contingency basis. That means you don’t have to advance any money to hire one. An attorney is paid only if he or she wins your case and usually receives 25 percent of any back benefits you’re awarded, up to a maximum of $6,000. So there’s no reason to think you can’t afford a disability lawyer.
The bottom line is that there’s a significantly higher incidence of benefits being awarded in cases with professional representation than those in which claimants represent themselves.
Don’t Feel Ashamed
A lot of people who’ve worked their whole lives and are now disabled feel guilty or ashamed about applying for benefits. They think Social Security Disability benefits are equivalent to welfare, and it’s demeaning to apply for them. In fact, this is a main reason many delay in submitting their claims.
Let’s clarify the issue. Applying for Social Security Disability benefits is exactly the same as putting in an application for benefits from any other disability insurance policy you’ve paid into. The only difference is this policy is issued by the federal government. You are not asking for a handout. You paid for this coverage with your tax dollars so it would be available if you needed it.
Consequently, there’s absolutely no need for you to feel any shame whatsoever in applying. You’re entitled to benefits if you meet the work history and disability requirements. It’s that simple.
Similarly, Supplemental Security Income or SSI is a public benefit for disabled people that is ultimately funded with tax dollars, and no one should feel guilty about applying for it. The wisdom inherent in the American system acknowledges that sometimes citizens need financial assistance, especially when they’re disabled. Things happen in life — from time to time, almost everyone needs some kind of help. So don’t hesitate to ask for what you need.
Whether you are seeking Social Security Disability or SSI benefits, you should always apply as soon as you become disabled. Some applicants wait months or even years to file, and then tragically lose their opportunity to collect.
With Social Security Disability, if you let too much time pass before applying, you could be out of luck even though you might have worked enough to qualify. For example, although you may have worked for 10 years, if you wait, you could become ineligible because you don’t have a total of five working years within the past 10. The 10 years are counted backward from the day you apply. Had you filed sooner, you would have met the requirement and qualified.
Sadly, many people who are eligible don’t apply in enough time to qualify. This “five years of the past 10” requirement knocks a lot of people out of qualifying, even though they satisfy the 40 quarters, or 10 years, of work history rule. Once you’re beyond your “date last insured,” you won’t get SSDI benefits even with a lawyer’s help — unless you can satisfy the difficult burden of proving that your disability started years before your application. Waiting is dangerous.
Even though these work history requirements don’t apply to Supplemental Security Income or SSI, it’s still a good idea to file an application for benefits as soon as you become disabled, since your payments start from the month following your application date. In addition, because qualification can be an extended process, sometimes spanning a year or two, applying early will speed up your access to much needed financial assistance.
Any back benefits you receive will be determined by the date of your application. With Social Security Disability, you can receive back payments up to 12 months prior to the date of filing, depending on the onset date of your disability. For SSI, you’ll receive benefits only from the date of application.
One case the Law Office of Stephen M. Jackel handled involving an autistic adult client illustrates the point well. She had a long history of working at fast-food jobs, but experienced difficulties after her father died. Once Stephen secured SSI benefits for her, she was able to continue receiving group and individual therapy and caretaker visits four evenings a week. Additionally, it allowed her to move into supportive housing and maintain her independence. Had she waited, it could easily have precipitated a financial crisis that would have disrupted her therapy and new living arrangements.
You don’t necessarily need the assistance of a Social Security Disability attorney or SSI lawyer to apply. Although professional representation is advantageous in many ways, you can file a claim by yourself either online or at your local Social Security office. To apply online, go to www.ssa.gov.
Provide Everything Needed For A Favorable Decision
One of the most common reasons for denial of benefits is that Social Security doesn’t have all the information it requires to award benefits. What’s usually missing is appropriate medical documentation of the disability.
In some cases, the claimant doesn’t supply what the Social Security Administration needs. In others, it’s because doctors or hospitals don’t cooperate and forward records or those they do supply are not in the most helpful form. The claimant has the burden of proof through most of the process so if the necessary medical information isn’t supplied, the chances of getting a favorable decision are greatly reduced. When an administrative law judge has to make a determination based on insufficient information, the answer will almost certainly be no.
Many people, particularly those suffering with emotional illness, find it difficult to compile all the required medical data and assemble it properly. Case files, including transcripts of a prior hearing, are frequently 400 pages or more. But without good records and physician reports, getting approved is much more difficult.
Also, Social Security will send most applicants to its own consultative physicians, who many times perform only cursory examinations. This happens whether it’s an evaluation for mental illness or physical disability. In fact, sometimes you’ll even be sent to two doctors. Frequently, a Social Security consultative physician will say, in effect, “The claimant has this and that wrong, but in my opinion is able to do light work.” Or medium work. Or just enough work not to get any benefits.
Additionally, a larger percentage of people under 50 years old are denied. If you’re under 50, you are considered a younger individual by SSA and it’s difficult to qualify initially, unless you have a serious illness or injury that is substantiated by medical records. At age 50, Social Security regulations make eligibility a little easier.
So whenever you file an initial application or an appeal, be sure to include your most recent medical information with your request, including any test results. The more data to support your position, the better. Be aware that if you don’t have medical data from the last 90 days, you will almost certainly be required to get an independent medical evaluation by a Social Security doctor.
These are added reasons why you want to retain an SSDI/SSI lawyer. A diligent attorney will contact all your doctors, hospitals and treatment facilities and develop a coordinated plan to win your benefits. He or she will contact your treating physicians, gain a thorough command of all the facts relating to your illness or injury and be ready to effectively answer any question a judge may have when you attend your hearing.
List all of your medical conditions on your application, including any mental illness or impairment. Some claimants neglect to do this and are denied benefits because the picture they present does not show them as disabled.
Remember, it’s not the medical condition itself that is the issue, but rather how it limits your capacity to work. If a disability examiner or a judge does not see your overall health condition as diminished enough to fit the definition of being disabled, you won’t get any benefits. Consequently, it’s in your best interests to fully disclose all medical and psychiatric factors relating to your health status to establish a legitimate basis for an award.
If you have to appeal an initial denial, an administrative law judge will base a decision primarily on what’s in your medical records. While your testimony at the hearing will be important, the judge will most likely be reliant on medical documentation, especially objective records like MRIs or X-rays. Judges especially want to see records and reports from treating doctors.
Don’t assume that because you’re not currently being treated for a condition that it’s not relevant. The fact that impairment exists is a critical aspect of your total health profile and should be listed on your application.
One of the main reasons it’s important to be complete is that if your condition fulfills Social Security’s pre-established requirements for disability, you’re automatically eligible for benefits. This is called “meeting a listing.” The phrase refers to Social Security regulations that list specific elements of an illness or injury, which are considered in total to constitute a disability. If you qualify in this way, it’s a very clean-cut decision and it will be significantly easier for your SSDI/SSI attorney to get an award for you.
Here’s an example. The firm represented a man in his 20s suffering from AIDS and mental illness. In New York, AIDS used to be a routine favorable decision. That’s no longer the case, since now it often can be controlled with medication and people with the disease can still work. Although the client’s physical condition was under control, we were able to “meet a listing” with psychiatric testimony and won his case.
You should also be thorough in including your previous work and educational experience. In this way, you may be able to take advantage of “the grids.” These are vocational and educational guidelines. The grids are used in combination with medical parameters and take your age, education and previous work experience into account to determine if you can work. For instance, a claimant who is 55 or older, with limited education and unskilled work experience, by law may have to be considered disabled, depending on the limitations caused by his or her illness or injury. This can help you to short-circuit an otherwise lengthy approval process and get a quick decision.
With serious illness, time is often of the essence as far as benefits are concerned. One client was a victim of myasthenia gravis, a grim medical condition causing fatigue, blurred vision, difficulty swallowing and overall weakness. We obtained all the records from her neurologist and made a persuasive case before the administrative law judge at her hearing. The result: We won almost $16,000 in back benefits for her and the ongoing financial support she desperately needs as this dreaded disease progresses.
Needless to say, if you’re seriously ill or have been badly injured, you don’t want a delay caused by not supplying the appropriate information. If you have trouble getting records from doctors, hospitals or clinics, your lawyer can ask the judge to subpoena them. If you have questions or doubts about what to write on any Social Security form or how to respond to any question, you should ask your attorney first.
Beware Of Misinformation
There have been instances in which claimants have been given misleading information by Social Security personnel. For example, some applicants go to their local office to file a claim soon after falling ill or being injured, only to be told they need to wait 12 months before filing. This is entirely untrue, as long as the disabling condition is expected to last for at least 12 months. In fact, as previously mentioned, it’s to your advantage to file immediately and get the process started.
So be careful about where you get your information. It may not be accurate. The best defense against misinformation is to check with your lawyer.
Be Prompt In Everything
Once you receive a denial letter from Social Security, you have only 60 days to file an appeal. If you don’t respond in a timely fashion, you lose your right to appeal.
If you’re even 10 minutes late to your hearing, your case can be rescheduled and you may have to wait months before you see the judge. At worst, your case can be dismissed, and you’ll have to start the entire process all over again. Never miss a hearing, unless you’re too ill to attend or it’s a genuine emergency. If you have to start over, it may be two years before you see a dime of benefits, even if you do win.
If you move and don’t let Social Security know your new address immediately, a disability examiner may have difficulty contacting you and deny your claim because your whereabouts are unknown or for “failing to cooperate.” Also, if you don’t get a denial letter because of an address change, the time in which to file an appeal may slip past you.
If you receive a letter from a disability examiner requesting a phone call, respond immediately, but notify your SSDI/SSI attorney first. Whenever you receive any notice from Social Security, call your disability lawyer. Correspondence from Social Security officials is often confusing and can easily lead you to make a mistake that results in a delay or denial of your claim. It’s best to get professional advice on how to respond.
Keep everyone involved with your case up to date with regard to your medical status and contact information, and you’ll avoid unnecessary problems. Follow this rule to avoid unnecessary delays and aggravation: Be alert, responsive and precise in all your dealings with Social Security.
Stack Your Benefits
Depending on your work history, previous and current income and current assets, you may apply and qualify for multiple benefits.
If your work history is limited, a Social Security Disability award might be a small amount because you haven’t paid much into the system. However, you can get Supplemental Security Income to bring your total benefits up to the New York minimum, which is adjusted each year for inflation. In that case, SSI “supplements” your Social Security Disability income.
If you were injured on the job, you can receive workers’ compensation and Social Security Disability, but your total benefit cannot exceed 80 percent of what you were earning. Your SSDI/SSI lawyer should be able to refer you to a reliable workers’ compensation attorney to assist with that part of your case.
There are also reasons SSI benefits may be reduced. For example, if you’re disabled, but are living with a spouse who earns money, then you may not qualify for benefits or you might get less than the full amount. Or if you live with a parent or a roommate who pays the rent and buys food, your benefits are going to be reduced.
Disabled government employees may be entitled to SSDI benefits in addition to their city, state or federal pensions. Disabled uniformed employees such as police officers, firefighters and corrections officers may receive SSDI benefits in addition to their disability or regular pensions.
As you can see, these combinations of factors can complicate the formula by which your ultimate benefit determination is calculated. This is yet another reason to have professional representation. A competent disability lawyer can help you sort through all the details, figure out what you’re legally entitled to receive and fight on your behalf to get it.
Change Lawyers If You’re Not Happy With The Service You’re Getting
Here’s what your attorney should be doing for you:
- Coordinating with your doctors and hospitals or clinics to compile a complete medical file
- Obtaining supporting statements from your treating physicians
- Making sure the administrative law judge has all the relevant medical evidence
- Preparing a “theory of the case” letter, which some judges request in advance as a concise summary of your position — the better disability lawyers will even prepare these when not asked, if circumstances warrant it
- Preparing you for the hearing by explaining what to expect, counseling you on responding to questions, and familiarizing you with the judge’s personality and approach
- Tracking and keeping you abreast of developments in your case
- Answering all your questions with clear explanations
- Returning your phone calls promptly
If you are not getting this level of service, consider visiting another SSDI/SSI attorney and switching. After all, your financial future is on the line, and you’re entitled to the best representation you can get.
Additionally, not all attorneys have full-service SSDI/SSI law firms. For example, some lawyers will not take child SSI cases because they can be difficult to win, with many more factors to deal with. These include the parents’ income, expenses, and the number of other children, to name just a few. Here’s an example.
The Law Office of Stephen M. Jackel helped the parents of a 12-year-old child with oppositional behavior. The boy rebelled against any authority figure, was violent, had serious emotional problems and a mild learning disability. He was disruptive at school and required medication. By establishing a rapport with the assistant principal and getting extensive reports from the school, we were able to put together a solid case, in conjunction with the usual medical records. His parents were awarded $8,000 in back benefits and continuing monthly support on behalf of the child.
Ask a lot of questions before you decide on a lawyer.
Be Prepared For A CDR
A CDR is a continuing disability review. Once you’re awarded benefits, Social Security will check up on you periodically to see if you’re still disabled. Typically this is every two or three years, although it could be sooner. Sometimes it’s annual.
If you no longer are deemed to qualify, your benefits will stop. Worse, you may end up owing Social Security money, and have to pay back your benefits. This would occur if it was determined that your disability ended at a certain point, and you received payments beyond that time.
To avoid these problems, keep your medical records up to date. Continue to see your doctor and get treatment. In this way, you make sure there’s medical documentation that substantiates your condition and inability to work. Generally, if there’s no medical improvement, Social Security considers your disability status to be the same.
It’s to your advantage to anticipate and be prepared for scrutiny. Few experiences are more devastating than receiving a letter from the government saying your income stops immediately, and you owe Social Security thousands or even tens of thousands of dollars.
Send A ‘Dire Need’ Letter
A dire need letter spells out specific circumstances that expose a claimant to immediate danger. These include eviction or foreclosure, not being able to pay for essential medications, loss of needed services such as utilities, child support obligations, etc.
Sending a convincing letter such as this to Social Security’s Office of Hearings Operations can speed up your request for benefits through an “on-the-record” review. If granted, your claim will be evaluated before the scheduled hearing date, expediting your opportunity to gain benefits.
You won’t get an on-the-record review without compelling medical evidence or true dire circumstances. If your request for a faster decision is denied, you can notify your local congressional representative and ask him or her to intervene. With a call from a congressional office, you may get faster action. You have nothing to lose by trying, if your circumstances genuinely warrant it.
A dire need letter is best drafted by your disability attorney. Additionally, your SSD/SSI lawyer can prepare letters to creditors who are harassing you. Once they’re informed that you are awaiting disability benefits because you are unable to work and have no income, they may be more amenable to working out a payment arrangement you can live with.
Here’s an example of a particularly difficult Social Security Disability case in which we got a quick decision and award. The client suffered from diabetes and serious psychological problems. The firm submitted the necessary dire need request, loaded with medical proof, and contacted Social Security staff attorneys to request an “on-the-record” immediate decision. Our presentation of the facts was so convincing that the benefits were granted without the client even having to wait for a hearing.
Get A Referral To An Elder Law Attorney
In some instances, those who are injured in accidents will receive a significant sum of money as a result of a personal injury lawsuit. In other cases, people get inheritances or have relatives who want to assist them financially.
In either of these scenarios, your disability benefits can be lost without proper planning.
Fortunately, the law allows you to create a special trust to receive the funds, and you can still qualify to get your benefits. These trusts fall within the province of a legal specialty practice known as elder law. Your lawyer can refer you to an elder law attorney who can draft the necessary trust documents.
If you get a settlement or award through a personal injury lawsuit, the proceeds can be placed in a first-party supplemental needs trust. Legally, once financial assets are put in a trust, you no longer are considered to be in possession of them, and it’s for this reason that they don’t affect your benefits. However, the funds can still be used for your benefit. For this to happen, you’ll have to appoint a trustee who will make decisions about using the money on your behalf.
If you have a friend or relative who wants to help you financially, you can gain a major economic advantage by having them put the money in a trust for you, which can be done while they’re alive or after they pass on. In this case, a third-party supplemental needs trust serves the function. Financial resources can be placed in the trust for your benefit without disrupting your disability income.
If you receive a substantial amount of money and don’t use a trust vehicle to protect it, you’ll lose your SSI benefits and won’t be able to get them back until you spend down all the funds. Social Security takes the position that if you have money, you should use it for your own support rather than the government paying for your needs.
Some people have an issue with appointing a trustee and fear that they’re losing control over their own money. However, strict laws constrain what a trustee can and cannot do. If you select someone you know is responsible and has your best interests at heart, you can keep your SSI benefits and retain the advantage of any financial resources you receive through a lawsuit, inheritance or other support.
Trust law is complex, and many other factors apply to their use. While many Social Security Disability and SSI lawyers don’t handle the formation of trusts, they often will have a working relationship with competent elder law attorneys who can assist you.
If Your Condition Worsens, Reapply
If you go the distance with your claim and are denied benefits at every level, you should still reapply for benefits if your condition gets worse. If new medical evidence can prove that your medical status has degenerated to the point of interfering with your ability to work, you’ll have yet another chance to qualify.
Here’s an example of a case in which a medical condition deteriorated and we ultimately won benefits. The client worked in a supervisory role for a contractor who provided services to a major telephone utility. She was in her early 50s when she suffered serious injuries in a fall down a flight of stairs. Suffering severe pain in her hip, lower back and knee, she ultimately needed hip replacement surgery. Incredibly, even with these limiting injuries, Social Security denied her benefits.
To make matters worse, she developed depression as a result of the chronic pain. She was then forced to move in with her daughter, since all her financial resources were depleted as a result of not working. Over a six-year period since her initial injury, her life deteriorated in multiple and terrible ways.
When she retained the Law Office of Stephen M. Jackel, the firm immediately set about obtaining up-to-date medical proof of her disability. With a recent MRI and physician confirmation of her ongoing pain and subsequent depression, we were able to present a tight case that swayed the judge’s decision in her favor. We won more than $20,000 in back payments and an award of ongoing monthly benefits.
Although this was not a case in which the claimant had to reapply for benefits, the point of it is still relevant and clear. If your condition gets worse, pursue your benefits with new documentation of your current health status.
Beyond that, this case holds another lesson. Never give up hope. With the right approach and strong representation, you can qualify for benefits and get the financial support you need and deserve.
Results Are Achieved By Those Who Pursue Them Intelligently
You now have the crucial keys to winning benefits. It’s up to you to apply for them. These principles have won cases for many disabled individuals who had their financial backs to the wall. They can deliver similar advantages to you.
The most important thing to do right now is to get the process started. As you’ve seen, getting your benefits can take time. The sooner you get money coming in, the faster you’ll be on more solid financial ground.
If you need help, call the Law Office of Stephen M. Jackel at 212-393-1300, or contact him by email. Social Security Disability and SSI cases are the firm’s primary practice areas.
This site provides information about obtaining Social Security Disability and Supplemental Security Income (SSI) benefits, but it is not, nor is it intended, to give legal advice or apply the law to anyone’s individual circumstances. While we welcome your telephone and email inquiries, no attorney-client relationship is created simply by contacting the Law Office of Stephen M. Jackel by telephone or email. It is strongly recommended that you consult an attorney to obtain legal advice regarding your own particular situation. Every case is unique, with its own facts and applicable law, and success in prior cases does not guarantee results in your individual case.