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There is an article on this website that is fairly similar to this one and it's title is, How can I get disability? So, why this article? Aren't social security disability benefits and SSI disability benefits essentially the same thing. Well, yes and no. First of all, let's discuss the difference between SSD (social security disability) and SSI (supplemental security income). Social security disability is a disability benefit program administered by the Social security administration. It falls under title II of the social security act and is available to any individual who is deemed to have "coverage". What is coverage in terms of SSD? Simply this: to be eligible to receive social security disability insurance benefits, a claimant must have enough "earned credits". Credits are earned quarterly via payroll deductions. In other words, if you've worked enough, you'll have enough credits to be eligible for disability benefits. How many credits do you need for SSD? It varies, depending on a claimant's age. However, when an applicant files for disability, the social security office will determine whether or not the claim will be for social security disability, SSI, or even both types of benefits (this is known as a concurrent claim and it is available to individuals who have coverage for title II SSD benefits, but whose monthly benefit amount might be particularly low). SSI disability is a disability benefit program that is also administered by SSA. It falls under title 16 of the social security act and is available to individuals who have either never worked, or do not have enough earned work quarters to qualify for title II social security disability coverage. Obviously, then, SSI will apply to children who are disabled, individuals who, for whatever reason, have never worked, individuals whose earnings were very low, and individuals who once worked and were eligible to receive social security disability but are now no longer eligible because they have not worked in a very long time (and, thus, their coverage has lapsed, similar to car insurance lapsing). How do you get SSI? To have an application taken for SSI disability, you simply need to fit into one of the categories mentioned above. However, to actually be approved for SSI and get SSI disability benefits, you need to medically qualify. And to explain this, we should briefly explain how the disability process works (and since these programs are administered federally, this overview will apply regardless of your state of residence). When you file an application for SSI, the actual application itself is taken by a social security claims rep. Claims reps work at social security field offices and, in addition to a host of other duties that include resolving work issues and inputting retirement claims, take SSI disability applications. After an SSI disability application is taken, it is, obviously, "processed". But what does this mean when we say that a claim is being processed? It simply means that the SSI case is sent off to another agency that specializes in doing nothing but rendering medical determinations on SSI (and SSDI and medicaid) claims. This agency goes by a number of different names (depending on the state in which you live). However, in most states, it is known as Disability Determination Services, or simply DDS. When an SSI disability application arrives at DDS, this is what happens. The file is immediately assigned to an individual who will process the medical portion of the claim. This individual is known as a specialist, or disability examiner. On the same day that the SSI claim arrives on the examiner's desk, the examiner will begin to send out letters to the claimant's treatment sources (hospitals, doctors, counselors, etc) requesting the claimant's records. Then, for the most part, the file goes into a filing cabinet where it sits and waits until the records arrive. How long is this wait? Well, this accounts for most of the "wait time" on an SSI disability claim, since many medical providers (especially large hospitals) are particularly slow when it comes to copying and sending records. Sometimes the wait for medical records can stretch out to a period of months, despite the fact that multiple status calls may be made by the disability examiner along the way. At some point, however, the records will arrive. And after they do, they will be evaluated by the DDS examiner who will consult with a physician who acts as a medical consultant (DDS disability examiners work in units composed of supervisors, other examiners, and both a medical and a psychological consultant). What determines whether or not you will get SSI? It all comes down to what is in your medical records. And for this reason, it is particularly important that you keep going to a doctor so that, when your SSI claim is reviewed, not only will you be able to present a medical history, but recent medical records as well (basically, the examiner--or the judge if your case is at the hearing level--needs to have access to records that are no older than 60 days in order to determine that you are currently disabled). Likewise, it is also important that you have a supportive doctor since your treating physician's office notes may have a large impact on whether or not you get SSI. Medical record documention is the keystone of the evaluation process for both SSI and social security disability claims since it will determine, in the mind of the disability examiner or the administrative law judge (if your case has gone to the hearing level), what you are still physically and/or mentally capable of doing. What you are still capable of doing, of course, is referred to as your residual functional capacity. How does your RFC, or residual functional capacity, play into whether or not you will get SSI disability? Here's how: your residual functional capacity will be used to determine whether or not you are capable of going back to any of the jobs you did in the past. If it is decided that you are not capable of going back to your past work, an evaluation will be made to determine whether or not you are able to perform "other work" of some kind. Not surprisingly, most SSI applicants who are denied their SSI benefits are turned down on the basis of other work, i.e. it is decided that they are capable of doing some form of work other than what they did in the past. Without a doubt, the SSI disability process is a fairly difficult one and if it wasn't there wouldn't be such a strong need for disability lawyers. Do you need a lawyer for an SSI case? It may depend on where you are in the process. If you have just applied for SSI or SSD, having a lawyer may not make a difference (though in some cases it may, if you have a fairly energetic lawyer who doesn't mind doing some real work on your SSI claim before it gets to the hearing stage). However, if your SSI case has been denied and turned down, you should probably consider finding representation with solid experience in SSI claims. Disability Advocates Help with Claims Free Case Evaluation What are the legal fees for a disability lawyer? What can you earn on social security disability ? |
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SOCIAL SECURITY DISABILITY SSI LAWYERS ATTORNEYS ANSWERS TO YOUR SSDI & SSI QUESTIONS PAGE 3 ANSWERS TO YOUR SSDI & SSI QUESTIONS PAGE 4 |
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If you suffer from a medical disability such as hip, neck, shoulder, ankle, wrist, back, or other joint problems, disc herniation, degenerative disc disease, spinal stenosis, carpal tunnel syndrome, rsi or repetetive stress injury, inflammatory bowel disease, ulcerative colitis, irritable bowel syndrome, arthritis, dysthymia, depression or other mood disorders, congestive or chronic heart failure, type 1 diabetes, type 2 diabetes, diabetic neuropathy, high blood pressure (hypertension), seizure disorder, stroke, copd, emphysema, hearing loss or poor hearing, statutory blindness, peripheral field problems or other vision loss, clinical obesity, attention deficit hyperactivity or, simply, adhd, bipolar disorder or manic depression, panic disorder, schizophrenia, autism, head trauma, memory loss, low iq, mental retardation, learning disability, epilepsy, cancer, chronic fatigue, multiple sclerosis, lupus, anxiety, inner ear problems, meniere's, vertigo or dizziness, kidney failure requiring dialysis or other renal problems, cirrhosis, hepatitis, or other liver disease, pancreatitis, osteoarthritis, osteoporosis, asthma, bronchitis, cystic fibrosis, rsd or reflex sympathetic dystrophy, crohn's disease, sarcoidosis, peripheral vascular disease, lyme disease, cerebral palsy, down syndrome, hiv, aids, anemia, sickle cell, thyroid problems including hypothyroidism, esrd or end stage renal disease, reflux, gerd (gastroesophageal reflux disease), cfids, muscular dystrophy, coronary artery disease, cardiomyopathy, or tachycardia, bradycardia or other arrhythmia and have initiated or been denied on a social security disability, or ssi, claim for benefits, this site may assist you with your case. Social Security Disability benefits are often difficult to win; however many claims for social security disability are lost simply because a claimant did not know enough about the disability process to their social security or ssi claim. For information re: representation on a social security disability or ssi claim (attorney or non attorney representative), see the "questions" & "how" pages. |
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