Disability Secrets: Tim Moore: June 2010 Archives

Do the Social Security Disability Non Medical Requirements have to do with your Income Or Property?

By Tim Moore on June 27, 2010 1:19 AM | Permalink It depends on which disability program your claim is being filed in. Social Security disability non-disability requirements have nothing to do with your property or non-wage income. In fact, you can have all the property and all the income you want, other than wages, and still collect your monthly Social Security disability benefit. That is because Social Security disabilityâs non-disability requirements involve insured status, not income and resource limits. Insured status is earned through an individualâs work activity prior to becoming disabled. Each year, an individual has the possibility of earning four work credits or quarters of coverage. And the amount needed to be fully insured depends upon how old an individual is when they became disabled. However, an individual needs to be not only "fully insured" but "disability insured" to be eligible for Social Security disability benefits. Disability insured status requires that a person have worked twenty out of the past forty quarters or five out of the last ten years. If an individual is both fully insured and disability insured they meet the non-disability requirements of Social Security disability. However, if you are filing for Supplemental Security Income (SSI) disability, there are non-disability requirements that do include income and resource limits. To be eligible for this disability program, an individual or couple must not have income or resources that are over these limits. Resources might include land other than where an individual lives, vehicles other than the highest valued vehicle, stocks, bonds, cash, pensions, 401Ks, or even jewelry. Basically, anything that can be readily converted to cash. Income might include workmanâs compensation, long or short term disability benefits, rental income, trust fund income, etc. Basically, any kind of income entering into the household counts toward the income limit, even help from family and friends. In summation, in order to be meet the non-disability requirements of the SSI program, a person must be under the established income and resource limits (and these limits have the potential to change every year). Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

How Long After You Go On Social Security Disability Do You Have To Sign Up For Medicare?

By Tim Moore on June 23, 2010 6:15 PM | Permalink You do not have to sign up for Medicare benefits once you have been approved for disability benefits. Medicare entitlement does not begin until two years following the month you are entitled to a disability benefit check (which is NOT necessarily the same thing as having to wait for two years for medicare benefits following an approval for SSD benefits, but keep reading). Once you become eligible for Medicare, you will receive a Medicare card in the mail for your entitlement to part A and part B of the insurance plan with your month of entitlement plainly printed on the card. Once you are entitled to your Medicare part A and B, you can investigate if Medicare part C or D would give you the coverage you need. Be careful when choosing a Medicare Part C or D provider, because the insurance providers involved in Medicare C have differences in coverage and the drugs they cover. Congress decided long ago that there would be a two year waiting period for medical insurance coverage for individuals who have been approved for social security disability benefits. It was likely a pragmatic decision on the part of the US government to save money, and since this two year waiting period for Medicare coverage saves the government millions or even billions of dollars each year it is unlikely that the two waiting period will ever end. The wait for medical coverage after being approved for SSD disability is just another reason individuals who are considering a disability claim with Social Security should try to prepare for financial hardship while waiting for both disability and Medicare coverage. If at all possible, try to keep your insurance (granted, this may be impossible due to premium costs) when you file for disability because not only will you have the wait to be approved for disability, you also have a two year wait for Medicare coverage (note: if a claimant' disability onset date, i.e. when you became disabled, is set far enough back then it may be that by the time you are approved for disability your two year waiting period for medicare may already have been served out). If that is not possible, check for free medical clinics, or medical clinics that charge on the basis of income while you wait for Medicare coverage. These same clinics often offer free medications for their patients. Additionally, there are some websites that put individuals in need of medication in touch with manufacturers who have programs to help individuals who cannot afford their medication. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

Do Disability Lawyers only get paid if You Win Your Social Security Case?

By Tim Moore on June 21, 2010 4:23 PM | Permalink Recently, someone made the following comments (paraphrased of course): "Disability Lawyers only get paid if they win your case because their fee is paid out of your own disability backpay, which is limited to a maximum but also which changes from state to state". Were these comments correct? Only partially. Yes the fee charged by a disability lawyer does come out of a disability claimant's back pay. Which means, of course, that the lawyer (or non-attorney claimant's representative) only gets paid a fee if the case is won (Incidentally, the fee is limited to a maximum of 25 percent of a claimant's back pay and is capped to a certain maximum that it is not allowed to exceed. To see the current maximum fee that may be charged, visit this page: Social Security Disability Attorney Fees - How much is the Fee and When do you Pay?). However, contrary to what the commenter stated, the fee does not change from state to state. The social security disability and SSI disability system is a federal benefit system, not a state one. Consequently, the maximum fee that can be charged by a disability representative has nothing to do with which state you happen to reside in. Note: disability representation fees are set and regulated by the social security administration. Thus, a disability representative has no input into what can be charged as the maximum fee for representation. It is simply 25 percent of the back pay from social security, up to the max that is in effect. However, claimants should still carefully read the fee agreements that they sign since representatives can charge for a wide array of other expenses. The most typical of these is reimbursement for the cost of gathering medical records, but charges can include reimbursement for postage, phone calls, and even travel expenses. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

Being Prepared When Applying for Social Security Disability Benefits

By Tim Moore on June 19, 2010 1:53 PM | Permalink Here's a basic, brief list of things to keep in mind when applying for disability. 1. Be sure to take all needed documentation to the social security office when applying. This will include some basic documentation that you need to get your claim started such as an original birth certificate, a social security card, proof of military service if this is the case, information regarding a worker's comp claim if you have one, and forms that might have been mailed to you by SSA in advance of your application interview date. 2. Before you even initiate your claim, since you will be supplying the social security administration with your medical treatment sources (doctors, hospitals, and clinics where you've been treated) and your relevant work history (jobs you've done within the last 15 years), you may wish to write this information down now. In many cases, individuals need to look up the name and contact information for a doctor they've seen in the past. Additionally, since social security disability decisions and SSI decisions are both medical and vocational in nature and may be affected by how a claimant's past jobs are classified (for example, if a person spent the past 15 years working as a truck driver, the type of truck driven might involve different exertional and other requirements; thus, an improper job classification can have an adverse effect on the outcome of a case) be sure to provide job titles and very clear descriptions of what the work involved. 3. Prepare yourself mentally and emotionally for the distinct possibility that your disability claim may be denied. This is not an absolute, of course. Roughly, thirty percent of new claims for disability are approved. But the flipside is that approximately seventy percent of claims will be denied. Given that, a claimant should prepare for the strong possibility of a denial, and, likewise, prepare to react appropriately should a notice of denial arrive in the mail. How should one "react appropriately" to a denial? By not doing what so many claimants actually do, which is to either give up on their claim entirely, or procrastinate in the filing of an appeal, or mistakenly go through the process of filing a brand new application instead of filing a disability appeal (many claimants make the mistake of doing a new application when they should appeal the denial of their first application). If you get denied on your claim, immediately initiate steps to file an appeal. Being prepared when applying for social security disability also means knowing at the outset that, should your claim be denied and should you enter into the appeals process, several things will, in all likelihood, happen. Statistically, you stand a high chance of your first appeal, the request for reconsideration, being denied. This happens more than eighty percent of the time in most states. Secondly, if you file your second appeal, a request for hearing before an administrative law judge, you may face a very long wait before your disability hearing is scheduled to occur. Waits of over 2 years are not uncommon. The question that enters into many applicants and would-be applicants is often, "Can I speed up the process of getting a hearing scheduled?". Unfortunately, the answer is usually no, simply due to the facts that A) long waits for hearings have now become the norm, B) expedited hearings are granted as a result of compelling dire need, and C) due to extensive backlogs in the disability system, dire need situations have become fairly commonplace (meaning most applicants tend to be in the same boat). However, despite the long waits involved, claimants should not give up on their claims. The statistics are fairly clear in pointing out that individuals who have been denied for disability at the application level and who pursue their claim at least as far as the disability hearing level have a significantly improved chance of being awarded disability benefits. By some measures, individuals who go to disability hearings with representation have a better than sixty percent of being approved for benefits, despite the fact that they were previously denied at the first two levels of the disability claim system. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

If You Get Social Security Disability, Do You Have to Pay For Medicare?

By Tim Moore on June 15, 2010 1:27 AM | Permalink Yes, if you get approved for title II disability benefits, which are social security disability benefits, you will, at some point, receive medicare coverage. And you will be charged a monthly premium cost (the amount has changed over the years, but, until recently has always been under $100 per month, and for 2010 is still under $100 for most beneficiaries). The cost is something all social security and social security beneficiaries are made to pay, though some individuals may qualify for a special medicaid program that actually pays the cost of the medicare program (for example, in North Carolina this program is called MQB, medicare-aid for qualified beneficiaries). Medicare Insurance coverage comes in different parts; some parts are paid and one is free to the beneficiary. Medicare part A coverage is free to both Social Security disability and Social Security retirement beneficiaries. Medicare part A is basically coverage for a hospital stay and like all medical insurance programs it does not pay all the costs incurred during a hospital stay. It does not cover any of the cost of doctor visit or testing that your doctor may want you to have. If it happens outside the hospital, Medicare Part A does not cover it. Medicare part B is a pay-for-coverage insurance that all beneficiaries have to pay whether they receive retirement or disability benefits. What it covers includes doctor visits and some types of testing. Medicare will pay some of the medical costs for doctors in or out of the hospital, testing, and various other things, but it will most likely not pay all the cost incurred for testing or doctor visits. Medicare part D is prescription medication coverage that comes at a cost to Social Security part A and B beneficiaries. There are a lot of ins and outs to this coverage and you should consult Medicare when choosing an insurer for your prescription to make sure that A) they cover the medications that you take as well and B) to fully understand how Medicare part D works. Medicare offers one last type of pay coverage for Social Security beneficiaries, and that is part C. Medicare part C is a pay insurance coverage provided by a variety of insurance companies. It is designed to be a Medigap policy meaning that they cover costs that are not covered by Medicare part A and Medicare B. Once again, prior to deciding which company to go with, you should either review the company's coverage in your Medicare book (that Social Security sends out), or call Medicare. Note: To apply for Part C or D you must do contact Medicare. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

What If have a Job While Applying For Social Security?

By Tim Moore on June 13, 2010 1:03 AM | Permalink Contrary to popular belief, an individual can work when applying for Social Security disability. When a denial based on work activity occurs, it's not due to the simple fact that the individual has a job, but, rather, due to the amount of their monthly earnings. Social Security uses a monthly earnings amount that it considers to equate with substantial gainful activity (SGA). If you can earn this amount or more when you engage in work activity, you are not considered to be disabled. The performance of SGA-level work activity is a potential factor in all initial determinations, disability appeals, and even continuing disability reviews (all approved claims are subject to periodic reviews--that typically occur years later--to determine if the person is still disabled). And the performance of SGA-level work activity can cause an individual who is working to be denied at any level of the disability process. In other words, an individual is able to do "some" work while applying for, or even receiving, disability. But if they are performing work that is over the SGA monthly earnings amount, it can negatively impact their disability claim or their current entitlement to disability benefits. Once an individual applies for disability, they should be very careful about their work activity, because it can cause a denial of a disability claim even before the claim is sent to a disability examiner for a medical determination. Or, if the claim has been assigned to a disability examiner (the examiner is the person who reviews your medical records and work history for the purpose of rendering a decision on your claim), it could cause the disability claim to be recalled from the state disability determination agency and denied before a medical decision can ever be made. Basically, individuals who wish to file for disability should consider the fact that Social Security is a total disability program, not a percentage of disability program such as VA disability. In order to be eligible for Social Security disability, an individual must be impaired to the extent that they are not able to work at a level that is self-supporting. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

Denied For Disability But Didnât Get The Notice, Can I Appeal?

By Tim Moore on June 9, 2010 9:32 PM | Permalink All Social Security disability decisions can be appealed, but the appeal needs to be received by your local Social Security office no later than the sixty-fifth day following the date of the denial notice. This appeal period is a sixty-day period with five additional days for the mailing of the decisional notice. If you did not receive your denial notice it would have been difficult to make a timely appeal. But Social Security does allow appeals that were filed late to proceed in some cases. Social Security allows disability claims representatives and administrative law judges to grant âgood causeâ for appeals that are filed late, however the decision to grant good cause is at the discretion of the claims representative or administrative law judge. The question is, how do you get good cause for a late appeal filing? Some acceptable good cause reasons might be: 1. You were very ill and you could not contact Social Security in person, by phone, through another person; or 2. You had a death or serious illness of a member of your immediate family; or 3. Your records were destroyed through some kind of accidental cause such as a fire or flood; or 4. You were searching for additional information or evidence to support your disability claim but your appeal period ran out before you could get it; or 5. You were given confusing, incomplete, or incorrect information or you were in some way misguided by an SSA representative about your rights to file for pay continuation, a reconsideration, request for an administrative law judge hearing, appeals council review, or a civil action; or 6. You did not understand the requirement to file your appeal timely or you were not physically or mentally able to file timely; or 7. Your decisional notice was not received; or 8. You sent your appeal to another government agency within the appeal period and the request did not reach your local Social Security office until the appeal period had expired; or 9. You thought your representative filed your appeal timely; or 10. Some unusual and unavoidable circumstances exist that show that you could not reasonably be expected to file your appeal timely. These are just some of the reasons that could be used to show that you had good cause to file your appeal late. If you did not receive your decision notice, you must provide Social Security with a reason that you did not receive the notice such as the possibility you moved to a new address and did not report it to SSA. Obviously, in such a scenario, your notice would not have reached you in a timely manner. Another scenario might be that you continue to reside at the same address and have had a problem with your mail being delivered to others, or actually being stolen. Whatever the reason, you must provide a written statement explaining the reason you have filed your appeal late. Once the claims representative receives your statement, they evaluate the evidence and make a good cause determination. In the case of a late filing of a request for a administrative law judge hearing, the statement is included in the file and the judge determines whether or not they are willing to grant good cause for the late filing. Generally, SSA field office claims representatives are more flexible in granting good cause for late appeals than administrative law judges. Many disability claimants have to begin the disability process over if they miss their appeal period for an ALJ disability hearing. You should make sure to keep Social Security informed of any address changes so that you are less likely to miss your decisional notices. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

How Many Hours Can A Person Work If They Are Receiving Social Security Disability?

By Tim Moore on June 7, 2010 8:08 AM | Permalink For most individuals who are applying for disability or actively receiving disability benefits, the number of hours worked is not so much an issue. Yes, the social security administration, in applying its definition of disability, does examine an individual's ability to work, but it does this by considering whether or not a person can work and earn at least a certain amount each month (SGA). Hours by themselves only count against disability eligibility if the person in question is either self-employed or is a corporation head. Why? Because a self-employed person or corporation owner can potentially work hours while receiving no pay (perhaps because they are reinvesting money in their business or perhaps because they have not made a profit yet). Self-employed individuals may currently work up to eighty-five hours per month and be eligible for disability benefits. Of course, net earnings do count toward the SGA monthly earnings limit. SGA stands for substantial gainful activity and it is simply a monthly earnings amount that Social Security uses to determine if an individualâs work is self-supporting. Each year, Social Security establishes the monthly earnings amount that it considers to be self-supporting and that becomes the SGA monthly earnings limit. If an individual is not self employed but working for an employer, the hours they work are not necessarily a problem as long as they are not earning over the SGA monthly earnings limit. If you are receiving disability benefits, your monthly disability benefit will be affected by the performance of SGA (i.e. working and earning at least the SGA amount) and will initially cause you to use your nine trial work months. Trial work months are months for which you are allowed to make any level of earnings and still remain eligible to receive your monthly disability check. It is important to remember that a trial work month can occur anytime in a sixty-month period and they do not have to be consecutive. Once you use up your trial work months (you have nine of them), you enter an extended period of eligibility (EPE) that lasts for thirty-six months. You will not be eligible for your disability benefits during any month in which you earn over the SGA monthly earnings amount during the EPE. Recap: A) If you happen to be working over the SGA limit in the tenth month following your trial work months, your disability benefit will be suspended until you cease to engage in SGA-level work activity. B) Once your EPE is finished, any month in which you perform SGA will terminate your disability entitlement. If you are considering work activity, you should contact your local Social Security office so that a claims representative can explain work activity issues to you so that you do not cause your disability benefits to be suspended or terminated. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

Can You Collect Social Security Disability if You are Obese?

By Tim Moore on June 3, 2010 8:01 AM | Permalink Prior to 10/25/1999, Social Security had a specific medical impairment listing that dealt with obesity and the criteria needed to meet or equal the severity requirements for disability benefits. Mostly due to public opinion about disability benefits being awarded on the basis of obesity, Social Security deleted the listing. Now, Social Security considers obesity in conjunction with other impairment listings. For example: musculoskeletal, cardiovascular, and respiratory body system impairment listings. Social Security still considers obesity to be a medically determinable impairment and disability examiners must consider the effects of obesity when they evaluate an individualâs disability claim. Social Security disability examiners are supposed to consider a disability claimantâs weight over a long period of time with no consideration given to short periods of weight loss. For Social Security disability decision purposes, a disability claimant has obesity if their weight or BMI indicates that they have consistently been obese. Disability examiners generally accept the weights recorded in the disability applicantâs medical treatment records and Social Security considers obesity to be a severe impairment on its own or in conjunction with other impairments if it renders an individual unable to perform basic work activities. While Social Security no longer has any specific weights or BMI (body mass index) levels that, in and of themselves, indicate a severe impairment or a non-severe impairment, disability examiners are instructed to do individualized assessments of how a disability claimantâs obesity impacts their functional capacity. In order to make these assessments, the disability examiner must have A) medical records that give a description of an individualâs functional limitations, corroborated by objective medical evidence (exam notes, testing, etc.), B) a completed activities of daily living questionnaire (completed by the applicant), and C) perhaps a third party activities of daily living questionnaire (completed by the applicantâs chosen third party, who is often a friend, neighbor, or relative). When considering if a disability applicantâs obesity meets or equals the severity of a Social Security impairment listing, disability examiners can consider an impairment listing to be satisfied if the combination of obesity and the impairment (such as COPD or coronary artery disease, for example) meets or equals the criteria of the impairment listing itself. Obesity often increases the severity of co-existing impairments. This is particularly true for respiratory, musculoskeletal, and cardiovascular impairments. For example, disability applicants with COPD or asthma may be further limited by obesity if it prevents the chest and lungs from expanding. Another example might be disability claimants who have functional limitations as a result of musculoskeletal conditions (such as degenerative disc disease or arthritis); the effects of obesity might further impair their mobility. To reiterate, individuals with significant medical impairments that are compounded by the effects of obesity may equal or even meet the requirements of an impairment listing. So while the actual obesity impairment listing is gone, Social Security, officially, still gives consideration to the disabling effects of obesity in their disability determinations. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

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Disability Secrets: Tim Moore: June 2010 Archives

Social Security Disability

Workers Compensation

Do the Social Security Disability Non Medical Requirements have to do with your Income Or Property?

How Long After You Go On Social Security Disability Do You Have To Sign Up For Medicare?

Do Disability Lawyers only get paid if You Win Your Social Security Case?

Being Prepared When Applying for Social Security Disability Benefits

If You Get Social Security Disability, Do You Have to Pay For Medicare?

What If have a Job While Applying For Social Security?

Denied For Disability But Didnât Get The Notice, Can I Appeal?

How Many Hours Can A Person Work If They Are Receiving Social Security Disability?

Can You Collect Social Security Disability if You are Obese?

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