• DISABILITY INSURANCE BENEFITS
• SUPPLEMENTAL SECURITY INCOME BENEFITS
• MEDICAL EVIDENCE
• HOW DO I FILE A CLAIM?
• WHAT DO I DO IF I AM DENIED BENEFITS?
• CAN I HIRE AN ATTORNEY? WHAT ARE THE FEES?
  

DISABILITY INSURANCE BENEFITS 

Disability insurance benefits are paid to disabled persons who have worked for five years out of the last ten and who have paid Social Security taxes. Most people pay these taxes through payroll deductions (FICA). If you are found disabled, the amount you will receive each month is based on the amount of FICA taxes you have paid.

The Social Security Administration uses the following five-step analysis to determine whether a person is disabled:

1. Are you working? If you are performing substantial gainful activity, then you cannot be found disabled. Generally, substantial gainful activity means that you are earning approximately $500 per month or more. If you are not working or are not earning $500 (or close to that amount), the analysis continues to the second question.

2. Do you have a severe impairment? Your impairment must be severe enough to significantly limit your ability (mental or physical) to perform basic work activities.

3. Does your impairment meet or equal a listed impairment? The Social Security Administration has a "list" of impairments fully described at 
20 CFR §404, Subpart P, Appendix 1. If the medical records show that your condition meets or equals one of these listings, you will be found disabled. If your condition meets a listing, you will be found disabled at the third step of the analysis and no further analysis is required. If your condition does not meet a listed impairment, then the analysis continues to question number 

4. Does your impairment prevent you from performing your past work? The medical records are reviewed at this step to determine whether you retain the residual functional capacity to perform your past work. You may have medical records that show that you suffer from an impairment, but the records must indicate that the impairment reduces your physical or mental ability to perform your past work. If it does, you can be found disabled at this step, and no further analysis is required. If it does not, then the analysis continues to question number 5.

5. Does your impairment prevent you from doing ANY other work? "If you cannot do any work you have done in the past because you have a severe impairment, [the Social Security Administration] will consider your residual functional capacity and your age, education, and past work experience to see if you can do other work. If you cannot, [Social Security] will find you disabled." 
20 CFR §404.1520(f).

SUPPLEMENTAL SECURITY INCOME BENEFITS
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Supplemental Security Income, or SSI, is paid to persons who have a severe physical or mental impairment. The same five-step analysis applies to SSI cases. SSI payments are made to individuals who have not worked for five out of the last ten years. They are not covered for disability insurance benefits. Therefore, because SSI is not based on an amount of money paid to Social Security through FICA taxes, SSI benefits are subject to offset by any other income in the family.

SSI may also be paid to individuals who are covered for disability insurance during the first five months of disability. Disability insurance benefits are paid beginning with the sixth month of disability. During this statutory waiting period, an individual may be entitled to SSI if there is little or no income in the family.

MEDICAL EVIDENCE
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It is extremely important to have medical treatment and records of such treatment in order to present your case to the Social Security Administration. Many people who are severely disabled are not receiving treatment and are denied benefits. There are agencies in most cities that will help provide medical treatment at low cost or sometimes for no cost in severe cases.

HOW DO I FILE A CLAIM?
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You can file a claim for disability benefits by calling 1-800-772-1213. An appointment will be arranged for you with the district office closest to your home. You may also go to the Social Security district office in your area and file an application.

WHAT DO I DO IF I AM DENIED BENEFITS?
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You must file an appeal of any denial letter within sixty (60) days of receiving a denial. If you do not file an appeal, your case will be closed and you will have to file a new claim. A large number of applicants are denied the first and second times. So, be persistent and follow through with all appeals. You may ask for the appeal forms at the district office. You may also hire an attorney at any time after filing your claim. If you are represented, your attorney will file the appeals for you.

CAN I HIRE AN ATTORNEY?
WHAT ARE THE FEES?
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You may hire an attorney to assist you with your Social Security case at any time during the process. Attorney's fees are payable only if the attorney is able to obtain benefits for you. The fees are set by the Social Security regulations at 25% of any past due benefits that are payable. Costs and expenses incurred during the pendency of your case are a separate matter to be agreed upon by you and your attorney. These costs generally include postage and payments for medical records, if any. All fees paid to any attorney are subject to review by the Social Security Administration and must be approved prior to being paid to your attorney.

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