What You Need to Know About Social Security

Beside paying retirement benefits to you at ages 62 or 65, any adult unable to work for a year or more due to sickness or injury may qualify for Social Security disability benefits (Title II) and/or Supplemental Security benefits (Title XVI).

The Difference Between SSDI and SSI:

Social Security disability benefits are based on money that was withheld from your earnings and paid to Social Security by your employer just like insurance payments on a private insurance plan. If no money is paid in, there are no benefits. If benefits are not paid in for a long period of time, your coverage may expire. Even if benefits have expired, it may still be possible to qualify for benefits if you stopped work due to illness or injury. Even if several years have passed by, it still may not be impossible.

SSI pays whether or not employers have made payments for you or whether you have made self-employment payments. It is based on your income and property you own. Beside adult workers, Social Security will pay the children of disabled workers if the child is not married. This may include stepchildren, adopted children, and, in some cases, grandchildren. It will also pay a spouse who is not employed outside the home and is caring for a child. Disabled widows or widowers may also draw on the earnings of a deceased spouse after the widow or widower is 50 years of age and if the disability occurs within seven years of the date of the death of the spouse. SSI will pay disabled adults or children who have limited income and property.

For additional information on both types of benefits, please refer to the Social Security Administration website. In particular, the pages on Social Security Disability Insurance (SSDI) and Social Security Income (SSI) may prove to be useful.

Applying for Benefits:

My staff and I are happy to assist you with your application from the very beginning. You may also begin the process, by calling the local Social Security office. In Austin, the number is (512) 916-5404. If you are not inside the Austin city limits, you may use the Office Locator website provided by Social Security to find the local number to call. Alternately, you may call 1-800-772-1213 and an operator will help you. However, I encourage you to allow me to help you because everything you say may have a different meaning than you intend. For example, saying that you care for teenage children may be understood to mean you are able to do far more than is a fact.

You will need to be ready to give your Social Security number and to provide proof of age by birth certificate or family Bible or baptismal certificate.

Social Security also will need the names and addresses of all your doctors who have cared for you since you became unable to work and hospitals or clinics where you have been treated. Please remember that every problem you have is important. Begin with the top of your head. Think of such problems as hearing loss, vision loss, depression, forgetfulness, learning disabilities, asthma, allergies, high blood pressure, gastric problems, as well as the very severe condition that may have caused you to stop work.

Please do not be too embarrassed to tell about problems such as inability to control your bladder or bowels or anger or irritable moods. These are all health problems that are not your fault and nothing you should hide or deny. These problems may be one of the reasons you cannot work. You will need to list all the jobs you have done in the last 15 years before you quit working. Even if you do not have all this information, go ahead and apply as soon as possible. You can send in missing information later.

Following the application, you will either be given benefits or you will receive a letter telling you you are denied benefits.

Filing a Request for Reconsideration:

If you are denied, IMMEDIATELY talk to an attorney. Lawyers who devote a majority of their practice to Social Security know what evidence is needed to obtain benefits for you. Be sure you find an attorney who has experience and training. The National Organization of Social Security Representatives is the official membership organization for skilled representatives in Social Security.

Some representatives are not lawyers. These representatives will be unable to represent you in an appeal to court. These representatives also may be unaware of the importance of establishing legal grounds for a court appeal.

After you have been denied, you may request reconsideration of your claim for benefits. This level of review is a time that few cases are granted, however it is a good time to begin to work on shaping your case to ultimately have the best chance of success. Each appeal seems to take about four months.

This review is similar to the first review of your condition and requires that your condition match a list of medical conditions described in a book. Few people fit this kind of description and therefore, many people are denied at this level. Your doctor may not be familiar with the requirements of Social Security. This is when an attorney can help. After a review by the state agency at which time a team of clerical and medical personnel will look at the evidence before them, you will either be awarded benefits or receive another denial. Do not be discouraged by a denial. This really is not much of an indication of how good a case you may have.

Filing a Request for Hearing:

The next step is to request a hearing. This is the most important opportunity to present your case. A judge can consider all the evidence such as your education, work experience, pain, and other issues that have not really been considered before.

At this time, it is imperative you have a skilled representative. It is extremely risky to represent yourself. Whatever is presented at this hearing is all the opportunity you will have to present testimony. Questions asked by the judge may seem harmless and yet may lead to a denial because an inexperienced person cannot recognize how this may be used to deny you benefits. This is a face to face opportunity to tell your story. Often because of nervousness or a lack of understanding as to what significance questions being asked have, many people are denied benefits they should have been paid.

Filing an Appeal with the Appeals Council:

Even after a denial at this point, an appeal may be made to the Appeals Council. This is a time that pointing out legal errors is very important.

Filing an Appeal in Federal Court:

If you are denied again, your case may be appealed to federal District Court. Only an attorney can present your case effectively in court. Denial by the District Court may be appealed to the Appellate court. In very special cases, your case could be appealed to the Supreme Court. This would require that a constitutional issue be involved which is very rare.

For additional information regarding how Mary Ellen Felps can help you in Federal Court, please refer to Federal Court Appeals.

Determining Your Potential Benefit Amount:

You can learn what benefits you can expect to be paid by reviewing the annual report sent to your by Social Security. It is very important to check this each year to be sure it is accurate.

For a rough estimate, you may also refer to the Compute Your Benefit calculator on the Social Security Administration website.

Potentially Disabling Conditions:

Depending on the severity, frequency, and multiplicity, some of the below disabling medical conditions may entitle one to receive Social Security disability and or Social Security Income:

- Alzheimer's
- Anxiety
- Arthritis
- Asthma
- Bipolar Disorder
- Cancer
- Cerebral Palsy
- Chronic Fatigue Syndrome
- Depression
- Diabetes
- Fibromyalgia/Chronic Pain
- HIV/AIDS
- Insomnia
- Irritable Bowel Syndrome (IBS)
- Learning Disabilities
- Lyme Disease
- Manic-Depressive
- Migraine Headaches
- Muscular Dystrophy
- Multiple Sclerosis (MS)
- Obesity
- Post-Traumatic Stress Disorder (PTSD)
- Schizophrenia

This is by no means an exhaustive list. If you are suffering from conditions not listed here, do not give up hope of receiving the help you need.

Attorney's Fees:

Attorney's fees are limited to 25% of the lump sum recovery, with a cap of $6,000. Reasonable expenses may be billed so the attorney does not lose money representing you. Representation continues to remain limited to 25% of the recovery with the possibility that the government may be required to pay attorney's fees for you. There is no cap as to dollar limit. The attorney is carefully monitored by Social Security and the court in regard to fees charged.

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