Social Security Table » impairment

Being Eligible for Certain Social Security Claims

admin — Wed, 02 Dec 2009 21:06:40 +0000

Meghan DiTolla asked:

Many are surprised to learn that Social Security eligibility is similar to other types of lawsuits. For example, in certain personal injury lawsuits, the plaintiff needs to prove that he or she will not be able to work in the same capacity in the future due to sustained injuries. These injuries need strict medical documentation. This may come down to emotional impairment as well, not just physical impairment.

A Social Security claim acts in somewhat the same regard. The difference is that a personal injury claim is waged against a defendant. In Social Security cases, there is no “defendant” as such, as Social Security claims for illness involve a person’s own physical capabilities based on illness – not necessarily due to the fault of another person. That said, there needs to be the same burden of proof for demonstrating physical incapacitation.

Medical Guidelines for Social Security

Social Security guidelines are very strict, which can sometimes come as a disappointment for those claimants who do have cases that fall within these guidelines. For example, it is not enough for a person to suffer from HIV/AIDS. Rather, the patient needs to have a T-helper lymphocyte (CD4) count above 200/mm3. It is at this point that an HIV/AIDS patient is more susceptible to increased illness.

However, the Social Security Administration will take into account other issues besides the T-helper lymphocyte (CD4) count, such as weight loss – though the CD4 count is an important factor. The reason why a skilled and experienced Social Security attorney is necessary is to navigate thee possible permutations of illness and diagnosis that can mean the difference between receiving benefits or receiving none at all.

It bears stressing, but you should not think that there is a minimum threshold you have to cross to be eligible for benefits – these are guidelines. As each patient has a different circumstance in term of personal support, age, income, and other factors these will be factored in as well. This is made clear by Social Security benefits for anxiety. While mental illnesses can be measured in some way, it is a more generalized disability than something like a CD4 count that can be quantitatively measured. So this should tell you that there is some leeway with how Social Security benefits can be distributed.

In the case of anxiety, for example, OCD, post-traumatic stress, and panic attacks all qualify. While these can most certainly be diagnosed by a trained professional, it will take the expertise of a qualified attorney to help ensure that a patient receives ample support from the Social Security Administration. Financial support is the basis of clinical documentation, which a Social Security attorney can help gather together and ultimately secure long-term benefits.

These same rules apply to other illnesses: arthritis, heart failure, cancer, diabetes, and so on – chronic illnesses fall within the scope of Social Security Benefits. Receiving these benefits is the result of a combination of strict medical documentation and the skill of a good attorney. If you are ill, there is no reason to add to your trouble with increased financial worry. The goal of a Social Security attorney is to provide long-term stability and improve your overall quality of life.

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Traumatic Brain Injury And Social Security Disability

admin — Fri, 21 Aug 2009 07:22:35 +0000

Sharon A Christie asked:

I am frequently asked whether someone with a Traumatic Brain Injury can get Social Security disability benefits. The answer is YES, depending on the specific facts of each case. Social Security disability benefits are not awarded based solely on a diagnosis. The key to getting these benefits is to prove that your limitations are severe enough to prevent you from working on a full-time basis.

Social Security has a very specific definition of disability. I talk to many clients who believe that because they are unable to return to their specific job they will automatically be found disabled by the Social Security Administration. This is not true.

The definition of disability that applies to Social Security claims is:

“The inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. To meet this definition you must have a severe impairment(s) that makes you unable to do your past relevant work or any other substantial gainful work that exists in the national economy.” 20 C.F.R. §404.1505

What does this really mean? Basically, your medical or psychiatric condition must be so severe that it keeps you from doing any type of work on a full-time basis and has already lasted for 12 months or longer, or is expected to last that long. The determination of disability is based on the information in your medical records, reports from your treating doctors about your physical and/or mental limitations, reports from any Consultative Examinations scheduled by the Social Security Administration and your testimony at the hearing before an administrative law judge. The Social Security administration will consider whether you are capable of returning to any of the jobs that you most recently held or any other type of work. This determination of disability does not consider whether you could earn the same amount of money in other types of jobs. This determination is based solely on your physical and/or mental capabilities.

I am also frequently asked whether Social Security has some type of “partial disability” award. The answer is NO. For Social Security purposes your condition must be totally disabling for at least 12 months. However, you can still receive benefits if your condition improves and you return to work. This is called a “closed period” and means that you were unable to work on a full time basis for at least 12 months but have now recovered and can return to work. For example, if you are injured in a serious car accident you might require ongoing therapy for 18 months. After that period you may be able to return to work. You can still qualify for Social Security disability benefits for that 18 month period. You would not receive ongoing monthly benefits, however, once you can return to work.

Medical evidence of your physical and/or psychological limitations is the key to getting Social Security disability benefits. If you have been unable to work for at least 12 months or anticipate that you will be unable to work for that long you may qualify for Social Security disability. So, if this describes your situation you should apply right away.

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What Types of Social Security Benefits are Available?

admin — Sun, 02 Aug 2009 06:22:51 +0000

Greeman & Toomey asked:

Types of Social Security Disability Benefits

The Social Security Administration has established a number of different types of disability programs. Although the medical rules are similar under each program, the technical rules on eligibility set each program apart. What program you may be eligible for depends on a number of factors, including your work history, age, household income and marital status. You may be eligible for more than one type of benefits, but generally SSA will pay you the higher benefit amount of any one program you may be entitled to.

Disability Insurance Benefits: This program, also known as “DIB” or Title II benefits, awards benefits to individuals who, because of a physical or mental impairment, are unable to work at a “substantial” gainful level, and their condition has existed or is expected to exist for at least a 12 month period. By “substantial,” SSA means the claimant would be unable to earn over $900.00 per month because of their disability. This dollar amount increases slightly every year. To be eligible for DIB, a claimant must have worked long enough and paid enough into Social Security through their FICA taxes to be “insured.” As a general rule, if a claimant worked at least five of the last 10 years, he would be “insured” for purposes of DIB. How much a claimant receives each month if found disabled and entitled to DIB is based on how much he “paid into” the system during his working life. Generally, the longer someone has worked and the higher his earnings, the more he would be paid if found disabled. Individuals found disabled and entitled to DIB benefits may be awarded retroactive benefits. Retroactive benefits can only go back one year from the date of the initial application. There is a five-month waiting period from the date the claimant is determined to be disabled until entitlement to DIB benefits begin. To illustrate this, if a claimant files a claim for DIB on January 1, 2006 alleging disability as of February 2005, and SSA determines he is disabled and his disability began February 1, 2005, he would be eligible for retroactive benefits starting in July 2005. In addition to receiving individual DIB benefits, your minor children may also qualify for auxiliary benefits based on your disability. These benefits are granted in addition to any benefit you receive. To ensure any minor children are awarded any benefits they may be entitled to, it is important you furnish the names and Social Security numbers of any minor children you have to SSA. The children do not have to live in the same household to be eligible for auxiliary benefits.

Supplemental Security Income: This program, also known as SSI or Title 16 benefits, is a “needs-based” program in which individuals with little or no resources or assets may receive disability benefits. The medical criteria for SSI eligibility is the same as that used for DIB — a physical or mental impairment which prevents you from working at a “substantial” gainful level, and the condition has existed or is expected to exist for at least a 12 month period. Effective January 2007 the SSI payment for an eligible individual is $623 per month and $934 per month for an eligible couple. There is no retroactive eligibility for SSI benefits: benefits can go back only to the month in which your claim was filed. Unlike DIB, there is no five-month waiting period for entitlement to SSI, so your eligibility would begin the month in which you filed your claim or were determined to be disabled, whichever is later. A claim for SSI benefits can also be filed on behalf of any minor children with a disability; however, as with Adult SSI claims, to be entitled to SSI benefits the household income must be below certain limits.

Disabled Adult Child: This program provides disability benefits to adult children of deceased or disabled parents. In addition to the medical requirement that you have a physical or mental impairment which prevents you from working at a “substantial” gainful level, and the condition has existed or is expected to exist for at least a 12 month period, you must also show that your condition has existed and has been disabling since before your 22nd birth date. In addition, you must be the adult child of a parent who is currently receiving DIB benefits, or the Adult child of a parent who is deceased and was “insured” for purposes of eligibility for DIB benefits. It is not necessary that the adult child ever worked because benefits are paid on the parent’s earnings record. The adult child must not have worked and earned “substantial earnings” for an extended period at any point after turning 22; however, certain expenses the adult child incurs in order to work may be excluded from these earnings. An adult child already receiving SSI benefits should check to see if benefits may be payable on a parent’s earnings record. Higher benefits might be payable and entitlement to Medicare may be possible.

Disabled Widow’s/Widower’s Benefits: If you are a disabled widow or widower age 50 or older you may be able to receive benefits off your spouse’s (or former spouse’s) Social Security record. If you are a widow or widower from a spouse you were divorced from, to be eligible for benefits you need to have been married to your spouse for 10 years or longer and your disability must have started before age 60 and within seven years of the date in which the worker died. If you were married to your spouse when they passed away, Social Security does not require that you were married for 10 years. In either case, you will need to provide proof of relationship in the form of your marriage certificate or divorce decree, along with your spouse’s death certificate when you file for benefits. If you file a claim for Disabled Widows/Widower’s benefits and DIB or SSI benefits, you will receive only the higher monthly benefit amount of the two programs.

Medical Insurance: Once you are found disabled and entitled to Social Security disability benefits, you will also be eligible for medical insurance though Medicare or Medicaid. If you filed a claim for DIB, Disabled Adult Child or Disabled Widow’s/Widower’s benefits, you may be eligible for Medicare. However, eligibility for Medicare does not start until you have been disabled for 25 months. If you are approved for Social Security benefits under any of the above-listed programs, SSA will contact you approximately two months before your eligibility for Medicare begins. If you have already been disabled for 25 months, be sure to keep a record of all medical bills as you may be reimbursed by Medicare for these expenses. There is no waiting period for Medicaid; however, your income and resources must be very low to qualify. If you have applied for and have been approved for SSI you probably qualify for Medicaid. You may think that Medicaid and Medicare are the same, but actually they are two different programs. Medicaid is a state-run program that provides hospital and medical coverage for people with low income and little or no resources. Each state has its own rules about who is eligible and what is covered under Medicaid. Some people qualify for both Medicare and Medicaid. For more information about the Medicaid program, contact Social Security or your local social services or welfare office.

This article has been written to give you a general overview of the Social Security disability programs and the disability process. As this article may not address all questions you might have, please contact us for further information.

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