What You Need to Know About Social Security Law

If you’re suffering from a serious and debilitating injury or illness and are unable to work, you may be able to qualify for Social Security income.

You may be eligible to receive government benefits such as:

    Social Security Disability Insurance (SSDI) – If you are unable to work due to injury or illness
  • Supplemental Security Income (SSI) – If you are 65 or older, blind or disabled
  • Retirement Insurance Benefits – If you are of retirement age

While most Americans who have worked and paid FICA taxes are able to receive Retirement Insurance Benefits automatically as soon as they reach retirement age, receiving Disability benefits can be much more complicated.

Qualifying for Disability Benefits

In order to receive Disability payments, you must have a documented disability that prohibits gainful employment and you must be unable to find other employment due to your disability, lack of training or other valid reason.

Social Security Disability Insurance

Social Security Disability Insurance is a federal insurance program available to eligible taxpayers in the U.S. who have suffered a disability that renders them unable to work. SSDI is available on a permanent or temporary basis, depending on the nature of the disability.

Eligibility for SSDI

Your eligibility for Social Security Disability Insurance depends in part upon your work history.

Disability benefit payments are based on work credits, which are awarded for certain amounts of taxed income that is adjusted each year. These taxes pay into Social Security which allows a worker to receive benefits once they become disabled.

A maximum of 4 credits can be earned each year and most workers need to have earned 40 credits to be fully eligible for Disability benefits.

However, this requirement is lowered for younger workers and in other special circumstances.

In order to receive SSDI, a person must:

  • Be under the applicable full retirement age as defined by the Social Security Administration.
  • Have a condition that is expected to last at least 12 months or result in death.
  • Have a physical or mental condition that prohibits substantial gainful employment.
  • Have earned the necessary amount of Social Security work credits within a certain period of time

Social Security Disability Insurance is a form of income available for those who are unable to work due to a medical condition that is expected to last 12 months of longer.

SSDI is considered an entitlement program because those who are eligible to receive Disability payments have been working and paying into the system through payroll taxes called FICA deductions.

Supplemental Security Income

Supplemental Security Income is a government benefit program designed to help those with long-term disabilities who have no real income and few personal assets.

SSI can provide a safety net for those in need, but, like some other forms of government benefits, receiving SSi is not an automatic process.

Eligibility for SSI

SSI is not an entitlement program and as such, it doesn’t have any pay-as-you-go requirements. Instead, this form of Social Security is available to those in need of financial help. The amount you may be eligible to receive will depend on your unique financial situation.

The legal requirements for receiving SSI are being “indigent,” blind or disabled. A person is considered indigent if he or she has very little income other than child support or TANF benefits for children.

Besides being disabled, legally blind or 65 years or older, an individual must meet the following criteria:

  • Has limited income (wages and other benefits)
  • Has limited resources (savings and physical assets under $2,000 for an individual)
  • Is a U.S. citizen or national, or is a qualified alien
  • Resides in the United States, Washington D.C. or Northern Mariana Islands

The under $2,000 asset qualification does not count your home and one car.

The amount of benefits you may qualify for depends on need at the annual Federal benefit rate, which may be updated each year for inflation. In some states, this amount may be supplemented by other federal or state-level income benefits.

Supplemental Security Income may also be paid to those who are 65 or older who also meet similar standard of living requirements. Those who are eligible can typically receive SSI in addition to their entitled Retirement Benefits from the SSA.

Unlike Retirements benefits, SSI is not guaranteed and the process to file claim benefits can be difficult and drawn-out.

Many people who file a SSI claim find that their claim is rejected. You have the right to appeal this decision.

If your claim is eventually accepted, you’re entitled to backpay from the date that you originally filed.

Medical Conditions for Social Security Disability

There is no finite list of disabilities that are covered by Social Security disability. Any illness, injury or other medical condition may be approved for benefits if the Social Security Administration agrees that the claim is warranted.

The following conditions include some of the most common claims that are submitted to and approved by the Social Security Administration. Even if your medical condition is not listed below, you may still qualify for disability benefits.

  • Bipolar Disorder
  • Cancer
  • Chronic Fatigue Syndrome
  • Chronic Headaches
  • Chronic Pain Disorders
  • Complex Regional Pain Syndrome
  • Congestive Heart Failure
  • Crohn’s Disease
  • Diabetes
  • Depression
  • Fibromyalgia
  • Hepatitis C
  • Huntington’s Disease
  • Lung Disease
  • Lupus
  • Mental Illness
  • Multiple Chemical Sensitivities
  • Muscular Dystrophy
  • Multiple Sclerosis
  • Post-Traumatic Stress Disorder (PTSD)
  • Reflex Sympathetic Dystrophy
  • Rheumatoid Arthritis
  • Traumatic Brain Injuries

Filing a Social Security Claim

If you think you may be entitled to receive Social Security Disability Insurance payments of Supplemental Security Income benefits, you need to file a claim with the Social Security Administration.

Filing a Social Security claim can be a complex process and may involve a thorough exploration of your medical condition, sources of income and personal assets.

Because there is so much at stake when applying for Social Security, many people choose to work with attorneys or advocates throughout the process.

Federal law prohibits Social Security attorneys and advocates from charging fees for Social Security cases unless your claim is approved. The total amount your attorney or advocate can collect is limited by law.

How to Apply for Social Security

Generally, you can apply for Social Security in person, online at the SSA website or by phone.

Depending on the form of benefits you are looking to receive, you may need to provide:

  • Access to your bank accounts and other financial records
  • Medical information detailing your disability (illness or injury)
  • Proof of citizenship or qualified alien status
  • Proof of employment and FICA tax payment history

Meeting the standards of the Social Security Administration (SSA), especially in terms of providing medical proof of your disability condition, can be one of the most challenging parts of filing a claim.

In fact, most people who apply for Social Security find that their claim is initially denied due to not having adequate enough proof. In this situation, you can appeal the denial of benefits.

Appealing a Denied Social Security Claim

The Social Security Administration is looking for specific information in each Disability claim and many filers do not meet the standards of an acceptable claim.

Even if you feel that your claim specifically outlines how your condition makes working impossible, it may not be accepted without a valid medical reason.

If you wish to appeal your denial of benefits, you must send a request in writing within 60 days to receive an administrative hearing.

In most states, there are four levels of appeals. If a claim is denied, it can be taken to the next highest level.

  • Reconsideration
  • Hearing by an Administrative Law Judge
  • Review by the Appeals Court
  • Federal Court

At each stage of the process, time is of the essence. Acting quickly to appeal a decision to deny your benefits removes the risk of having the statutory time to respond lapse.

Disability Benefits for Veterans

Veterans of the United States military are often entitled to a wide range of benefits from the Department of Veterans Affairs (VA) upon receiving their discharge.

For vets who have a disability that was caused or aggravated by active duty, the VA may offer monthly disability benefits on a temporary, or permanent, basis.

Much like receiving disability benefits from the Social Security Administration, the process of applying for veteran’s disability and proving your need can be time-consuming and tedious.

The Department of Veteran Affairs allows veterans to be represented by an attorney or advocate if they wish to appeal a denial of an initial claim.

Requirements for Disabled Veteran Benefits

In order to eligible to receive disability benefits through the VA, a veteran must meet the following qualifications:

  • Disability was not the result of willful misconduct or abuse or alcohol or drugs.
  • Currently suffering from a temporary or permanent disability that was caused by or aggravated by active service.
  • Medical evidence must link the disability to active duty service.
  • Must have received a discharge status other than dishonorable.

Based on the above factors, the Department of Veterans Affairs will decide 3 things:

  • If the veteran is entitled to disability compensation.
  • How severe the disability is, based on the VA’s rating system.
  • When any compensation will start being paid.

In its assessment of your claim, the VA will rate your disability on a scale of 10 percent to 100 percent to reflect the severity of the disability.

Veterans with multiple disabilities may rate at a higher level, but the disabilities will not simply be added together.

Veterans with dependents to support may be able to receive a larger amount than those supporting only themselves. Spouses, children and live-in parents may be qualified dependents, allowing a disabled vet to receive a larger sum of benefits each month.

Filing and Appeals Process for Veterans Benefits

  1. Submitting a claim: Claims for disabled veteran’s benefits must be filed with your VA Regional Office. There is no statute of limitations for filing a claim. A disabled veteran may file a claim at any time after serving active duty.
  2. Appealing a denied claim: Often, the VA will reject an initial application, or accept it but give it a rating that results in little compensation for the veteran’s disabilities. When this happens, the applicant can appeal the decision. An applicant has one year to appeal by filing a Notice of Disagreement with the Board of Veterans Appeals (BVA).
  3. Submitting a brief: A legal brief that details your disability and provides medical evidence of temporary or permanent disability can be submitted along with the Notice of Disagreement to the Board of Veteran’s Appeals. The BVA will either reverse the decision of the Regional Office, or send the claim back to the Regional Office. A stronger argument for receiving benefits can often help the process go more smoothly for the applicant.
  4. Second appeal of a claim: If the BVA denies a claim, or approves a claim at a low rating, the decision can be appealed again to the United States Court of Appeals for Veterans Claims. This appeal must be filed within 120 days of the BVA decision, and requires a much more formal legal brief.
  5. Third appeal of a claim: If the claim is denied by the United States Court of Appeals for Veterans Claims, the decision can be be appealed again, this time to the United States Court of Appeals for the Federal Circuit.