Below, you will find answers to questions we commonly receive about Social Security claims.
What Kind Of Social Security Benefits Claims Do Your Lawyers Handle?
The Social Security Benefits lawyers at Zavodnick & Lasky Personal Injury Lawyers handle two types of Social Security disability benefits claims.
We handle claims for Social Security Disability Insurance claims, or “SSDI,” as well as claims for Supplemental Security Income, or “SSI.” Below is a general overview of the requirements associated with each type of benefit, as well as the benefits available should you qualify.
Social Security Disability
- Entitlement: Must have paid enough taxes to be fully insured and prove disability insured status under 20/40 test
- Medical coverage: If you are awarded SSDI benefits, Medicare coverage kicks in 29 months after the established onset date of your disability
- Waiting period for monetary benefits: Five months from the disability onset date
- Retroactivity: Up to 12 months
Supplemental Social Security Income
- Entitlement: Income and resources must be below $2,000 for an individual and $3,000 for a married couple
- Medical coverage: Medicaid coverage is available if receiving SSI
- Waiting period for monetary benefits: First full month after all requirements satisfied
- Retroactivity: None, can only get benefits moving forward
What Does It Mean To Be Disabled?
Whether you apply for Social Security Disability benefits or Supplemental Security Income benefits, you will need to demonstrate that you are “disabled” under the laws and regulations. To qualify as “disabled” you must be “unable 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 which has lasted or can be expected to last for a continuous period of not less than twelve months.” The Social Security Administration utilizes a five-step sequential evaluation process in determining whether an individual is disabled and qualifies for Social Security benefits. It is explained below.
The first step in the process is to determine whether or not you are engaged in substantial gainful activity. The dollar amounts change each year. In 2015, any work paying over $1,090 per month after deductions is considered substantial under the law.
The second step in the Social Security evaluation process is to determine whether you have a “severe impairment.” A severe impairment is one that significantly limits physical and/or mental capacities to perform basic work-related functions. It is typically determined by medically acceptable, clinical and laboratory diagnostic techniques. The impairment must be one that lasts or is expected to last at least twelve months or result in death. Short-term conditions, such as broken bones and muscle sprains and strains, while temporarily debilitating, do not qualify a worker for Social Security Disability Benefits.
Once it is determined that a person seeking Social Security benefits has a severe impairment, the next step is to utilize specific listings published by the Social Security Administration.
The fourth step in the evaluation process is to examine your residual functional capacity and the physical and mental demands of any past work. If your condition does not prevent you from performing past relevant work, you will be deemed not disabled. Social Security utilizes three tests when considering whether you can return to past relevant work. In essence, they seek to determine whether you remain capable of performing a past relevant job based on a broad classification of the job; whether you remain capable of performing the particular job that you actually performed; and whether you remain capable of performing the job as is ordinarily required by employers.
The final step in the evaluation process is whether your impairment, or combination of impairments, prevents you from performing other work that is generally available considering your age, education level, and work experience, as well as your physical limitations resulting from your impairments. If your conditions, when considered in light of your vocational qualifications, do not permit you to perform other generally available employment, you will be deemed disabled and entitled to Social Security benefits. We should note that at this stage of the evaluation process the regulations require use of medical vocational guidelines known as “the grids.”
Having an experienced Philadelphia Social Security benefits lawyer by your side is critical. The rules and regulations regarding what it means to be “disabled” can be confusing. Our attorneys have years of experience reviewing, interpreting and litigating Social Security benefits claims.
Do I Need A Social Security Benefits Lawyer?
Yes. A Social Security benefits lawyer can help you both with respect to your initial application for benefits and an appeal from an initial denial of Social Security benefits. The laws are complicated. Our Social Security disability lawyers have years of experience. We can help you to complete your initial application for benefits online, gathering medical records to ensure that Social Security has all of the records it will need to make its initial determination. If you are initially denied benefits, we will then be in position to file an appeal on your behalf and represent you at the hearing before the Administrative Law Judge assigned by Social Security.
To qualify as “disabled” you must be “unable 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 which has lasted or can be expected to last for a continuous period of not less than twelve months.”
Do I Have To Pay My Social Security Benefits Lawyer?
No. We will never ask you to pay us a fee directly. Instead, when we represent you, we do so on a contingent fee basis, which means we only get paid if we obtain Social Security Disability benefits or Supplemental Social Security Income benefits for you. In those instances, we present our fee to the Social Security Administration and, upon approval, they pay us our fee directly out of any past-due benefits we have obtained for you.
Our fee is 25% of any past-due benefits, but cannot exceed a total that changes from year to year. In 2015, this total was $6,000.
What Should I Bring To My Initial Consultation?
During your free initial consultation with one of our Social Security lawyers, we will review your work history with you as well as your treatment history. It is therefore important that you bring the following:
- Complete list of all physicians and healthcare providers you have seen for your condition
- Specific dates of any hospitalizations
- Specific dates of diagnostic studies performed
- List of medications taken
- Copies of any medical records you may possess
- Complete list of all employers for whom you have worked during the last 15 years, including wages earned, job title, and job duties performed
Of course, don’t be alarmed if you do not have all of the information above. We can always fill in the blanks later on. However, the more information we provide initially to Social Security, the faster your application for benefits may be processed.
Can I Get Medical Benefits If I Receive Social Security Disability or Supplemental Social Security Income Benefits?
Yes, if you qualify for Social Security Disability benefits or Supplemental Social Security Income benefits, you will be eligible for medical coverage as well. If you receive Social Security Disability benefits, you will be eligible for Medicare coverage 29 months after the onset of your disability as determined by the administration. If you receive Supplemental Social Security Income benefits, you will be eligible for Medicaid coverage in Pennsylvania.
When Do My Social Security Cash Benefits Start?
There is a 5-month waiting period from the disability onset date for Social Security Disability benefits. There is no waiting period for Supplemental Social Security Income benefits.
Can I Get Social Security Benefits For Past Disability?
Yes, Social Security Disability will pay up to 12 months of retroactive benefits for past disability. Supplemental Social Security Income benefits will not.
Can I Receive Social Security Benefits And Workers’ Compensation Benefits At The Same Time?
Yes. However, if you receive workers’ compensation benefits in Philadelphia as well as Social Security Disability benefits, Social Security will reduce the amount it pays you based on the amount you receive in workers’ compensation benefits.
There are also potential tax consequences associated with the receipt of both benefits, so we suggest you consult with an experienced workers’ compensation attorney who is familiar with Social Security benefits. If you are receiving Social Security Disability benefits and you settle your workers’ compensation claim, you will want to include very specific language in the workers’ compensation Compromise and Release Agreement to make sure that Social Security prorates your workers’ compensation settlement over your remaining life expectancy, resulting in a lower reduction of your Social Security Disability benefits following the settlement. Again, consultation with an experienced workers’ compensation attorney is essential.
Can I Receive A Pension And Social Security Benefits?
Yes, and your receipt of pension benefits most likely will have no effect on your Social Security benefits. As long as you worked for private employers and Social Security taxes were withheld from your paychecks when you worked, your receipt of pension benefits won’t result in any reduction of your Social Security benefits. If you worked for the government or some other employer who wasn’t required to withhold Social Security taxes and you subsequently receive a pension, it may impact your Social Security benefits. Contact an experienced Philadelphia Social Security benefits lawyer today to review the specifics of your situation.
