Frequently Asked Questions
Q. What is Social Security Disability?
A. Social Security Disability, also called SSD, SSDI (Social Security Disability Insurance) or DIB (Disability Insurance Benefits), is a benefit received by disabled workers and/or their dependents from the Social Security Administration. Just as you may begin collecting “regular” Social Security Retirement benefits when you retire, if you become disabled and are unable to work before you reach your “full retirement age,” you may apply to collect Social Security Disability benefits.
Q. Am I eligible for Social Security Disability payments?
A. You are eligible if you cannot perform any substantial work, due to a condition or combination of conditions that has lasted or is expected to last for twelve months or more. A finding of disability is not made only upon showing you cannot perform your regular work. Your disabling condition(s) may be from any source, such as an injury either on or off the job, congenital illness, or contracted or hereditary disease. Social Security may consider you disabled due to either a physical or mental impairment or some combination of both.
If your condition is extremely severe it may meet a “Listing” level with Social Security, and you will be found disabled regardless of your educational and vocational background. If your condition(s) are not of “Listing” level, then the Social Security Administration takes into consideration your age, education, and past work history in connection with your medical problems to determine if you can perform any work.
In addition, unless you are a disabled widow, you must have worked for five of the ten years preceding the date you claim to have become disabled. In order to succeed in your claim, you will need to produce proof of age and legal status (citizenship or legal alien papers).
The spouse and minor children of a disabled worker may also be entitled to benefits. The same is true of a disabled widow or widower, who may be eligible on the spouse's account, regardless of his or her own work history.
We are happy to advise you as to whether you are eligible for benefits. However, every case is unique, and requires individual, careful analysis, which we can discuss at your free initial consultation.
Q. What if I haven’t worked long enough to be eligible for Social Security Disability?
A. You may still be eligible for benefits under Supplemental Security Income, or SSI.
Q. What is SSI?
A. SSI, or Supplemental Security Income, is a needs-based program, intended for disabled people with very low household income and minimal resources. In determining whether or not you qualify for SSI, the Social Security Administration will consider your assets and income status, including spousal and other household income. People who fall into this category include stay-at-home parents, or young people who have worked little or not at all before becoming disabled.
If we help you to apply for SSI, we will also make sure to correctly characterize support or loans you may be receiving from family members. Otherwise, Social Security will probably try to reduce SSI payments to “offset” the value of living expenses covered by family members who are helping you out.
Click here to learn more about the difference between Social Security Disability and SSI
Q. How long should I wait before I apply for Social Security Disability benefits?
A. You should file for benefits as soon as you become disabled, if your condition is expected to last at least twelve months. Don’t make the mistake of waiting, because your retroactive benefits can only go back one year from the date of your application. You do not need to wait until other, related claims such as Workers’ Compensation or a personal injury lawsuit are settled, and you should not wait until your resources are low. Your claim will take months or possibly years to resolve, and your SSD benefits are based on your medical condition, NOT on your finances or need.
Q. What are Retroactive Benefits?
A. Retroactive benefits are benefits from the Social Security Administration that you may receive starting in your Month of Entitlement, which is either one year prior to the date you applied for benefits or 6 months after your disability began (whichever is closer to the date of the application). The retroactive period is the period between your Month of Entitlement and the date that the Social Security Administration notifies you of their determination that you are disabled.
Q. If I am suffering from mental illness, can I be eligible for Social Security Disability payments?
A. Yes. Mental illness is a medical condition, and we have helped many of our clients win disability benefits where mental illness was the basis of their claim. It is also important to note that even if a physical condition is the primary reason you are applying for disability benefits, any psychological limitations or conditions may strengthen your claim and should be included.
Q. Do I need an attorney to apply for Social Security Disability Benefits?
A. No. Claimants can apply on their own or with help from a Social Security representative. However, the government's statistics show that claimants who are represented are far more likely to succeed than those who are not. Being represented by an experienced attorney will significantly increase your odds.
At Insler & Hermann, we are successful in over 90% of the claims we handle (based on statistics over the past 12 months). The percentage of claims we win at both the initial level and at the hearing level is far above the national averages of claims otherwise approved.
Q. What will an attorney do for me?
A. At Insler & Hermann, we will review or help you to complete all necessary forms, and we will file them electronically for you---a service that can shorten the wait for a decision. We will contact your doctors and other health care providers in order to collect all the necessary medical information required to prove your case. We will deal with Social Security on your behalf, and make sure that your case moves through the system as quickly as possible. If your case is appealed to a hearing, we will develop your claims file and make sure that you are fully prepared to testify. We will always be available to answer your questions and provide advice regarding various benefits to which you may be entitled. We will also review your benefits once they are awarded, and make sure that you continue to receive your benefits so long as you are unable to work.
Different attorneys will provide you with different levels of service. The basic job of a Social Security Disability attorney is to prove to the Social Security Administration, based on medical evidence, why you cannot work, and to advocate for you to receive the benefits to which you are entitled.
Q. How do I pay my attorney?
A. Attorneys' fees in Social Security Disability claims are generally paid out of the claimant's retroactive benefits.
If an attorney represents you, the government withholds 25% of all retroactive benefits as a possible attorney's fee. Although you and your attorney can agree to any payment (for example: a flat fee, hourly charge, or percentage of your award), in most cases our office accepts the 25% that the government withholds as the attorney's fee. At Insler & Hermann, we will not charge you any fee unless we are successful in obtaining a favorable decision for you.
Occasionally, a claimant's application is granted before there are any retroactive benefits, or the benefit is quite small. In those cases, we may ask you for a minimum fee, which must also be approved by the Social Security Administration.
Q. What will my Social Security Disability Benefits be?
A. Your benefits depend on your previous work record, and how much you have paid into the system. Most workers receive a Benefit Estimate and Earnings Record annually in the third month before the month of their birthday. You can also get an estimate of your benefits by visiting the Social Security website at http://www.socialsecurity.gov/
If you have children under the age of 18 years, you may be eligible to receive additional monthly benefits for them. You are also entitled to Medicare Benefits beginning twenty-four months after the first month for which you receive a payment for disability. After our initial consultation with you, we will be able to give you an idea of what benefits your benefits are likely to be.
Q. How long will my benefits last?
A. Your Social Security Disability benefits will last either:
a. until you return to substantial gainful activity for more than nine months and are earning more than the amount set by Social Security, or
b. the government proves that your condition has significantly improved, or
c. you reach full retirement age. When you reach full retirement age, your benefits will continue by converting to Social Security Retirement Benefits.
Q. Can I receive Social Security Disability along with other benefits, such as Workers’ Compensation or Long Term Disability?
A. Absolutely. Your eligibility for Social Security Disability is not affected by any other benefits you may receive. If you are disabled you may also be entitled to Workers' Compensation, Long-term Disability or some other disability pension, State Employees Disability, No-Fault and company or union pensions, private disability insurance payments, and more. However, the interplay between these different sources is complex and confusing, and some of these other benefits may offset the total payment amount of your Social Security Disability benefits.
An important part of our job is to review with you all of the benefits for which you might be eligible, and to develop a strategy for you to maximize each of these benefits and awards. This will be a major part of our discussion with you when you meet with us at our office.
Q. Am I allowed to do any work while I receive Social Security Disability?
A. Of course! You can always return to work. However when you return to work , how long the job lasts and how much you earn are three factors that determine what effect your work will have on continued receipt of benefits. Since those factors can lead to many different scenarios, at Insler & Hermann we deal with each work attempt on a case by case basis. We are happy to discuss this with you at any time if you are ready to go back to work. We have heard from clients as long as 15 years after a winning claim with questions about working!
You may return to work in what is known as a "trial work period," and receive benefits for up to nine months while you are working, regardless of how much you earn. If you show more than nine months of substantial earnings, your Social Security Benefits will cease. However, if you earn less than a certain amount (set annually by the Social Security Administration), it should have no effect on your ongoing receipt of benefits.
We always encourage our clients to try to go back to work if they are up to it, but we remind them to tell us before they do, so that we can advise them about what is likely to happen to their benefits once they do.
For more information, click here to learn 7 Things You Need to Know Before You Return to Work.
Q. What Happens to my medical benefits if I can't work?
A. Under a Federal law known as COBRA any employer with more than 20 employees must give an employee who leaves their employment the option to pay for and maintain his or her medical benefits for a maximum of up to 18 months. If you are approved for Social Security Disability during that 18 month period, you can extend your COBRA coverage for an additional 11 months, such that COBRA will expire you’re your Medicare eligibility begins, giving you continuous medical coverage.
The drawback to COBRA is that it is quite expensive, and you may not be able to afford to pay for it. However, low cost medical programs do exist to cover individuals or families who cannot afford or have lost their COBRA benefits. At Insler & Hermann, we will help you to identify the programs that are best for you, and we will guide you on how to save money on prescription medications.
Click here to learn more about saving on healthcare and medications.
Q. What happens to my other benefits and pension if I can't work?
A. Unfortunately, there is no simple answer to this question. You need to check your employee manual, and contact the Human Resources/Personnel department of your employer or your union. Many employers and almost every union have special pension provisions for disabled employees or members that often depend upon their receiving Social Security Disability. We can advise you regarding this after we meet to discuss the particulars of your case.