Social Security Disability benefits are available to people who have worked and paid in to the Social Security tax. Benefits are also available to people who have never worked a day in their life. Benefits are even available to children if they meet certain criteria. If your claim is initially denied and then appealed, a judge will ultimately look at your medical impairments and determine how they impact your ability to function in daily living to decide whether you qualify for benefits. If you have questions about benefits, I’ve put together a nice list of basic questions, along with my answers. Click on a question to jump to the answer.
Questions About Social Security Disability Benefits
- What does it mean to be disabled under Social Security?
- Are there different types of Social Security disability benefits?
- How do you apply for Social Security benefits?
- How long does a person have to be off from work before you can apply for benefits?
- Can I draw long/short term disability benefits from work and still apply for benefits?
- Am I able to draw workers’ compensation benefits and still apply for Social Security?
- How do I know if I will qualify and be found disabled?
- What if I will be off work for more than a year, but will eventually go back to work?
- What is used to determine if I am disabled?
- Who determines if I am disabled?
- Are there any illnesses that would automatically qualify me as disabled?
- Most of my issues are related to mental impairments. Can I qualify with mental issues only?
- Do you need an attorney to obtain Social Security benefits?
- What is a typical attorney fee for helping someone get Social Security benefits?
- Is there a waiting period in social security?
- Can children obtain benefits?
- Will I get health insurance benefits with my Social Security?
- Are you automatically found eligible for Social Security benefits if you have been found 100% disabled by the Veteran’s Administration?
- How Can I Get the Answer to a Question Not Listed Here?
What does it mean to be disabled under Social Security?
Disability is defined as the “inability 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 has lasted or can be expected to last for a continuous period of not less than 12 months.”
Are there different types of Social Security disability benefits?
There are several benefits available under Social Security, but the most familiar are Title II and Title XVI benefits. Title II is called Social Security disability and is based upon a person’s earning history. Title XVI is called Supplemental Security Income (SSI), and it does not matter how much a person has earned if any at all.
How long does a person have to be off from work before you can apply for benefits?
There is no waiting period to apply. In fact, you can lose rights to benefits if you wait too long. You have to have a condition that has kept you off from work for a year, or is expected to keep you from work for a year.
Can I draw long/short term disability benefits from work and still apply for benefits?
Am I able to draw workers’ compensation benefits and still apply for Social Security?
Yes, you do not have to choose one or the other. However, there are intricate laws involved in determining how much you can receive from both benefit packages. Social Security will most likely have an “offset” for some of the money paid by workers’ compensation.
How do I know if I will qualify and be found disabled?
There really is no set formula to determine this. A person may be determined disabled due to multiple ailments or one single impairment. You must determine on your own if you believe that you will be off from work for a year and can prove that to the court.
What if I will be off work for more than a year, but will eventually go back to work?
A person does not have to be found permanently disabled in order to qualify for Social Security. For example, you could obtain benefits for a couple of years, then return to work. Once you return to work, your Social Security benefits will cease.
What is used to determine if I am disabled?
Who determines if I am disabled?
There are basically three stages that a typical person will undergo in a disability process. You first apply for benefits. At this stage, there are disability examiners at the local office that will review your records and make a decision. You will be notified of the decision usually within a couple of months. Statistically, more than 60-70% of these people are denied benefits. At that point, you have 60 days to appeal the decision on what is called Reconsideration. The Reconsideration is sent to the same local office but reviewed by another individual. The denial rate at this stage is nearly the same as the first state, and usually takes 2-4 months. Once again, you have 60 days to appeal, but this time it is called Request for Hearing. The Request for Hearing is sent to a different office for review, and also set for a hearing before a judge. Typically, it takes more than one year before you will receive a trial date. The Social Security process is extremely busy, and a typical case will take well over a year to complete. In fact, the national average in 2008 was 541 days before you received a hearing.
Are there any illnesses that would automatically qualify me as disabled?
This is somewhat difficult to answer. Social Security has laws that they follow called Listings. If you meet the qualifications for certain medical conditions, then you could be found disabled without having to prove your physical or mental limitations.
Most of my issues are related to mental impairments. Can I qualify with mental issues only?
Do you need an attorney to obtain Social Security benefits?
No, you can obtain benefits on your own, but it will be very difficult if you have been turned down at the application stage. You must know what forms and information to submit to Social Security and you must turn them in within the time frames designated.
What is a typical attorney fee for helping someone get Social Security benefits?
All attorney fees are set by federal law at 25% of past due benefits. Past due benefits are the checks you should have been receiving while you are going through your appeal. If it takes a year to win your case, then your past due benefits would be for that year. If an attorney does not win your case, then you would owe no fee.
Is there a waiting period in social security?
Can children obtain benefits?
Yes, a child could qualify under Title XVI. The same standards are applied to children but not compared to work. The disability is evaluated against what a child of that same age would typically be able to do.
Will I get health insurance benefits with my Social Security?
There are two types of health insurance through Social Security. Medicaid is a welfare benefit and Medicare is not. Once you receive Title XVI (SSI) you would be able to get Medicaid. Medicaid virtually requires you to prove poverty. Medicare is not dependent upon whether you have money or assets. A very wealthy person could actually obtain Medicare benefits. Medicare does not pay for prescription costs and you must be on Social Security benefits for 2 years before you are eligible. Medicare pays doctors at higher rates than Medicaid.