Frequently Asked Questions
While your doctor’s opinions are important, SSA has its own definition for disability—that is, you must have a physical/mental health problem or a combination of problems severe enough to keep you from working any job that exists in the national economy in significant numbers for 12+ months. SSA considers your age, education, work experience, medical issues, and daily activities when making its decision.
Social Security Disability pays benefits to claimants who qualify, as well as certain family members if the claimant has worked long enough and paid Social Security taxes.
Supplemental Security Income (SSI) pays benefits to disabled adults and children who have limited income and resources.
Apply for Social Security Disability as soon as you and your doctor(s) agree that your disability is going to last a full year. A claimant is not eligible for SSD if the condition does not last a full year; many people must wait to see how their medical conditions progresses.
If you have been struggling to work in spite of your disability and know the condition is going to continue, apply as soon as you stop working.
Apply for Supplemental Security Income benefits as soon as you become disabled. Unlike SSD, there is no retroactivity prior to your application. The sooner you file, the safer you are.
Every case is different and must be carefully evaluated on its own facts and circumstances.
Elizabeth A. Smith has years of experience and expertise in evaluating cases. When you call to receive an evaluation, we will obtain some information first and schedule a free initial consultation to take place at our office with you and your family. It still may be difficult to conclusively decide if your case is “good;” however, you can be sure Elizabeth will be honest and forthright with you about your situation.
That depends. It usually takes about 12 to 16 months from when the appeal is filed before you have your hearing before the Administrative Law Judge. On occasion, cases will take longer than 16 months. In certain cases, if dire circumstances exist, cases may be expedited. However, you can be assured that Attorney Elizabeth A. Smith will vigorously pursue your claim within the bounds of excellence and professionalism.
Stage One – Initial Application
In order to receive Social Security benefits, you must first apply. Begin by calling the Social Security Administration (SSA) at 1-800-772-1213 or by applying online at http://www.ssa.gov/applyfordisability/. Once you contact Social Security, you have established a protective filing date for your application for benefits. You will then be scheduled for an interview with a claims representative at a local Social Security office. If you are unable to go to your local Social Security office, you can have a telephone interview. When you apply for benefits, you should advise Social Security about every health problem that is preventing you from working. You should also tell Social Security about every doctor, therapist, clinic and hospital you have been to for treatment. Make certain that you ask for copies of your disability report, vocational report and any other forms completed by Social Security at the time of your application for benefits. A claims examiner at Social Security will make an initial determination as to whether or not you qualify for benefits and the State Disability Determination Section will make a medical decision on your case. You will be sent a written decision in approximately 90 to 120 days following your application. If you do not hear from Social Security within this time frame it is a good idea to call and check on the status of your claim.
Stage Two – Reconsideration
Reconsideration is the next step in the Social Security disability appeals process. Simply, it is a request for the Social Security Administration to give your application another look. It is rare that claimants get their denials overturned during reconsideration. This is because of the way the process works:
- The Social Security Administration assigns your case to a disability examiner
- The disability examiner looks at your application and medical evidence
- The official determines whether the initial denial was appropriate, based on the evidence
In other words, the disability examiner looks at mostly the same evidence to make a decision. While the examiner can request new medical records, they are not always persuaded to make a different determination.
The Social Security Administration still requires you to request reconsideration.
Stage Three – ALJ Hearing
If you receive a notice of denial of your request for benefits, you must file a request for a hearing within 60 days or the Law Office of Attorney Smith can assist you with filing the request for a hearing. Since your hearing is your best opportunity to win benefits, and because you will be appearing before a judge, it is wise to have Attorney Elizabeth A. Smith working on your case. Social Security’s own statistics show that claimants who have lawyers win more often than claimants who go to hearings alone.
Stage Four – Appeals Council
If you lost at the hearing level, you can appeal to the “Appeals Council” and ultimately to Federal Court. The Appeals Council accepts written arguments in support of an appeal. You must file your request for review within 60 days of your receipt of the hearing denial notice. The Appeals Council will only reverse or remand a hearing decision for a limited number of reasons. An experienced attorney will know how to argue on your behalf before the Appeals Council.
Stage Five – Federal Court
Even if you lose all of your administrative appeals, an attorney can still represent you in an appeal to the federal district court. Again, this appeal must be filed within 60 days of your receipt of the Appeals Council denial notice. Unlike the previous stages of appeal, an appeal to the Federal District Court is an adversarial proceeding and a United States Attorney will defend the Social Security Administration and their decision in court. Like the Appeals Council, a District Court Judge will only reverse or remand a hearing decision for a limited number of reasons. An experienced attorney will know how to argue a case in District Court, but very few cases are reversed or remanded at this level of appeal.
You can also file a new application for benefits. However, filing a new application is not the same thing as appealing a denial, and you could lose benefits by not appealing a denial. In some instances, failure to appeal a denial can even result in your becoming ineligible to receive further benefits.
Elizabeth A. Smith accepts SSD and SSI cases on a contingency fee basis and may advance costs and expenses to help you and your family in a time of need. A “contingency fee” means you do not pay unless you receive benefits. In cases with a favorable decision, fees are limited to 25% of the total back benefit aware or $6,000—whichever is less. There is no fee if there is an unfavorable decision. The fee must be approved by SSA; SSA will withhold the approved fee from the past-due benefits payable to you and your family.
In cases where benefits are received, you will be asked to reimburse Elizabeth A. Smith’s office for the expenses incurred to support your claim, primarily medical records, reports, charges by doctors to complete questionnaires, etc.
If you are win Social Security Disability, you are granted Medicare 29 months after your onset date or 2 years after the first date you were eligible for cash benefits—whichever is later.
If you get Supplemental Security Income, you receive Medicaid, effective the day you applied for SSI.
Those with amyotrophic lateral sclerosis (Lou Gehrig’s disease) or those with end-stage renal diseases are eligible for Medicare without the normal waiting period.
You will need all of your Social Security papers—denial notices, appeal forms, and your recent social security statement (go to https://www.ssa.gov/myaccount).
We also need information regarding your Recent Medical Treatment, Current Medications, and Work History for the past 15 years. (You can easily and confidentially provide the information through these links!)
Attorney Smith will meet with you and your family to explain the Social Security appeal process, obtain information from you to evaluate your claim. Once the hearing has been scheduled, Attorney Smith will meet with you and your family in order to review the hearing procedure, to explain the legal standards, to review with you and your family the evidence obtained in order to support your claim, and to go over the types of questions that will be asked.
You will be asked to keep a simple calendar or journal containing different kinds of details depending on the type of disability you have. You will be asked to mark down all of your doctor’s appointments, Emergency Room visits, hospital stays, chiropractic appointments, physical therapy appointments, counseling sessions, therapy sessions, and medication changes.
From time to time a representative from Attorney Elizabeth A. Smith’s office will contact you by telephone or e-mail or text to ask how you are doing, ask if you have worked at all since the last contact, obtain information about any changes in your condition, ask about any new medications, ask about any doctor’s appointments, and ask about your medications.
Strictly speaking, you do not need an attorney. The procedures followed in Social Security Disability hearings and the general issues in these cases are not impossible to understand. As recently as 1980, attorneys were involved in only 20 to 30 percent of the hearings.
However, beginning in the early 1980s there were a number of changes in the law that added to its complexity, and those changes (in the form of changes to the Social Security Act, Regulations and Social Security Rulings) continue to this day. Claimants who are not represented at their hearing before the administrative law judge (ALJ) are denied twice as often as those who are represented.
The decision about whether you need an attorney is up to you. But allow us to tell you some of the things we can do to put your case in its best light and increase your changes of succeeding in your claim:
- Gather medical evidence and other evidence
- Contact your doctor(s) to obtain a report of your medical condition that is geared directly to Social Security Disability requirements
- Request that Social Security schedule a medical or psychological examination
- Review your Social Security file
- Review decisions made by the Social Security Administration
- Ask for reopening of prior applications
- Prepare you to testify at your hearing
- Question any witnesses at your hearing
- Present opening and closing statements at your hearing and/or argue that your claim may be favorably decided without a hearing
- If you are successful, make sure the Social Security Administration correctly calculates your benefits