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Social SecurityTHE FOLLOWING MATERIAL IS GENERAL INFORMATION ABOUT THE SOCIAL SECURITY SYSTEM. FOR ANSWERS TO YOUR QUESTIONS ABOUT YOUR SITUATION, PLEASE CALL SWANSON, THOMAS & COON AT (503) 228-5222 ALERT: As part of the economic stimulus, Social Security is sending every citizen who receives Social Security disability or retirement benefits a one-time payment of $250. You can find more information here: VIDEOS The Importance of Appealing a Denial of Benefits in a Timely Manner by Swanson, Thoman & Coon Social Security Attorney Kimberly Tucker
As Social Security is a federal program, this video contains good advice for everyone -- not just people living in Portland or Oregon. How to Apply for Social Security Disability A SOCIAL SECURITY PRIMER FOR CLAIMANTS
What is the Social Security Disability Program? The Social Security Program is the most important financial protection plan and social safety net in the country. Social Security and Medicare pay about $600 billion in benefits every year. Anytime one's income is affected by significant events such as retirement, disability or death, Social Security can pay benefits, which increase with the cost of living. The disability section of the Social Security has two parts: 1. Title II, Social Security Disability Insurance (SSDI). This program for disabled workers is like a long-term disability insurance plan. The disabled worker receives benefits because he or she has paid contributions in the form of Social Security taxes on wages earned. This money comes from the FICA deduction taken from your paycheck. 2. Title XVI, Supplemental Security Income (SSI). This is a federal welfare program for those who have not paid enough Social Security taxes to get Social Security Disability Insurance. You can receive SSI if you are disabled or over 65 and you have very little income or property. For example, if you have $2,000 or more ($3,000 for a married couple) in money or property, you cannot qualify. Your home and one car generally do not count. Social Security's definition of disability: You are disabled under the Social Security law if:
Social Security Regulations provide for a five-step evaluation process to determine disability. Step 1: Income Levels. Work generating more than $700 per month after appropriate deductions constitutes substantial gainful activity (SGA) and disqualifies an applicant for disability benefits. Unsuccessful work attempts of up to 6 months generally don't count. Step 2: The Severity Step. You must have a medical condition, either mental, physical or both, which limits your ability to work. The duration requirement: Your impairment must have lasted or be expected to last for 12 months. However, claimants with symptoms that wax and wane may still qualify under this requirement if the active periods of their illness are enough to keep them from working. Step 3: The listing of impairments. This is a shortcut to disability, though it is difficult to meet. If your condition is one of the conditions described in these complicated medical rules, you will be found disabled. If not, you go on to Step 4. Step 4: Not able to work at previous job. If you are not found disabled at step 3, the next question is whether you are capable of doing any work that you have performed in the last 15 years given you current limitations. Step 5: Other work available. If you are found unable to return to your previous work, then Social Security must prove that you can do work that exists in the national and local economies in significant numbers. In this part of the evaluation process, the older you are, the more likely it is that you will be found disabled. For example, a 50-year-old person, who performed heavy unskilled labor all his life but is now limited to sedentary work due to an injury would be found disabled. A younger person with the same circumstances would not be disabled. Our office, Swanson, Thomas and Coon, takes calls from claimants at any stage and answers questions they may have concerning the process, whether we represent them or not. The Application ProcessAnyone who believes he or she may qualify for Social Security benefits should apply immediately. The process is a long one, and benefits are paid based on the date of application. If you are able to go back to work, you can always withdraw your application. The important thing is to get the process started. You can call 1-800-772-1213 to make your application. Within several months you will have a decision. If that decision is unfavorable, you have the right to request reconsideration, and you should do that because many applications are not granted until the third step in the process - the hearing. Your request for reconsideration must be filed within 60 days of the day you receive your denial. You may be asked to see a doctor who will evaluate your condition. You should cooperate with any such examination. The process of initial application and reconsideration can take more than a year. Requesting a Hearing If your claim is denied on reconsideration, you have 60 days to request a hearing before an administrative law judge (ALJ). The ALJ hearing is the only time you get to present your case in person to a decision maker in Social Security. You are entitled to a lawyer at your hearing. The lawyer can argue your case to the judge and can cross-examine witnesses the Social Security Administration is likely to call such as medical experts and vocational experts. The ALJ hearing is a very important stage because over 60% of denied claimants who go to hearing have their cases finally approved. A claimant may have to wait two years or more for a hearing. After the hearing, the judge will issue a written decision, but it can take up to a year to receive it. Appeal Process - Time lines If the Administrative Law Judge has found you are not disabled, you can appeal this decision to the Social Security Appeals Council located in Fairfax, VA. The appeal takes about 18 months. If that decision is unfavorable, you can appeal that decision to United States District Court. District Court decisions can take as much as six to eight months to adjudicate. Those decisions can then be appealed to the Ninth Circuit Court of Appeals. Thus, a decision in a social security case can take several years to become final. Drug and Alcohol Addiction If drug or alcohol addiction is found to be a material component of disability, benefits will not be paid. What does "material component" mean? If a claimant has a drug or alcohol addiction, a determination has to be made about the significance of the drug or alcohol problem. The question is if the claimant stopped using drugs or alcohol for a period of three months or more, she would still be disabled due to her other impairments. This is a less complicated determination to make when the other impairment is a physical one or when the claimant has stopped using drugs or alcohol for a substantial period of time. Problems arise however, when the claimant is still using. Questions If you have questions concerning eligibility for the social security program or any related questions, we encourage you to call our office at Swanson, Thomas and Coon (503) 228-5222.
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