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Social Security Disability FAQ

What is the difference between Workers Compensation and Social Security Disability?

Workers Compensation is provided for injured workers and pays medical benefits and a percentage of lost income as a result of a work-related accident.

Social Security Disability is payable to an individual who qualifies regardless of how they became disabled; it is not necessary to demonstrate that the disability was the result of a work related injury.

Is there such a thing as "partial Social Security Disability"?

No. Either an individual qualifies for Social Security Disability in full or they do not. You cannot "partially qualify".

How do I file a claim for Social Security Disability?

You can file either online or in person at a local Social Security Disability office. This application together with any available medical reports will be reviewed and an initial determination issued as to whether you qualify. In many cases, the Claimant is asked to be examined by a physician on the part of the administration to provide additional information to determine disability.

What happens after my claim is filed?

If you receive a favorable decision you will receive an award certificate detailing the actual amount of your benefits. If you are denied, you then have 60 days in which to file an appeal. If you have not had an attorney prior to this time in the process, you would be well advised to do so. Call Silverman Law and speak with one of our attorneys.

What kind of the hearing do I get? Is it like a trial? Is it held in the courthouse?

You receive a hearing before an administrative law judge at a Social Security Disability location. These hearings are surprisingly informal, yet there is so much that is actually going on. The administrative law judge will listen to the Claimant's testimony regarding his ongoing daily problems, medical needs, side effects to medications, etc. The administrative law judge may also request the assistance of a vocational expert hired by the administration.

The vocational expert will review the limitations placed upon you by the treating physicians, consider your age, education, the transferability of your skills, and your residual functional capacity and will offer a professional opinion as to whether or not you are employable. While the administrative law judge is not required to agree with the vocational expert, that's typically what happens.

What are the basic requirements for Social Security Disability benefits?

To obtain benefits - in which your age, education, residual functional capacity, transferability of your skills and any non-exertional impairments are all taken into account - it must be demonstrated that you cannot work on a full-time basis in any job for which you are medically qualified which is available in significant numbers in the national and local economy.

Are there particular guidelines to determine whether or not I am disabled?

Yes, there are "listings" which detail particular medical problems that are automatically deemed disabling. Most Claimants who are disabled enough to actually meet a listing are often approved for benefits and do not require the assistance of an attorney.

If the Claimant does not meet a listing (and only a very small percentage do) the Social Security administration looks at the "grids". These grids are a compilation of disability findings based upon, and in consideration of your age, education, residual functional capacity and the transferability of your skills.

Perhaps the most important aspect is the Claimant's age. What is disabling to a 62-year-old, may also be disabling to a 52-year-old, but probably not to a 42-year-old Claimant. If there is a grid, which supports a finding of "disabled", the administrative law judge is mandated to make that award. In the event a claim does not meet either a "listing" or a "grid" then the court must consider non-exertional impairments, problems suffered by the Claimant without reference to his exertion. The most common non-exertional impairment is pain.

Is it true that pain is considered by the administrative law judge and can help to support a claim for benefits?

Yes. However, the Claimant must demonstrate an underlying medical condition which is the cause of that pain and the administrative law judge must be satisfied that the extent of that pain in this particular individual is such that he or she cannot work.

How long does it take between initial denial and a hearing?

In some instances it has taken up to 19 months to obtain a hearing, which is clearly excessive. Additional judges have been hired for the Albany district resulting in shorter delays, however it could still take at least a year. It is extremely important to take advantage of this delay to obtain up-to-date medicals from your physicians detailing the nature and extent of your disability.

Can I obtain both Social Security Disability and Workers Compensation at the same time?

Yes. Workers Compensation, except in rare circumstances, is not reduced because the Claimant is receiving Social Security Disability benefits. However, Social Security Disability benefits may be reduced if you're also receiving Workers Compensation benefits. At Silverman Law, we carefully consider both aspects so as to maximize your overall award.

But if the Social Security Administration finds me to be totally disabled, isn't that binding on the Workers Compensation board?

Not at this time. Recall that entitlement to Social Security disability can be based on all problems suffered by the Claimant in addition to those resulting from his work-related accident. It is entirely possible that while the workers compensation injury contributes to the Claimant's overall total disability, it is certainly not the sole aspect.

The Workers Compensation Bar Association has proposed statutes requiring the workers compensation board to accept the total disability findings of the Social Security Administration provided those findings were based upon the Claimant's work injury. At present, this is not the law.

Is it true that when I go to a local Social Security Administration office to discuss my disability claim the examiner may put notes in my file as to my appearance?

Yes. The examiner will often indicate in the file that the Claimant appeared to have great difficulty getting out of a chair, walking or sitting, etc. On the other hand, the examiner may make notations that the Claimant appeared to have no problems, did not appear to be in pain and did not appear to be disabled.

If the administrative law judge turns me down what can I do?

It is possible to take an appeal to the Social Security Administration Appeals Council. In the event that they do not reverse the determination of the administrative law judge you may then bring a lawsuit in the appropriate Federal District Court. Whether or not that would be appropriate in your particular case is something to discuss with your attorney.

What are the basic earning requirements to qualify for Social Security Disability?

While there are exceptions, generally you need to demonstrate that you worked for a minimum of five out of ten of the years immediately preceding your alleged onset date of disability.

If it is clear that I am disabled but I do not meet the earnings requirements can I still receive Social Security Disability benefits?

No, but depending on your household income you may qualify for supplemental security income benefits "SSI". SSI benefits are lower than SSD benefits.

Do I need to be disabled for a certain amount of time?

In most instances you will need to have been disabled for six months and it has to be clear from the record that you will remain disabled for at least one year.

So I believe I'm disabled and entitled to Social Security disability benefits. What should my first step be?

Contact Silverman Law. We have decades of experience representing Claimants before the Social Security administration. Our success rate is excellent. We can help you take advantage of the delays in the system to obtain additional information to support your claim.

Is there a fee for contacting Silverman Law to discuss my claim?

Absolutely not. You can call our office or contact us online to set up an appointment to come into our office to discuss your case in detail. If that is difficult, you can contact Silverman Law by phone.

It is the policy of Silverman Law that every call is put through to any available attorney. In the event that we are unavailable we will set up a telephone appointment to have an attorney contact you at your earliest convenience to get all the information necessary to review your claim and represent you as you move forward.

During the course of your claim we will need to meet with you at some point, however we can undertake all of the initial steps by phone for your convenience.

Then how do you get paid if I win? How about if I lose?

Under the rules and regulations of the Social Security Administration, a law firm can submit a fee request whether we win or lose in the representation of your interests.

At Silverman Law that is simply not the case. There is no charge to a Claimant if we are not successful in obtaining Social Security Disability benefits or supplemental security income benefits.

With a favorable finding from the Judge, the Social Security Administration automatically withholds one fourth of the retro-active benefits as an attorney fee.

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Frequently Asked Questions
  • What do I need to show to obtain Workers Compensation benefits?


    In order to obtain compensation benefits you need to document that you were an employee, that an accident occurred during the course of your employment (or you developed an "occupational disease" during the course of your employment), that you gave notice to your employer within 30 days of the accident and that you filed your claim for benefits within two years of the date of the accident. There are some exceptions to these requirements which should be discussed with your attorney in detail.
  • If the administrative law judge directs the carrier to pay my medical bills and to pay me compensation benefits, and the carriers still objects, what happens?


    If a carrier believes that there are grounds for an appeal they may file such an appeal within 30 days to the Workers Compensation board. Pending the resolution of that appeal in most instances the carrier is not required to pay medical bills or make biweekly payments to the Claimant as directed by the administrative law judge.
  • Am I required by law to have an attorney?


    No. But bear in mind that the insurance carrier is mandated by law to have an attorney or a licensed representative appear at every hearing. These attorneys and licensed representatives often have years of experience, have handled thousands of hearings and are well versed in representing the carrier's point of view. While there is no similar statute requiring the Claimant to be represented, we would highly recommend that they retain counsel. Silverman Law has decades of experience in representing Claimants.
  • The carrier argues that my condition was pre-existing. I don't think that it was but even so I never had these symptoms. What should I do?


    This question of a pre-existing asymptomatic (unnoticed) condition which is made symptomatic by a work-related accident has been decided by both the Appellate Division of the Supreme Court of New York State and the New York State Court of Appeals.
  • Can I collect both Workers Compensation and the Social Security Disability benefits at the same time?


    Yes. If you qualify you may indeed collect both Workers Compensation and Social Security Disability benefits. While Workers Compensation is not reduced because of Social Security Disability payments, your Social Security Disability payments may indeed be reduced because of your Workers Compensation benefits.
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Silverman, Silverman & Seligman, P.C., is located in Schenectady and serves clients from Albany, Colonie, Guilderland, Cohoes, Watervliet, Glens Falls, South Glens Falls, Hudson, Troy, Queensbury, Saratoga Springs, Amsterdam, Gloversville, Johnstown, Cobleskill, Middleburgh and Menands as well as Schenectady County, Saratoga County, Albany County, Rensselaer County, Montgomery County, Fulton County, Schoharie County, Greene County, Columbia County and Warren County in upstate New York and the Capital District.