Disability Under Social Security FAQ

Medicare will pay medical bills if you are found eligible for Social Security Disability Insurance Benefits but only after you have received 24 months worth of benefits. If you qualify for SSI, you should also qualify for Medicare.

Whether you have been found eligible for SSI or SSD, you will receive a monthly cash benefit. The amount of benefits payable under SSD depends on the amount of money you have paid into the system by posting earnings. Additional amount are payable if you have minor children. A cost of living adjustment is calculated and added each December. SSI benefits are paid up to a certain maximum amount and in New York, are supplemented by the state.

If you initial claim is denied in whole or in part, in the New York area, the next step is to request a hearing before an Administrative Law Judge who works for the Social Security Administration. The request for hearing must be filed with 60 days from the time you receive the decision and failure to file on time can result in you waiving some of your rights. The list of claimant’s waiting for a hearing is long. While you can wait until your claim is denied before seeking legal representation, it does not cost you any more in legal fees to hire a lawyer at the beginning of the process. If the lawyer succeeds in obtaining benefits for you without the need for a hearing, your attorney fee will actually be less.

Representation is almost always on a contingency basis meaning that before a lawyer can charge a fee, a contingency must be satisfied. In a Social Security case, a lawyer is not entitled to collect a fee unless his client is awarded benefits. Fees are regulated by Social Security and prior approval is required before an attorney can collect a fee. Generally, Social Security will approve a fee of 25% of past due benefits capped at certain amount.

It is certainly possible for you to file a claim on your own and represent yourself before the Social Security Administration as there is no requirement that you have an attorney. However, an attorney who knows the ins and outs of Social Security disability rules and regulations can provide you valuable assistance in proving your case for benefits. At Erwin, McCane & Daly, we stand ready to help you at every stage of the process from prior to your application to appealing an adverse decision to the U.S. District Court, should that prove necessary. We can help by contacting your treating doctors to obtain appropriate medical records and assist you in completing all necessary forms.

You will need to provide your birth certificate and military record, if any.
Your medical records will be needed in order for the Social Security Administration to make a decision about your claim. If you can, bring copies of your records with you when you file your application.
The Social Security Administration will attempt to obtain medical records directly from your doctors, and other treating sources. The Social Security Administration may send you to be examined by one or more of their physicians, or a psychologist, if appropriate.
You will be asked to answer questions about your education and work history for the last 15 years, including the duties and responsibilities you had on your jobs. You may also have to fill out additional forms concerning your daily activities, pain level, etc.
In connection with an SSI claim, the Social Security Administration will need information concerning your income and things you own, as well as your living arrangements.

You can call Erwin McCane & Daly at 888-EMD-LAW8 or 518-380-6310 before you even apply and we will provide a free consultation. We can help with the application process or you can call the Social Security Administration directly at 800-832-3471 or you can visit your local Social Security office.

In general, the law defines disability as the inability to do any substantial gainful activity due to a medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for at least 12 months. The impairment or impairments that form the basis for your claim must be “severe” as defined in the law and they must prevent you from doing not only any work that you have done in the 15 years prior to becoming disabled but also prevent you from performing any gainful work which exists in the national economy. Your age, education, training and past work experience are all factors that the Social Security Administration may consider in determining whether you are disabled.

While benefits may be payable under either or both SSD and SSI, the standard for disability is the same and eligibility for either or both programs is determined by the same process. In addition to proving disability, a claimant for Social Security Disability must show that he or she had worked long enough to be “insured”. An SSI claimant must have limited assets and income. There are other differences in the eligibility rules for the two programs.
There are three categories under which a person can qualify for disability payment: disabled workers under 65 who have paid enough into the Social Security system; persons disabled continuously since age 22 if one of their parents is deceased, disabled or retired; and a disabled widow or widower between the ages of 50 & 60 whose spouse was covered by Social Security at the time of death.

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