Frequently Asked Questions About Social Security Disability Insurance
What is the difference between workers’ compensation and Social Security Disability Insurance?
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 Insurance 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, Silverman & Seligman 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, Silverman & Seligman, 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 10 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, Silverman & Seligman. 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, Silverman & Seligman 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 our law firm by phone.
It is the policy of Silverman, Silverman & Seligman 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.
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, Silverman & Seligman, 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 retroactive benefits as an attorney fee.