Am I Eligible for Supplemental Security Income (SSI)?

Am I Eligible For SSI?

I would say that the first (most important) question I receive from prospective clients during consultations is “Am I Eligible For SSI?” Unfortunately, without having the initial consultation, I am only able to give the stereotypical lawyer answer of “Well…it depends.”

The Social Security Administration has outlined very specific criteria for eligibility regarding Supplemental Security Income (SSI). Pursuant to the SSA Website, an individual is eligible for SSI if they are:

– Aged (age 65 or older);
– Blind; or
– Disabled

And, who:

– Has limited income; and
– Has limited resources; and
– meets certain other requirements.

Many of the above criteria are self-explanatory; however, some do contain caveats that, when understood, actually assist individuals in obtaining SSI Benefits. Generally, limited income for SSI is $750 per month for an individual and $1,125 per month for a couple in 2018. For the benefit of the individual, not all income is countable. Therefore, it is possible to earn more than $750 per month and still qualify for SSI.

SSI allows an individual to deduct certain medical and/or disability-related expenses from their calculated income. For example, special transportation need for doctors’ visits, specialized medical devices needed to treat the disability in the home, and many others. Also, the SSA will allow you to deduct the first $20 from many kinds of income you receive such as tax refunds, loans, and/or other governmental benefits.

The calculation process is tricky and complex. It is best to set up a meeting with an attorney and have all income-related documents, i.e. bank statements, car insurance forms, legal settlement documents, etc., on hand ready to present. This will allow the attorney to follow the governmental regulations in calculating income and determining your eligibility.
My next post will be entitled, “May My Child Receive SSI?” I do not believe I am wrong in saying that we care about our children and want to see them receive all benefits to which they are entitled. In my next post, you will learn how to go about calculating the income that must be reported to determine if your child is eligible for SSI benefits. After that, we will tackle the application process.

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Can You Pass this Social Security Quiz?

My colleague Social Security Attorney Ben Decker from New Mexico had a recent blog post that ties in nicely with a recent presentation at the Butler County Bar Association about Social Security benefits. Brad asked:

“Do you plan to retire someday? Then you should really understand how Social Security works—not Social Security Disability, which we talk about a lot in this space, but the regular old Social Security for retired people. Turns out, there’s more to it than just retiring and then getting paid. You have to do the right things at the right times, or you might only receive a fraction of the amount you’re expecting.”

Click this link to see the entire post and quiz

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What is SSI and What is SSDI?

The primary issue I see when practicing in this area of law is that prospective clients are unaware of the benefits to which they are entitled from the government. Individuals will walk into my office and simply just say, “I need help.” Usually, this help comes in the form of financial assistance from the government for individuals who are making limited income and/or have a disability which makes it difficult for them to participate in substantially gainful activity.

The Social Security Administration administers Supplemental Security Income (SSI). In doing so, the Federal Government pays a monthly benefit to people with limited income and resources who are disabled, blind, or age 65 or older. This benefit may also be conferred upon children who are blind and disabled. (I will write a post on children’s SSI soon!). Individuals who qualify for SSI may also be eligible for other Federal and State benefit programs (i.e., SNAP or TANF); however, each benefit program does affect the income level of the other.

Social Security Disability Insurance (SSDI) is slightly different from SSI. SSDI acts as a quasi-insurance for individuals who have worked for a certain number of years and have made contributions to Social Security throughout their tenure. The primary perceived benefit of SSDI is that an individual who receives SSDI for two-years will become eligible for Medicare. Thankfully, an individual who qualifies for SSDI has the ability to receive partial benefits for their spouse and children as well. This program has assists many of Americans with getting back on their feet.

That is a general overview of the two services. Please check out my next blog post, “Am I Eligible for SSI,” to learn about the qualifications for which the SSA looks when determining whether to approve or deny an application. The application process can be tricky if you are not prepared with the appropriate information at your fingertips.
Unfortunately, many applications are denied during their first submission leaving the issue open to appeal. If you have received a denial of SSI benefits and wish to appeal, please Contact Us as soon as possible because your time to appeal could lapse, leaving you susceptible to having to begin the application process anew.

I hope this post has assisted you with your knowledge of Supplemental Security Income and Social Security Disability Insurance. It is important that you know which benefits to which you are entitled and how you may go about obtaining them. Please do not hesitate to give me a call, and I look forward to speaking with you soon.

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Average for winning Disability and SSI in 2017 is 70% at Law Office of Elizabeth A. Smith

The Office of Disability Adjudication and Review in Seven Fields, PA, conducts disability and SSI hearings. The average wait time for a hearing is 20 months. The Seven Fields average for winning a disability or SSI hearing is 44% as of 3/10/17. My average for winning a disability or SSI hearing is 70% in 2017 as of 4/26/2017.

If your claim for disability or SSI has been denied, please call our office for a free consultation appointment on disability and SSI cases.

Let me put my experience to work for you.

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Seven Fields Pennsylvania Office of Disability Adjudication and Review

This excerpt is from the disabilityjudges.com website – information as of 2-7-17

At the Office of Disability Adjudication and Review (ODAR) in Seven Fields, Pennsylvania, 7 different administrative law judges (ALJ) conduct Social Security Disability (SSD) hearings and Supplemental Security Income (SSI) hearings. Currently, in Seven Fields, the average wait time for a SSI or SSD hearing is 19.0 months. The average case processing time in Seven Fields is 590 days.The Seven Fields average for winning a SSI or SSD disibility hearing is 40%. Click on the name of one of the ALJs below to see detailed information about their hearing results. This information for the Seven Fields ODAR office was last updated on 2/7/2017.

Average statistics
Office Judges Avg. Hearing
Wait Time
Average
Processing Time
Dispositions
Per Day Per ALJ
Cases
Dismissed
Cases
Approved
Cases
Denied
Seven Fields 7 19.0 months 590 days 1.8 26% 40% 34%
Pennsylvania 20.4 months 650 days 1.8 26% 42% 32%
National Average: 16.8 months 540 days 1.7 21% 44% 34%
AVERAGE TIME
Hearing Wait Time: 19.00 months
Dispositions Per Day Per ALJ 1.77
Average Processing Time 590 days
Cases Pending 6211
Dispositions 745
New Cases 1019
Hearings In Person 69%
Video Hearings 31%
LIST OF JUDGES / 18
Full Name Dismissed Approved Denied
Judge William J Bezego 24% 35% 41%
Judge Daniel F Cusick 37% 21% 41%
Judge Patricia Daum 15% 49% 36%
Judge John Kooser 27% 45% 29%
Judge Wayne Stanley 28% 46% 26%
Judge Melissa Tenenbaum 19% 54% 27%
Judge Brian W Wood 23% 46% 32%
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5 Day Rule Letter – WHAT? No worries – our office submits ALL evidence well before 5 days

SocialSecurityTNSSA has started to change procedures and notices to comply with the “5-day rule” regulations. Hearings held on or after May 1, 2017 must comply with the requirement that the ALJ receive or is informed about evidence at least 5 days prior to the hearing, with certain good cause exceptions. Prehearing memos and other written statements also have a five day deadline. Subpoenas must be requested at least 10 days prior to the hearing. Good cause exceptions apply to all of these deadlines.

SSA sent notices to all claimants who have hearings pending. Unfortunately, the notice was sent even to those with hearings scheduled prior to May 1, 2017, which is causing a great deal of confusion among claimants. Be assured that there has been no change to your hearing date already scheduled or the procedures regarding evidence submission.

Our office prides itself on submitting ALL evidence in a timely manner – so if you get this letter – and have questions – reach out to us – but it’s business as usual here.  We will be happy to update your file, estimate when your hearing will be held, and answer any questions you may have.

 

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Do I Need to Talk at My Hearing?

I’m often asked by clients if they will have to testify at their Social Security disability hearing. In many cases, the answer is yes.

An administrative law judge (ALJ) will decide cases based on the medical evidence in the file – this includes x-rays and other imaging exams, lab panels, treatment notes, and written statements from the claimant and the claimant’s treating physicians, and likely your testimony.

Your testimony is offered with the intent of allowing the ALJ to better understand your specific medical conditions and how it affects your ability to function and perform basic work activities (including your past work), and your life in general.  The ALJ may also ask about apparent inconsistencies between your medical records and your statements or testimony.

Many of my clients relay to me that the disability hearing is anxiety provoking.  For this reason, it is especially important to have an experienced attorney or advocate by your side. Your attorney can help you prepare for your hearing by discussing many of the questions that may come up, and can provide responses to some of the important issues that may arise at your hearing.

If you are asked to testify before an ALJ, your responses should be honest and detailed, but not to the point of exaggeration (i.e., “I cannot get out of my bed at all” or “I cannot do anything anymore”). You also need to avoid being modest or showing how strong you are by not complaining about how your impairment(s) impact your ability to function on a day-to-day basis. Being modest about your medical condition is a mistake many claimants make at their hearing.

If you are applying for disability and have questions about testifying, it never hurts to talk to or retain my office – we can help you properly prepare your case.

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Status Updates During the Initial Application

Filing for Social Security Disability (SSD) or supplemental security income (SSI) benefits can be a long process.  It typically requires you to wait for months before you get a response from anyone at the SSA. Your wait is particularly difficult when you are struggling to pay your bills because you cannot work.

STATUS UPDATES DURING THE INITIAL APPLICATION

SSA provides an online application that allows you to obtain the status of your initial claim.  You can check it out here.  You will need your application number in order process your request. You can also get a status update by contacting a representative at your local social security office.

You may also contact the disability examiner at the state agency reviewing your claim. This professional works at a disability office on the state level instead of with the SSA. It is typically easier to reach the disability examiner to ask questions about a specific application than it is to reach a representative at the SSA who can find information related to your application.

The disability examiner is able to tell you whether a decision is pending or complete, but the examiner cannot tell you whether the application was approved or denied.

A disability examiner may also be able to assist you with expediting the review process. However, it is important to understand that applications can only be expedited in special circumstances. A knowledgeable Louisiana SSD attorney can help you better understand how to have the application process expedited.

STATUS UPDATES AFTER THE INITIAL APPLICATION BUT PRIOR TO THE ALJ HEARING

Application status updates following the initial application (or a reconsideration) can be obtained by contacting the Office of Disability Adjudication and Review (ODAR) disability examiner. However, the disability examiner can only tell you whether the case is scheduled, ready to schedule or currently being processed.  They do not make a decision on the case and cannot tell you whether the case is approved or not.

UPDATES FOLLOWING THE ALJ HEARING

Once your hearing is held, again the ODAR disability examiner can help best.  Again, however, they usually do not tell you if you were approved or denied, but only if the case was decided, still being decided, or further information is needed.

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Average Wait Time Until Hearing Held for January 2017

The Social Security Administration announced that the average time in months from the hearing request date until a hearing was held for the Pittsburgh Office of Disability Adjudication and Review was 20 months and for the Seven Fields Office of Disability Adjudication and Review was 19 months. This is as of January, 2017.

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Trump’s Hiring Freeze May Worsen 526-Day Disability Case Backlog

Trump’s Hiring Freeze May Worsen 526-Day Disability Case Backlog

by Josh Eidelson

 

President Donald Trump’s federal hiring freeze may exacerbate a backlog of appeals for Social Security Disability Insurance that has grown so big that an average case takes more than a year to be heard.

“These are people who are desperate,” Judge Marilyn Zahm, president of the Association of Administrative Law Judges union, said. “There may be a hiring freeze on federal employment, but there’s no freeze on people getting older, people getting sicker, people having injuries and accidents, and people needing disability insurance.”

Zahn is among around 1,650 judges tasked with considering claims from Americans whose initial requests for Social Security Disability Insurance benefits have been denied by state agencies.

As of May 2016, the average wait for an appeal to get processed was 526 days, according to the Social Security Administration’s inspector general. A total of 1.1 million people were waiting for a decision on their eligibility for benefits under the sixty year-old program, which provides income support to people who paid into the system and due to disability will be unable for at least a year to work.

The ranks of beneficiaries in the program have grown substantially in recent years: Whereas fewer than 2.5 percent of working-age Americans got checks in 1990, more than 5 percent did in 2015. Last year the Social Security Administration announced that, along with efforts to streamline the process, it wanted to grow the ranks of judges to 1,900 by the end of fiscal year 2018.

That may be impossible now that President Trump, in one of his first executive actions, has imposed a federal civilian employee hiring freeze. Trump’s order allows agencies to exempt staff needed for “national security or public safety responsibilities,” and authorizes the director of the Office of Personnel Management to grant exemptions. The order requires the Office of Management and Budget to develop a plan within 90 days for shrinking the workforce, and says the blanket freeze will expire once that plan is implemented. White House press secretary Sean Spicer told reporters Monday that the order “ensures that the American taxpayers get effective and efficient government.”

But like the judges’ union, former Social Security commissioners from both parties expect the freeze will worsen the backlog of appeals cases.

“To better serve the American public, the Social Security Administration needs more budget and staff resources, not less,” said Kenneth Apfel, who led the agency under President Bill Clinton and now teaches at University of Maryland’s public policy school. “I think it’s going to be pretty devastating,” said Michael Astrue, a George W. Bush appointee who served in the same role.

Astrue blamed the backlog on multiple culprits, including what he said was a long-running failure by the personnel office to efficiently vet candidates and insufficient focus on the issue from his Obama-appointed successor. But he said freezing the agency’s hiring would only make the problem worse. “I don’t agree with the union on much, but I do agree with them on that.” Astrue said he hopes Social Security officials will seek an exemption for appeals judges and their clerks, and that Trump’s personnel department would grant it.

Officials at the Social Security Administration declined to discuss their plans. “At this time, we have no further information and are awaiting guidance,” spokeswoman Dorothy Clark said Wednesday. The Office of Personnel Management referred an inquiry to a budget office spokesperson, who did not respond.

Trump’s nominee to helm the budget office, South Carolina Congressman Mick Mulvaney, did address the issue briefly during his Tuesday confirmation hearing. Virginia Senator Tim Kaine, Hillary Clinton’s 2016 running mate, cited the backlog of claims, along with veterans’ benefits and drug approvals, as areas where a hiring freeze “could have the effect of even making it harder for citizens to get the services they need.”

“I don’t think you’re wrong to be concerned about it, Senator,” Mulvaney responded. “I don’t think it automatically follows that hiring more people will create more efficiency.”

Judge Zahm said many judges have been working extra uncompensated hours every day to try to get through the outstanding cases, some of which require reviewing 1,000 pages of medical records as well as experts’ assessments. “This is not a job where you should be doing slapdash work,” she said. “People’s lives, livelihoods, are at stake.”

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