Social Security Disability, the Trial Work Period, EPE, and Expedited Reinstatement

"After my 9 month work window has depleted, what happens with my family's benefits next?"


Kest,

The nine month trial work period is a time that an individual can earn over the SGA limit and not have it affect their ability to receive a disability check.

Remember, that nine month period does not have to be continuous, but can occur at any time in a rolling five year period. Your disability benefit will not stop as long as your work activity in the tenth month is not SGA (a monthly earnings amount established by SSA that they consider to equate with substantial gainful activity).

If you are earning over the SGA monthly amount in the tenth month your disability benefits as well as the benefits payable to your family will be suspended due to your work activity and you will begin a period of extended period of eligibility known as the EPE.

The EPE allows an individual to restart their disability benefits anytime they become unable to work at an SGA level. The EPE lasts for 36 months. Once the 36 month period elapses, then the first month you perform SGA your disability benefits will be ceased.

At this point. You have an additional five years to file an expedited reinstatement of your benefits if you stop work due to the same disabling conditions, or you file a new disability claim all together. The expedited reinstatement will give you six months of provisional payments while they make a decision as to your disability status.

A Social Security claims representative will go over your options with you. Sometimes if you can wait, a new disability decision will increase your monthly benefit amount.

These are your options as far as what happens after the nine month trial work period. Anytime your disability benefit is stopped, your family's benefits stop as well.






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Social Security Disability Secrets

Social Security Disability Benefit Questions



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Should Social Security Disability Have A Separate Impairment Listing For Migraines?

Individuals who experience debilitating migraines have a difficult time being approved for Social Security disability and Supplemental Security Income disability benefits. Social Security has no specific impairment listing for migraines (in the listing of impairments referred to as the blue book).

That means that individuals with migraines have their symptoms and residual functional capacity--what an individual is able to do in spite of the limitations of their disabling condition or conditions--evaluated under other impairment listings.

This type of evaluation process leaves individuals with migraines at a disadvantage. Individuals with migraines may or may not meet or equal the listing criteria of the “other” impairment listing or listings. In fact, most individuals with migraines have their symptoms evaluated under the neurological or mental impairment listings which have criteria that are difficult for an individual suffering from migraines to meet or equal.

This further means that most individuals suffering with migraines have to depend upon medical and vocational guidelines to be approved for disability benefits.

Due to the nature of migraines, i.e. intermittent exacerbations, it is often hard to even meet the criteria for medical vocational disability allowances (note: medical vocational allowances are approvals based on the determination that a claimant's condition is so limiting that it prevents the ability to engage in substantial and gainful work activity).

In my opinion, there should be a separate migraine listing and the criteria should possibly mirror, in approach, the Social Security asthma impairment listing.

The criteria for a migraine impairment listing could potentiall be along these lines:

A) Chronic migraines due to any cause with migraine headaches occurring in spite of prescribed treatment that requires a doctor’s intervention,

B) headaches occurring every month or even every couple of months.

Additionally, C) if an individual has to go to the emergency room and it takes a full twenty-four hour day to get the headache under control, it could count as two attacks within a consecutive twelve-month evaluation period.

And D) if an individual has at least six migraines that meet the above criteria in a consecutive twelve month period they should be able to meet or equal the migraine listing.

Unfortunately, under current disability evaluation guidelines, individuals with migraines are forced into trying to meet the criteria of another impairment listing. This fact causes many individuals with migraines to have a harder time being approved for disability benefits.

Keep in mind, I am not implying that you should not file for disability on the basis of migraines if your migraines prevent you from maintaining employment, because statistics indicate a large percentage of individuals who apply for disability and follow the disability appeals process through to the hearing level will be awarded disability benefits.

For instance, over sixty percent of all individuals who file a request for a disability hearing before an administrative law judge are approved for disability benefits.





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Social Security Disability Secrets

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How Hard Is It To Sign Up For Social Security Disability?

I was quite amazed at the response that I found at a forum for this question.

“An attorney will only help out with paperwork. That may be worthwhile as they know how things should be worded for SSA to be able to understand how disabled the individual is. My child is blind and we have filed two times and have been turned down two times. Each time the soc sec office was full of people that seemed physically ok. Do not be surprised if you are turned down, I have been told that it is routine. Keep applying”


First of all, regarding the "physically ok" comment, please remember that Social Security offices take care of much more than disability program claims. Many individuals are there to apply for Social Security cards, get replacement cards, or to file for other benefits, such as retirement and widow or widower’s benefits.

This person goes on to state that a lawyer might be useful in filling out paper work because they know how to word things so that Social Security can understand how debilitated an individual is. She mentions that she has applied for her blind son twice and been denied. Well perhaps she should think of appealing her son’s disability claim rather than continuing to file new initial disability claims. There is no doubt that it is more beneficial for a person to use the disability denial appeal process than filing a multitude of initial disability claims (and, yes, some people do file a multitude of new claims--as many as twenty--while never seeming to realize that they have the option to file an appeal).

This person is correct in stating that it is routine to receive disability claim denials and that is true; however it is just as routine for individuals to be approved for disability. Depending on the state in which you live, about thirty to forty percent of all initial disability claims are approvals. And while that still means sixty percent are denied, it is not as grim as most individuals think.

Unfortunately, many individuals who are denied initially do not file any appeals. And some never file again even when they have severe health problems.

Social Security disability is not hard to sign up for, nor is it impossible to win disability benefits, but an individual has to take the step to file or sign up for disability and then follow the disability appeal process if they are denied.

Using a Social Security representative or attorney can help with the filing of initial disability claims (especially for individuals with memory deficits and those with conditions of a cognitive or affective nature). And representatives can be especially helpful in filing disability appeals and, if necessary, presenting an individual’s disability claim in the most favorable manner at an administrative law judge disability hearing.

To reiterate:

1. If you get denied, don't keep applying. In most cases, if you keep applying, you'll keep getting denied. Instead, appeal the denial.

2. Denials on social security disability and SSI claims are not a matter of standard procedure, meaning there is no "automatic denial system". A large percentage of claims do get approved at the initial claim level. On the flip side, more claims get denied than get approved which is why claimants should prepare for this possibility.

3. Disability representatives at the hearing level do quite a bit more than simply "filling out paperwork". They assemble a presentation of the case that is optimized for winning a claim. Statistically, represented claimants have about a fifty percent greater chance of winning at a disability hearing than unrepresented claimants.





Return to:

Social Security Disability Secrets

Social Security Disability Benefit Questions



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