Applied Benefits Inc > Frequently Asked Questions

Frequently Asked Questions

1. Do I need a representative, such as a social security disability advocate or social security lawyer? Statistics have shown that disability applicants with representation are much more successful than people without professional help. You need to consider whether you have the time and energy to learn and understand the complex Social Security process for determining disability. This includes learning the techniques necessary to properly advance your disability claim, the information you should obtain and send to Social Security, and how to present your case to an Administrative Law Judge. The process can – and often does – involve evaluations and testimony from medical and vocational experts at the hearing. These issues, along with the ability to pick up the phone and get reassurance that things are on track, are all reasons for having a representative by your side.

 

2. How much does it cost to hire a representative? The Social Security Administration controls fees for representation (whether it’s a social security disability advocate or a social security disability lawyer) in disability claims. Generally, cases are handled on a contingency basis of 25% of the retroactive benefit, with a cap established by SSA. If your disability claim is not successful, there is no fee. Social Security approval is required for any fee charged. Unlike most firms, Applied Benefits, Inc. pays for all expenses related to medical records. We will not ask you to reimburse us for these expenses.

 

3. What is the difference between Social Security Disability (SSDI) and SSI Disability? Social Security Disability (SSDI) and Supplemental Security Income disability programs are both administered by the Social Security Administration. For most people, the medical requirements are the same and the person’s disability is determined by the same process. The major difference is that, while both programs require proof of disability, SSDI entitlement is based on past work experience and SSI is based on financial need. Social Security Disability Insurance (SSDI) is a program financed with Social Security taxes paid by workers, employers and self-employed persons. Disability benefits are payable to disabled workers, disabled widow(er)s, or adults disabled since childhood who are otherwise eligible. Auxiliary benefits may be payable to a worker’s dependents. The monthly disability benefit payment is based on the Social Security earnings of the insured worker on whose Social Security number the disability claim is filed. After 24 months of SSDI entitlement, you are also entitled to Medicare health coverage. Supplemental Security Income (SSI) disability is a welfare-type program financed through general tax revenues. SSI disability benefits are payable to adults or children who are disabled, subject to income, resource and living arrangement requirements. No dependent benefits are paid with SSI. The monthly amount of SSI payments is different in every state and can vary by the person’s income and resources. You can be eligible for SSI even if you have never worked, or paid taxes under FICA. Generally, however, to be eligible for SSI payments you need to be a U.S. citizen or meet certain requirements for non-citizens. If you receive SSI, you are entitled to Medicaid.

 

4. I am over 50 years old. Are there any special rules that can help me get my benefits? Yes. The Social Security rules for awarding benefits change for individuals age 50 and above. It does not necessarily mean your case will be easy to win however. SSA uses what is described as the “Grid”. The Grid is a framework for decision making. SSA applies the grid when an individual is not performing substantial gainful activity and is not capable of performing his/her past relevant work. Age, education, and work experience are used in combination with an individual’s physical capacity. When the individual’s vocational factors coincide with the criteria of a particular rule, a conclusion as to disability is directed. Non-exertional limitations are not reflected in the Grid, but may be considered in combination with the Grid.

 

5. Am I too young to get benefits? Anyone, young or old, can be awarded Social Security Disability and/or SSI benefits. First, you need to satisfy the eligibility criteria. Eligibility can consider work quarters, income and resources. Second and most important is that you have a severe medical condition that prevents you from being able to work in a competitive work environment. Social Security, for the most part, will not consider part-time work or job share work to be competitive employment.

 

6. When should I apply? Social Security requires that your condition has lasted or is expected to last for at least 12 months. Therefore, if you apply too early, you will likely be denied, with Social Security saying that they do not have sufficient evidence to support that your condition(s) will be disabling for the required 12 months. Therefore, applying after your condition has lasted for approximately 5 months is a good reference.

 

7. How do I apply for benefits? You can apply in several ways:

You can visit the Social Security website and apply online. You will need to complete the application, and the disability report. You will need to print out the application, sign it and mail it to the local office.

You can call Social Security and request a telephone interview at (800) 772-1213. Social Security will set up a time and date and will call you directly to take the necessary information over the telephone. They will then send you various forms for signature.

You can call Social Security at (800) 772-1213 and request an in person appointment. You will then go to your local Social Security office for an interview. At the conclusion of the interview, you will be asked to sign various forms.

Before filing a new application, you should consider contacting an experienced Social Security Disability Advocate. This legal representative can explain the purpose for all the forms that have to be completed and signed and, if you desire, will handle your entire claim from initial application through each level of disability appeal. In Louisiana, Texas and Arkansas, call 318-226-8543.

 

8. What is the Disability Test? To satisfy the Social Security disability and SSI programs requirements, you must have a physical or mental health condition (or a combination of impairments) that has lasted or is expected to last for at least 12 months. Your conditions or impairments must be severe enough to interfere with regular full time employment. In addition to the medical condition, Social Security will consider your remaining capabilities along with, age, education, previous work experience, training and skills to make a decision on your claim.

 

9. My claim was denied – What’s Next? Don’t be discouraged. Initial claims for Social Security are denied over 75% of the time and reconsideration appeals average 85%. The denial and award statistics change in relation to individual states, hearing offices, judges and disability claim adjudicators. There are deadlines for filing a disability appeal. Keep track of the dates and watch your calendar. Be sure to discuss your claim with an experienced representative (such as a social security disability advocate or social security lawyer) to fully understand the alternatives for disability appeal.

 

10. What is the Administrative Law Judge Hearing? This is the third step in the disability claim process. (Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, Pennsylvania, and some locations in California do not have a reconsideration stage; if your initial application is denied in these states, you will proceed to the hearing stage.) If your request for reconsideration is denied, you have 60 days to request a hearing. This step involves an Administrative Law Judge and frequently includes expert Medical and Vocational testimony. You will be sworn in and the Judge will question you directly regarding your medical problems and why they interfere with you ability to work. Your representative will be able to ask questions, as well as cross examine any of the witnesses that might appear on your behalf. Your representative can also question any expert requested to testify by the Judge. Any statements made or evidence provided will be included in the official record. After the hearing, the Judge will issue a written decision awarding or denying benefits. On rare occasions, the Judge will announce a decision at the end of the hearing; or, sometimes, issue an “On The Record Decision” without a hearing. On the record decisions are generally the result of a pre-hearing brief prepared and presented by your representative.

 

11. My Claim was Denied At The Hearing – Now What? If you are within the 60 day appeal period, you should immediately contact a representative. An experienced Social Security Disability Advocate will be able to present your case at the Appeals Council level.

 

12. Will I receive Retroactive Benefits? SSDI Benefits are payable after a 5 month waiting period. The maximum retroactive benefits from the date application is 12 months. There is no waiting period for SSI benefits. If you receive an award after lengthy delays and/or appeals, the past due benefits can be substantial. This can also include a retroactive award of Medicare.

 

13. Can I Shorten the Claim Process? To some extent, yes. There are a few things you can do to help move things along if you have a representative. Some examples are:

  • Assist your representative in obtaining necessary medical records by letting him/her know about all visits to your doctor and/or any test.
  • Keep your representative informed regarding changes in contact information (i.e., phone, address etc.) and any new developments in your medical condition.
  • Let your representative complete all forms.

 

14. Will Disability Benefits include Medical Coverage? Yes. If you are awarded Social Security Disability, Medicare coverage will begin after 24 months. If you are awarded Supplemental Security Income(SSI), Medicaid coverage begins immediately.

 

15. My claim is filed – When will a decision be made? An initial determination can take as little as 30 days, if your condition falls into specific categories. But, it will generally take approximately 2-4 months. Whether you live in Louisiana, Texas or Arkansas, the SSA will perform the same type of development activities, such as requesting and reviewing medical records from your doctors, getting statements from your family members, employers or other individuals familiar with your condition.

 

16. Do I have to be totally disabled to receive benefits? No. The Social Security regulations spell out specifically what is required for a disability award. You need to show, through medical evidence, that you are disabled from competitive, full time employment.

 

17. I was recently awarded benefits. How long will my payments continue? You can remain on disability as long as you continue to meet the disability rules. For some people, disability will end with a return to work, or until a Continuing Disability Review (CDR) shows that you no longer meet the test for disability. The first CDR is done 3 years after being approved. Then, 5 years after the first review, another one will be done. You should contact your Social Security Disability Advocate – in Shreveport- Monroe Louisiana, El Dorado – Arkansas – Texarkana, Marshall, Longview, Tyler, Lufkin Nacogdoches – Texas – once you receive the SSA notice advising that your case is being reviewed. Some people will remain on disability until they reach retirement age.

 

18. Can I win my case if my doctor won’t support total and permanent disability? Yes, but it’s always helpful to have the support of your treating source. Social Security requires that your disabling condition has lasted or is expected to last for 12 consecutive months. In fact, your doctor’s opinion on “total” or “permanent” disability could be essentially meaningless without the help of a knowledgeable Social Security Disability Advocate who knows how to develop the medical evidence in your case. What is important is your doctor’s assessment of your condition from the date it started through the present, and how it affects your ability to perform various work related activities.

 

19. If I’m on disability, am I allowed to work? Yes. But remember that Social Security looks at both the activity and the amount earned. If your earnings are too high, that can be used as an automatic presumption that you are performing competitive work activity and are not disabled. It is recommended that you consult with your representative first before engaging in any type of work activity as it is usually not a good idea.

 

Confused by all the rules and requirements surrounding Social Security Disability? You’re not alone. That’s why you need the assistance of an experienced professional on your side. A social security disability advocate can handle the process for you from the beginning and ensure you get the income you are entitled to. If you have already filed for disability and have been denied, the experience of a social security disability advocate can go a long way in winning your disability appeal.

George Poleman is a social security disability advocate with over 30 years of experience, thousands of satisfied clients, and a 98% success rate! Unlike a social security disability lawyer (where you will likely speak with a paralegal or secretary more than the person handling your case), you will work directly with Mr. Poleman throughout your disability appeal. And remember – you pay no fees until your case is won.

Let us take a look at your case and see what we can do for you. We will make the entire process smooth and easy – beginning with your very first consultation. Simply fill out the quick online form on the upper right of this page for a free disability consultation. We will contact you soon.