Transcript Social Security Disability Website

Social Security Disability Basics
Prepared by: Saundra McDowell
Based on material from websites
provided by SSA and NOSSCR in
addition to experience in SSD field.
Types of Disability Benefits
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Disability Insurance Benefits (DIB)
Supplemental Security Income (SSI)
Disabled Widow/Widower Benefits (DWB)
Childhood Disability Benefits (CDB)
Eligibility Requirements for Social
Security Disability Insurance Benefits
(SSDI)
• A Claimant must have worked for five of the last ten years to be
within their Date of Last Insured (DLI).
• A Claimant’s disability must have lasted (or be expected to last)
longer than 12 months.
▫ To meet this requirement one must be, or expected to be, disabled for 12
months or the disability is expected to result in death.
• A Claimant must be under the age of 65.
• A Claimant must be unable to perform “substantial gainful activity.”
▫ Substantial Gainful Activity is the ability to perform work or work-like
activity. If you are able to perform any type of work, even if it is not your
previous job (depending on your age), it may be determined that you are
capable of performing substantial gainful activity.
• A Claimant must provide a doctor’s diagnosis and medical evidence
that supports their disability claim.
• If a Claimant does not qualify for SSDI, they may still qualify for
Supplemental Security Benefits (SSI).
Eligibility for Supplemental Security
Income Benefits (SSI)
• A Claimant must have limited income and
resources;
▫ Income/resources can not be worth more than 2,000
for a single person or 3,000 for a couple.
▫ Some things are not counted such as your home and
one car.
• SSI is for elderly people as well as blind or disabled
people of any age, including children.
• One may have to meet certain other requirements.
• Monthly payments for 2011 is the same nationwide:
▫ $674 for one person; or
▫ $1,011 for a couple.
Stages in Applying for Disability
Benefits
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Application
Initial Determination
Reconsideration (in some states)
Request for Administrative Hearing
Appeals Council
Federal Court Review
What a Claimant Will Need When They
Apply at the Initial Application Stage
• Medical Documentation
▫ The Claimant will need:
 Information on all previous and current doctors’ visits and
hospitalizations;
 Dates and places of lab reports, x-rays, and other clinical diagnostics that
provide evidence of impairments; an d
 A list of current medications and dosages.
• Work History
 SSA will need to know the name and location of previous employers for the
last 15 years, the job description of the positions held at those jobs, and how
long the Claimant worked at each job.
 W-2 forms will need to be submitted as well.
• Other Documentation
▫ Included by not limited to: Marriage Certificate, Certificate of Divorce,
Birth Certificates, Death Certificates, Social Security Card, Military
Service or discharge paperwork, and Documentation of Child Support
Payments.
What SSA looks at to Determine
Whether a Claimant is Disabled
• There are 5 Steps to the Analysis of Disability
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Step One – Eligibility
Step Two – Severe Impairments
Step Three – If they meet or equal a listing
Step Four – If they can return to any of their prior
work from the past 15 years.
▫ Step five – If there is other work in the national
economy that the Claimant could perform with
his/her current limitations.
When Claimants are 50 Years or Over
• While it is not the only factor, age is an important
factor in determining whether one is approved for
SSDI and/or SSI.
• When a Claimant is 50 years old or over different
rules apply to their claim.
• They must prove they can not perform their
previous work from the past 15 years.
• Judges do not expect Claimants to go out and learn
other work when they are 50 and over and are
significantly limited because of their impairments.
Administrative Law Hearings
What to Expect
• The Administrative Law Judge hearing is a relatively
informal process.
• Before the hearing, the attorney will gather evidence
to support the claim and prepare the Claimant for
testimony at the hearing.
▫ This significantly increases the chance of success at the
hearing stage.
• The attorney will represent claimant at the hearing
and will present evidence on his/her behalf.
• The attorney will also have the change to question
the Vocational Expert and the Medical Expert if one
has been retained for the case.
Benefits of Representation
• The process is lengthy and complicated for the average person.
• Attorneys collect and organize medical records and other
documentation needed to file requests for reconsideration, hearings,
and appeals in a correct and timely manner.
• Attorneys prepare claimants and witnesses for Administrative Law
Judge (ALJ) hearings and Appeals Council hearings.
• Attorneys make the hearing process easier as they are at the hearing
to give legal advice, to help Claimants better understand the process,
and to help put them more at ease in a normally stressful situation.
• No upfront costs to having legal representation.
• Legal fees are mandated for Social Security Cases so even after a
Claimant wins, the legal representatives only gets paid a percentage
of their back pay with a maximum allowable fee of $6,000.
Forms to Submit at the Hearing
• Medical Source Statements
▫ Medical Source Statement – Physical (MSSP)
 This provides physical limitations based on the Claimant’s
physical impairments.
 Make sure the appropriate physician fills this out and signs it.
 If more than one physician is seeing the Claimant for physical
problems, have each of them complete a MSSP
▫ Medical Source Statement – Mental (MSSM)
 This provides mental limitations based on the Claimant’s
mental symptoms
 Make sure a psychologist or psychiatrist fills this out and signs
it.
 If Claimant is only seeing a therapist, counselor or primary
care provider for their mental symptoms, their opinions are
better than none.
Frequently Asked Questions (FAQ’s) For
Claimants
• How do I apply for Social Security Disability Benefits?
▫ Go to nearest Social Security office in person and wait to
see someone to file a claim in person, contact SSA by
telephone and arrange for a telephone interview to file a
claim or go online to the SSA website and file your claim
online.
• Am I allowed to collect unemployment or worker’s
compensation benefits when I am applying for
disability?
▫ Yes, but benefits may be offset, which reduces the amount
you may get for SSDI or SSI.
• If I expect to return to work in the future, should I still
file for disability?
▫ Yes, if you expect to be out of work for a year or more on
account of an illness or injury, you should file.
FAQ’s continued…
• What can I do to improve my chances of winning my disability
claim?
▫ Be as open and honest with SSA as you can when giving
them information on your medical impairments and
what keeps you from working. Many people fail to tell
SSA about any mental impairments or learning
disabilities that may keep them from working. Problems
with learning, concentration, and memory as well as any
symptoms you may have from depression or anxiety
significantly effect your ability to work a full time job.
▫ Also, make sure you see a medical provider for any and
all impairments, complain about all of your symptoms
and go to see them as much as possible in order to get
adequate documentation on your disabilities.
FAQ’s continued…
• How do I get the medical documentation I
need if I do not have the money to go to the
doctor?
▫ You should apply for Medicaid. There are
also some free clinics in the area that your
legal representatives can give you
information on that you can get treatment
and some medications for free or at a
reduced cost. There may be a wait time to
get into some of these free clinics so it is
better to call sooner rather than later.
Resources
• Free or Reduced Cost Medical Care
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Kansas City Free Health Clinic
Samuel U Rodgers Health Center
Swope Health Central
Truman Medical Center
Northland Medical and Wellness Center
Comprehensive Mental Health
Johnson County Mental Health Center
ReDiscover (formerly Research MH Services)
Tri-County Mental Health Services
Wyandot Center
Mental Health Association of the Heartland
Different Types of Resources
• Shelters
▫ Metropolitan Lutheran Ministries of Kansas City
(MLM)
▫ Kansas City Rescue Mission
▫ City Union Mission
▫ reStart Inc.
▫ Hope Faith Ministries
▫ Mt. Carmel Community Outreach Ministries
▫ Joyce Williams Shelter
Contact Information:
• Saundra J. McDowell
• Peterson & Associates, P.C.
• 801 West 47th Street, Suite 107
• Kansas City, MO 64112
• 816-LAW – FIRM
• [email protected]