Spruce Pine SSDI Benefits Attorney
When a person has a disability, not only are they often in pain and unable to perform basic tasks like self-care, but they may also be unable to work and earn an income, too. In addition to the physical and psychological strain that living with a disability presents, this can place a financial strain on an individual and their family.
If you have a disability and the disability makes working and earning an income impossible, government benefits in the form of Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) may be available.
While these benefits are available, millions of Social Security disability claims are denied each year. You should work with a qualified Social Security disability benefits lawyer who understands the claims process and what the Social Security Administration is looking for.
At the Elmore and Smith Law Firm, PC, our Spruce Pine attorneys are ready to assist you. Contact us now for a free consultation.
How Does Social Security Define Disability?
In order to qualify for Social Security disability benefits from the Social Security Administration (SSA), an individual must suffer from a qualifying disability. Under the law, a disability is defined as a medically determinable physical or mental impairment that:
- Results in the inability to engage in any substantial gainful activity (SGA)
- Has lasted or is expected to last for at least 12 months or result in death
Breaking down the definition even further, SGA refers to earning more than a certain amount of money per month. The amount varies year-to-year. In 2019, the SGA amount for blind individuals was $2,040, and the SGA amount for non-blind individuals was $1,220. If you earn more than that each month from work, you will likely be unable to receive disability benefits from Social Security.
Another essential phrase to define is “medically determinable impairment.” The SSA defines a medically determinable physical or mental impairment as an impairment that results from psychological, anatomical, or physiological abnormalities, and which can be demonstrated by medically acceptable diagnostic techniques.
What Kinds of Disability Benefits Are There?
The SSA maintains two types of disability programs: SSDI and SSI. While both of these programs are designed to provide benefits to disabled individuals who cannot work and earn an income themselves, eligibility for these two benefits types varies significantly.
Social Security disability benefits, both SSDI and SSI benefits, are paid to an individual in the form of monthly cash benefits, which are directly deposited into individuals’ accounts. How these benefits are calculated is either based on your average lifetime earnings or the federal benefits rate, depending on how you are receiving benefits.
In addition to cash benefits, other potential benefits through one of the two Social Security disability benefits programs include:
- Healthcare: If you are disabled and qualify for SSDI or SSI benefits, you will also become eligible for Medicaid or Medicare healthcare benefits. However, it is best to discuss this with a qualified professional, as exactly what type of healthcare you receive, the two-year waiting period for eligibility, and the details of your coverage can be complicated.
- Ticket to Work: Another benefit of receiving Social Security disability benefits is free and voluntary participation in the Ticket to Work program. The program helps people who receive Social Security disability benefits find a job and become financially dependent while maintaining their Medicaid/Medicare coverage.
The SSA also maintains a representative payee service, which provides management services of benefit payments to benefit-receiving individuals who are incapable of managing their benefit payments.
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What Is the Difference Between SSDI & SSI?
The SSA maintains two disability programs: SSDI and SSI. Here’s an overview of each.
Social Security Disability Insurance (SSDI)
SSDI is probably the Social Security disability benefit that people are most familiar with, and the one that they are referencing when they talk about disability benefits through the SSA. SSDI benefits are available to workers who are disabled or blind and are “insured” by the SSDI system through their Social Security contributions during their working years.
To qualify for SSDI, a person must have earned enough credits while working in a job that made contributions to Social Security. The number of work credits that a person needs is based on the individual’s age at the time that they become disabled. On average, a person will need at least 40 work credits, and 20 of those credits must have been earned in the 10-year period immediately preceding the disability. A person earns one work credit per a certain amount of money earned.
Example: In 2019, a person earned one work credit for every $1,360 in wages earned. However, a person can only earn up to four work credits per year. Therefore, in most cases, to satisfy the 40-work-credits requirement, a person must have worked for at least 10 years.
Another notable fact about SSDI benefits is that not only must a person have earned work credits to qualify for SSDI benefits, but also that the amount of SSDI benefits a person receives per month is based directly on the amount of income on which they have paid Social Security taxes. This means that a higher income-earning individual will be eligible for a larger monthly benefit payment.
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Supplemental Security Income (SSI)
Not everyone who becomes disabled has earned work credits. In fact, some people who have a disability, such as children, have never worked or earned work credits. For these individuals, rather than being denied benefits, SSI disability benefits may be available.
SSI benefits are intended for blind, disabled, and aged individuals, including children, who have limited income and resources. These benefits are funded by general tax revenues. An individual who requires SSI benefits does not need to have “earned” the benefits by working. Instead, a person may qualify for SSI benefits by proving that they are blind or aged or have a qualifying disability and that they do not have a certain amount of income and resources.
You cannot earn more than a certain amount of money per month or possess a certain value of resources (for example, cash in a bank account) to qualify for SSI benefits. Our lawyers can help you understand what counts as “income and resources” to determine SSI eligibility. As a note, there is no limit on the amount of income/resources a person who is applying for SSDI can receive.
In some cases, a person may be eligible for both SSDI and SSI benefits.
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When Should I Apply for Disability Benefits?
The SSA recommends applying for SSDI or SSI benefits as soon as you become disabled. As the process can take many weeks or months to finalize, especially if benefits are initially denied and an appeal is necessary, starting the process as soon as possible is strongly recommended.
How to Apply for Disability Benefits
There are three ways you can apply for Social Security disability benefits: online, over the phone, or in person.
While working with an attorney is not required when applying for Social Security disability benefits, it is strongly encouraged. There are millions of Social Security disability applications denied per year in the United States. The SSA will not hesitate to reject a claim if any information is missing or inaccurate, or if criteria are not satisfied.
When you apply for Social Security disability benefits, you will need to present evidence and personal information to the SSA, including:
- Recent tax returns
- W-2s or other wage reporting and income forms
- A description of your work history, including where you worked and the type of work you performed during your working years
- Social Security number
- Personal information, including date of birth, address and contact information, and your age
- Proof of marriage if you are married (your spouse may qualify for benefits on your record, as may an ex-spouse)
- Information about your disability, including your diagnosis, dates, and locations of all care received, names of medications you are taken or have taken in the past, your treatment regimen, details of the limitations of your disability, your doctor’s name, lab and test results, and any other details about your disability
- Information about your income and resources if you are applying for SSI benefits
Note that if you do not fill out your application in full, if there is a mistake made on your application, or if you do not submit the right amount of evidence and enough evidence to the SSA when applying for disability benefits, the processing of your claim may be significantly delayed or your claim may be denied outright.
Our lawyers at the offices of The Elmore and Smith Law Firm, PC know what the SSA is looking for and what a complete and thorough application looks like. When you hire our Spruce Pine Social Security disability lawyers, we will be responsible for managing all aspects of your disability benefits application on your behalf.
How Long Does it Take to Receive Disability Benefits?
After you submit your application, it will usually take the SSA between three and five months to issue a determination about your claim. This is if the SSA does not determine that your application is incomplete, and therefore needs more information from you.
If your application is approved, your benefits will not necessarily start immediately. SSDI benefits do not begin until the sixth full month of disability. The waiting period begins on the first full month after the date that the SSA determines your disability began.
You may be eligible for back pay benefits in some cases. These payments are offered for the months between when you become disabled and when your claim was approved after the five-month wait period has been satisfied.
What Should I Do If My Application Was Denied?
If your application for SSDI or SSI benefits is denied, you have the right to appeal the SSA’s decision. If you have not already hired an attorney at this point who is well-versed in the SSDI/SSI benefits process, you should absolutely do so for help in appealing the SSA’s decision.
To appeal a decision issued by the SSA regarding your disability benefits, you must generally act within 60 days from the date that you receive notice that your benefits application was denied. The first level of appeal is asking the SSA to reconsider its decision.
During this process:
- Your claim will be reviewed by someone who did not take part in the original claim review process.
- All existing evidence will be reviewed.
- You will also have the opportunity to submit new evidence to prove your disability.
If the reconsideration is not concluded in your favor, you still have the option of appealing the decision by requesting a hearing in front of an administrative law judge (ALJ). The ALJ will hear all evidence related to your disability claim, and then issue a determination about benefits.
If you do not agree with the ALJ’s decision, you may request a review by the appeals council. However, the appeals council reserves the right to deny the request if it believes that the ALJ’s decision was made in accordance with Social Security disability regulations.
How Our Spruce Pine Disability Lawyers Can Help You
At The Elmore and Smith Law Firm, PC, our disability lawyers will help you by reviewing your case, guiding you through the two types of disability programs and helping you understand which one is right for you, gathering evidence and documentation on your behalf, organizing your claim, filing your claim, and representing you in your appeal should your claim be denied.
We have years of experience and are passionate about helping our clients receive the benefits they deserve.
Please call us for a free consultation today. We are here to serve you.