On the subject of requiring a lawyer to get a disability claim approved, which seems to be the common belief: When my late wife filed for disability benefits and was initially denied, I filed the appeal request myself. The denial was upheld, at which point I requested a hearing by an Administrative Law Judge (the next step in the appeals process). While waiting for the hearing to be scheduled, there was an automatic review of her claim. This was (and may still be) standard policy to try to reduce ALJ caseloads. The reviewer determined that the original denial was incorrect; apparently whoever had denied the claim had neglected to consider how her various conditions combined to make her unable to work.* The entire process, IIRC, took less than a year, and within a month of receiving the approval notice she was paid all the back benefits due based on when the claim had been filed. I guess we just got lucky?
*She had vision problems which made it virtually impossible to do clerical work, and mobility issues which would have still allowed her to do clerical work.
I don’t know if it still is, but blindness used to be an “express lane” for disability. I got mine approved the month after I self-filed, with just one doctor report, and it was never reviewed.
From one who has been through the process, myself, by myself, for myself, with one of the “listed diseases”.
Facts:
You need 40 credits, not 80.
A credit is one quarter worked.
20 of those credits in the last ten years makes it easier.
SSDI benefits will not start until six months after disability eligibility date.
If someone, like above here, says they got their pay in two months, it means their DED was 8 months ago.
You SSDI benefit is your FRA amount.
Lawyers fees are capped by law, by the SSA.
(I want to see case law wherein the fees over the cap was awarded.)
YOU CAN APPLY ONLINE.
Apply immediately.
The Feds sub contract with (some of) the states for determination.
The Feds Can and will override their findings.
MEDICARE eligibility starts two years after the DED.
Opinions:
If you are older, with an unbroken work history, it is more likely you will
be approved, especially…
If you have a critical mass of doctor’s exams and lab reports documenting quantitative results
regarding the disability, it is more favorable than “I’m too depressed”
Hiring a lawyer is not NECESSARILY a help.
Most of the time a clerk will fill out the paperwork, maybe an esoteric point of law may come into it, but not usually. Besides, judges don’t like these guys and gals.
Do it yourself.
If you get denied, do the first ALJ yourself.
Send everything registered with return receipt requested.
Be neat and courteous, the SSA people just need to,“check the box” in their process.
So, if they ask for form ABCDWXYZ9876.54321, signed by your doctor, get it done. Then send the Dr’s receptionist flowers. You will need them again.
Everything, all of it, all the time. Get to know your UPS store people.
The “easy” cases are approved almost immediately, in government terms, that means 6 months.
You will get retroactive benefits back to your DED, for a maximum of two years, but there is some gymnastics about application date, first disabled date, and DED, they will explain it all to you.
I don’t think that cite is worded very well. AFAIK, the determination of whether or not you are considered disabled (by the SSA) is NOT based on your work credits. However, if you don’t have enough work credits you won’t be eligible for SSDI. Difference being, if you are determined to be disabled you can at least get SSI even if you don’t have enough work credits for SSDI.
The most important thing is to apply as soon as possible because even if you are rejected a first and then a second time, your backpayment grows all the while if you are finally deemed disabled by a Federal judge (that’s after they reject you a second time on appeal).
What is this cap on back-benefits? Who says ‘Giddyup’? The attorney? Why does he say goodbye? S/he either wins the case, gets you your back bennies plus monthly benefits going forward (minus the set percentage fee on backpayments), or they lose the case and you aren’t out a cent (with some small/rare exceptions).
Back-benefits are those that continue to accrue while nothing else is happening. There is a cap on how much of that the lawyer can receive as his fee, and he ha no incentive to file your appeal while that number is growing. He gets nothing from your benefits going forward. The lawyer fee is typically $5-10K. Forgot the percentage, about half of a year of backpay.
Social Security disability is probably the ONLY subject in which I would claim to be expert. For more than 33 years, the entirety of my fulltime profession has concerned Social Security disability. But feel free to disregard anything I have to say. Admittedly, I have formed personal opinions about various aspects of and players in the system.
The SS disab program is VERY complex, not all of it is rational or even internally consistent, and there are MANY “special rules” that might apply to one individual but not another. As much of an expert as you might feel you are based on your one case (or even a few cases), you should know that you are only an expert in that one/few case(s). You may be ignorant of some factor/rule that simply did not apply to you, but that dictates the outcome of an apparently similar case.
Re: time required - this morning I am working up cases to be heard on Friday, in which the applications were filed in March 2019. These were transferred to our office from another office with a greater backlog than ours. So different areas within different states can move faster or slower. You can find these stats online. We have to schedule hearings >75 days in advance, so these claimants received 2 administrative denials (initial and reconsideration) and had hearings scheduled approx 10 months after their application was filed. Decide for yourself whether that is an unreasonable amount of time.
If you file right now, expect the times to be longer. Disability applications generally mirror unemployment filings. The state agencies have drastically curtailed some of the services they provide on initial and recon (and hearing) level, and the rest of SSA is struggling with how to provide services on-line and via phone.
Approximately 30% of claimants prevail at the initial level. And those decisions are usually issued within a couple of months. I wonder how many of those folk think the system too slow? Those were people who were clearly disabled. Most people who make it to hearing level have closer cases - many in which reasonable people could reach different decisions. At hearing level, last time I checked, approximately 43% of claimants received favorable decisions. Those stats could mean various things to various people. Make of them what you may.
Everyone along the way - including ALJs - is human. They are capable of making mistakes, or even letting their emotions influence their decisions. So - for example - it will generally not help your case to piss off whoever is working on it, or make their jobs unnecessarily difficult. Hopefully the staff will be professional enough to not let their emotions come into play, but why take the chance? Moreover, although the SS staff will try to treat you as an individual, and although your case is THE MOST IMPORTANT case to you, realize that you are only 1 of 100s of cases on that employee’s workload, with a seemingly endless mountain of cases waiting behind yours. Not intended to make excuses, just suggesting you be aware of the realities. While you are entitled to the process you are DUE, you are NOT entitled to (nor will you receive ENDLESS process.
Further, being human, 2 different ALJs could issue different decisions on the same case. In my office, I believe the payrates range from approximately 30% to 65%, with most in the low 40s. it is not an entirely objective process. So you are fortunate if your case is assigned to the ALJ who pays 65%, rather than 30. And maybe an ALJ had a loved one who suffered from your exact condition. Or has other experiences. Like I said, they are human. And fallible.
Having said all that, I feel comfortable identifying only 2 factors as most determinative of an individual receiving a favorable decision.
BE DISABLED (as that term is defined by SS). You may not realize that I regularly hold hearings in which the clmt is employed, at levels which preclude receipt of SS disab bens. Many people simply do not understand the legal requirements. The fact that you are unable to do your past job may be of little import. The same for the fact that your local economy is in the crapper. Or that you KNOW no one is going to hire someone with your education, medical record, criminal record…
It is fine to be pissed off at SS staff if you feel they are responsible for delay. But you might want to direct at least a portion of your ire towards folk who are filing meritless claims. Each of their cases takes as much time as yours.
And it doesn’t mean you get SS disab bens simply because you, your doctor, your employer, their insurer, or the VA considers you disabled. They do not get to make the decision, and the standards they apply are likely different than SS’s.
ACTIVELY AND HONESTLY PARTICIPATE. You might not believe how many cases come up for hearing, in which the claimant has not responded to a single letter or phone call, and the record contains no evidence for the past year or more. If you are going to the doctor, and if you tell the Agency where to locate your records, and if you promptly respond to Agency queries, that will greatly speed up the time.
And you may not appreciate how fatiguing it is to have claimants - AND REPRESENTATIVES - flat out lie to you over and over. I would be lying if I said it did not make one cynical and desirous of confirmation/corroborations of any subjective claims.
I note, attorneys are among the worst at this. Too many attys fail to work up the medical record until shortly before the hearing. The reason is simple. They are (with some exceptions) limited to 25% of back benefits. This has 2 effects. The atty benefits from delay, because that increases the back benefits of which they might get a quarter. Also, since the atty fee is essentially fixed, the atty benefits from doing the LEAST amount of work to obtain that fee.
For the VAST majority of attys (and especially the major local/national firms), the only way to profit is to handle a large volume of cases, having low-level staff perform most tasks, and doing things as routinely and with as little time and effort as possible. Just the reality of the profession.
If you really feel you are disabled, apply and get denied, appeal, and when you get to the end, apply again. With sufficient persistence, any claimants either eventually age into a category such that they get a favorable decision, the evidence accumulates to support benefits, or someone at SS will screw up in your favor!
This was back in the 90s, and it’s possible that the disability considerations have changed. She was not totally blind, but qualified as legally blind as a result of an adverse reaction to cataract surgery, probably related to her severe diabetic retinopathy, which had repeatedly delayed the surgery.
I was going to post that if he hadn’t posted yet, that Dinsdale should be posting on this thread, as he is the resident expert of Social Security Disability.
It’s just a flat percentage. It’s 20% I think. And of course YOU decide when to file an appeal, not your lawyer, who works at your behest. Obviously if your lawyer refuses to file your appeal then they’ll no longer be your lawyer (unless you’re an idiot) thus no moola for them. That’s not a good money-making strategy, wouldn’t you agree?
The 2 comments in the immediately prior posts contain significant misstatements. For example, max atty fee capped at 25% of back bens or max of $6k (w/ exceptions). And - of course - there are time limits on seeking appeal.
The correct information can be readily gained either on the official SS site or countless disability message boards or atty sites. Might be a better place than this thread/forum for someone to look for accurate info on this specific topic.
