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What is Social Security Disability?

Social Security is a federal program that helps individuals with disabilities. For example, suppose you have paid Social Security taxes and worked an appropriate length of time. In that case, you and certain family members may be eligible for Social Security Insurance benefits if you or your family member meet the medical criteria for disability.

How Social Security Insurance Works

Unlike Supplemental Security Income, Social Security Disability Insurance bases benefit solely on a person’s level of physical disability and ability to work – not on the person’s income level. Therefore, it is possible for a disabled person of any income level to receive Social Security Disability. With Supplemental Security Income, people may be ineligible for benefits if their income rises above the state’s threshold for receiving the benefits. However, this is not the case with Social Security Disability.

Funding for Social Security Disability comes from a payroll tax that the government deducts from the wages of most workers in the United States. If you have paid into the Social Security system while working, and you suffer a disability – or if have a qualifying family member who does, such as a child born with a disability – you or your family member may be eligible to receive Social Security Disability benefits.

How Social Security Differs From Long-Term Disability

There are a variety of other forms of disability insurance, such as worker’s compensation and long-term disability. Social Security is different in a few ways. It provides an ongoing monthly payment that supplements other disability benefits that the individual receives, and it accounts for a yearly cost of living increase.

Anyone who receives Social Security Disability for 24 months or longer automatically becomes eligible for Medicare. The benefits of Social Security Disability can also apply to an individual’s dependents or spouse. And notably, a child who was disabled before age 22 can receive Social Security Disability benefits on his or her parent’s Social Security record – without any effect on the parent’s own eligibility for Social Security benefits.

Applying For Social Security Disability In Georgia

How Does the Initial Application Process Work?

Social Security Disability Insurance (SSDI) pays benefits to you – and certain family members – if you worked long enough in jobs covered by Social Security to qualify for SSDI. For most people, that’s a minimum of five out of the previous ten years.

The federal Social Security Act defines disability as the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or is expected to last for a continuous period of not less than 12 months.”

While SSDI is a federal program, each state administers its own SSDI applications. Once you reach retirement age, SSDI benefits become Social Security benefits at the same amount.

Filing the Claim

Since the application process takes time, it is crucial to apply for SSDI benefits as soon as you become disabled. Get started by contacting your local Social Security office – there are 35 in the state of Georgia – and set up an appointment for an interview. In-person visits are preferred, but if you cannot travel because of your disability, a phone interview is possible. After the interview and claim submission, the application is sent to a disability examiner for evaluation. The examiner contacts the health care providers listed on your claim. A decision usually takes between three and four months, and much depends on how quickly health care providers respond to the examiner’s inquiry.

What You Need

You will need to bring certain items and information to the interview or submit them to the Social Security office. These include:

  • Medical records – provide information about your diagnosis, all symptoms and pain, treatment and the names and addresses of your doctors and any facilities at which you were treated. Include current medications and any side effects you experience. List all physical, emotional and mental conditions.
  • Work history for the past 15 years – include job titles, rates of pay, hours worked and work descriptions. If your work included lifting or other exertion, state the amount done on a daily basis. Also include the amount of time spent walking, sitting and standing. Provide a detailed description of your work, because the examiner must determine whether you are capable of going back to any of these types of employment.

Can I Apply for Supplemental Benefits with SSDI?

Don’t limit your monthly benefits to Social Security disability; like many disabled individuals, you may also be eligible for Supplemental Security Income (SSI). Eligibility for simultaneous SSI and SSDI hinges on your current income and your history as a taxpayer.

What is Supplemental Security Income?

Supplemental Security Income (SSI) provides funds for people who suffer from certain disabilities and who have little to no income. Supplemental cash income helps seniors and disabled individuals cover essential needs such as clothing, shelter, and food.

Who Qualifies for Supplemental Benefits?

If you are over the age of 65; if you legally reside in the United States; and if you have limited income and resources (under $2,000 for a single person and under $3,000 for an individual along with his or her spouse), you are most likely eligible for SSI. Blind and physically disabled individuals also qualify. Concurrent SSI and SSDI benefits are particularly common for those who receive minimal SSDI payments.

How Much Assistance Could I Get?

Depending on your current income and living conditions, you may be eligible to receive the monthly maximum amount of approximately $733 for one individual and $1,100 for a couple. Eligibility for maximum benefits is most likely if you currently pay your own room and board. If you live in someone else’s home, and if you only pay a portion of the costs for living arrangements, your benefits could be reduced by as much as one-third.

How Do I Apply for Benefits?

Apply for Supplemental Security Income in person at your local Social Security office; or call in advance to arrange for an appointment. Seek legal counsel to handle any challenges you encounter with the process.

What Types of Evidence Do You Need to Win a Social Security Disability Case?

Merely claiming you have a condition worthy of Social Security disability is not good enough; the Social Security Administration (SSA) mandates that you provide ample evidence of your illness or injury. Thankfully, a variety of records and documents can be used to prove your eligibility. Keep reading to learn more:

Acceptable Medical Sources

The SSA highlights a variety of healthcare professionals who can be relied upon for proof of your debilitating condition. These medical experts play a critical role in assessing your impairment and gathering necessary evidence. They include:

  • Primary care physicians
  • Certified speech-language pathologists
  • Licensed optometrists
  • Qualified podiatrists

Other Sources

In select cases, non-medical sources may be called upon to confirm the presence of a severe physical or mental impairment. Often, this information is sought from school professionals who work with children suspected of having disabilities. Examples include school nurses, school psychologists, social workers, and caregivers. Alternative health care practitioners may also be called upon for insight into the patient’s condition. Adults seeking compensation occasionally obtain feedback from employers, volunteer coordinators, audiologists, or chiropractors.

Submitting Reports

Physicians and specialists may be asked to provide thorough reports about a particular patient’s impairments. Typically, these include the individual’s medical history, recent diagnoses, clinical findings, and prescribed treatments. Medical professionals may also be asked to submit detailed statements indicating what the person in question can and cannot accomplish due to the impairment. The focus should be on work-related activities, such as heavy lifting, carrying objects, traveling, speaking, or even sitting still for long periods of time.

What If I Need More Proof to Apply for SSDI Benefits?

Despite your best efforts to obtain evidence from your primary health care provider, you still risk being turned down for Social Security disability benefits. How can you defeat the odds win your case? Read on to find out.

Consultative Examinations

If initial assessments fail to garner approval for benefits, you may be asked to schedule a supplemental exam. The Social Security Administration mandates use of the treating source, unless that facility lacks appropriate equipment or the claimant otherwise has a good reason for using independent information.

Following the exam, the responsible health care professional will submit a report consisting of the injured party’s top physical or mental problems, the history of those complaints, the believed validity of said grievances, and anything unusual circumstances. The report may also include a statement indicating what the person can reasonably expect to accomplish at work. If the medical professional suspects mental impairment, he or she should indicate the individual’s ability to comprehend instructions and respond appropriately to typical workplace scenarios.

Symptom Considerations

A list of symptoms alone may not be enough to demonstrate that you deserve disability benefits. A variety of other factors may increase your suffering, making a seemingly minor grievance far more difficult to handle, particularly in the workplace. When assessing your current condition, your health care provider should take the following into account:

  • Intensity of pain or discomfort
  • Side effects of medication or other treatments
  • Other methods the claimant uses to relieve pain
  • Aggravating factors

Thorough evidence can significantly enhance your likelihood of coming away with the benefits you so desperately need during this difficult time. When in doubt, err on the side of more proof.

What Conditions Qualify for Social Security Disability Benefits?

The Social Security Administration (SSA) maintains a thorough Listing of Impairments, which highlights conditions deemed severe enough to prevent sufferers from remaining gainfully employed. Typically, impairments featured on this list are either permanent or expected to result in death.

Impairment Sections

The Listing of Impairments consists of two portions; Part A, which identifies adult conditions, and Part B, targeted at those under the age of 18. Criteria for Part A may be used among children if their condition has a similar impact on adults and minors.

The list is further divided into the following sections:

  • Musculoskeletal System
  • Special Senses and Speech
  • Respiratory Disorders
  • Cardiovascular System
  • Digestive System
  • Genitourinary Disorders
  • Hematological Disorders
  • Skin Disorders
  • Endocrine Disorders
  • Congenital Disorders that Affect Multiple Body Systems
  • Neurological Disorders
  • Mental Disorders
  • Malignant Neoplastic Diseases (Cancer)
  • Immune System Disorders

Each section consists of several specific categories. For example, the Mental Disorders section for adults includes categories for psychotic disorders, intellectual disorders, pervasive development disorders, and more.

How Long Should Impairments Last to Qualify For Benefits?

A specific duration may be indicated for certain disabilities, but typically, the SSA mandates that severe conditions result in continuous suffering for at least twelve months.

What If My Issue Is Not On the List of Impairments?

If the SSA does not list your condition, don’t panic; you may still qualify for benefits. Disabilities included in this document merely indicate that adjudicators must automatically move on to the next step in the process. More evidence may be necessary to prove that your problem warrants compensation.

The Listing of Impairments is not the be-all and end-all of Social Security disability, but it can provide excellent insight into your condition and its potential eligibility.

Winning Social Security Disability: A Guide From A Georgia Attorney

SSDI: Summing Up the Big Ideas

Social Security Disability Insurance (SSDI) is not the simple program you once might have assumed. It’s a mess of applications, documentation and claim denials. Your attorney can serve as the calm through the storm, ensuring that you secure the benefits needed to lead a satisfying life.

Why Are SSDI Claims So Difficult to Secure?

High SSDI rejection rates are nothing new, but recent Social Security Administration efforts have tightened the belt for this and other disability programs. The goal, ostensibly, is to prevent those in good health from acquiring undeserved benefits. Unfortunately, the ensuing qualification process discourages many eligible individuals from pushing for the benefits they deserve. Complications include consultative medical exams, medical source limitations and the SSA’s official listing of impairments.

Even after securing disability, claimants may receive surprisingly low payments; in 2016, the average monthly compensation was just $1,166, with many qualified individuals receiving less than $1,000 each month.

Overpayment and Stopped Payments

Remain vigilant after securing SSDI, since your payments could suddenly stop. The SSA may ultimately decide you earn too much or aren’t sick enough for benefits. If SSA officials believe you’ve been paid too much, repayment may prove necessary. You can request reconsideration, but if it’s denied, you may be forced to appeal.

Working with a Social Security Disability Attorney

Forget navigating the quagmire of the Social Security Administration on your own; a skilled attorney could spell the difference between getting by with benefits and an outright denial. That being said, your lawyer can’t do it all alone; you’ll need to arrive at all appointments prepared with requested paperwork. Be honest about your condition and the true extent of your suffering; even minor exaggerations could lead to claim denial.

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