Disabled veterans can collect Social Security disability benefits and veterans disability benefits at the same time, so disabled vets will usually find themselves dealing with the Social Security Administration (SSA) at one point or another. Many vets may end up very surprised when they learn how different the two systems are. In this article, we'll discuss the principal aspects of the Social Security system as well as the differences that exist between the two systems.
A person applies for disability benefits at a Social Security office or online, and receives an initial decision within three to four months. (Veterans with service-connected disabilities can have their cases expedited by asking Social Security to file a form called I-2-1-95. Exhibit – Critical Request Evaluation Sheet.)
The claimant's file is then assigned to a disability examiner, a specialist who will gather the claimant's medical records and, then, in consultation with a physician and/or a psychologist who is assigned to the examiner's unit, make an approval decision or denial decision. Unfortunately, the decision that is made is often a denial. If the claim is approved, the claimant is considered 100% disabled, and will be paid either SSDI benefits based on their prior wages or SSI benefits based on the amount of income they have (only those with low income and low assets qualify for SSI).
If the claim is denied, the claimant may follow the disability appeal process and get a reconsideration review. Then, after a very long wait, the claimant can get a hearing with an administrative law judge (ALJ). It can take an extremely long time to have a hearing date set. Depending on which part of the country the claimant resides in, and how backlogged the local hearing office is, it may take a year or longer to have a hearing date set. Asking Social Security to expedite your case for a service-connected disability can help.
Primarily, the SSA system is different from the VA system in that there are no percentages of disability. While the veterans disability system allows the VA to conclude that a vet is 10% or 40% or 100% disabled and then receive benefits based on that determination, in the Social Security system, it is all or nothing. In addition, the definition of disability used by the Social Security system stipulates that your condition must last or be expected to last for at least one year or to result in death. For more information, see Attorney Joel Ban's article on the differences between Social Security and Veterans disability benefits.
If your primary source of treatment is a VA medical center, don't assume that the Social Security disability examiner who is assigned to your case will be successful in obtaining your VA medical records. The VA is notorious in some areas for not supplying needed medical records to the Social Security Administration (SSA). For this reason, it's never a bad idea for vets to personally obtain their medical records themselves so they may turn these records in to the SSA when they apply for disability or file an appeal. One word of caution, though: never submit anything to Social Security without making a copy first, since the SSA is fairly notorious for losing things that have been submitted. Learn more about the medical evidence required by Social Security.
In the Social Security system, an attorney works off a contingency-fee basis from the moment they represent a claimant. In other words, if they win the case, they get paid up to 25% of whatever backpay that SSA decides it owes the claimant. The corollary of this, of course, is that the attorney receives nothing if the case is not won.
Is an attorney always needed in a Social Security disability case? No, there are some outstanding disability representatives who are not attorneys and are referred to as "non-attorney representatives" (some of these non-attorney reps are former Social Security employees who put their experience to use representing disabled individuals). (Read our article on disability attorneys vs. representatives.)
The rule of thumb for getting an attorney (or non-attorney rep) is usually this. If you get denied on your initial claim, you should probably get an attorney, because you can appeal for a hearing in front of a judge, and it will help to have an experienced representative at your side during the hearing. Find out more about how legal representation works in Social Security cases, or use our attorney locator tool below to find a local disability attorney.