Will My Disability Make Me Eligible For SSD Or SSI Benefits?
The Social Security Administration (SSA) and state agencies making determinations will consider you disabled if:
- You have a physical impairment or mental disorder that
- Prevents you from doing substantial gainful activity (SGA)
- For at least 12 months
The SGA requirement is measured by the wages you earn: If you are earning over a certain level, then you will not be considered disabled. The durational requirement means that injuries that will heal in less than a year (a sprained ankle or broken bone) will not qualify you for SSD or SSI.
Are SSD And SSI The Same Program?
While many people don't distinguish between SSI (Supplemental Security Income) and SSD/SSDI (Social Security Disability Insurance), they are in fact two different programs.
- To qualify for SSD benefits, you must have earned a sufficient number of “work credits”. In general, you receive one credit for each $1,200 of earnings, to a maximum of four credits per year — though there are exceptions for certain kinds of work and workers.
- SSI benefits are available to those who have not earned enough work credits to qualify for SSD, or who have never worked. In other words, it is primarily for low-income individuals with disabilities.
Both programs are managed by the Social Security Administration, and the criteria for medical eligibility is the same (see above).
Who Decides Whether I Qualify For Benefits?
Each state has an agency that decides disability claims — it is usually called Disability Determination Services, or DDS. When you apply for Portland SSI or SSD benefits, the Social Security Administration will send your claim to the DDS, which will decide whether you are “disabled” and therefore qualify for SSD or SSI benefits. Your state's DDS offices can provide information about why your application was denied and answer your related questions.
When Should I Apply For SSD Or SSI Benefits in Portland?
To avoid financial hardship, it is best to apply SSI or SSD benefits in Portland as soon as you are eligible. When you do receive benefits, they will be backdated to the date of your initial application, not to the date of injury or onset of illness. If you believe you may qualify for benefits, don't wait to apply.
How Do I Apply For SSD Or SSI Benefits in Portland?
There are currently three ways to apply for benefits:
- Online (SSD only)
- Calling the Social Security office to set up an appointment to apply for SSI and SSD benefits in Portland, and
- Walking into the local Social Security office without an appointment.
When you call or walk into an office, you will be given an appointment for an interview, and you will complete your application with the interviewer. If you are not comfortable with computers, or will need help completing your application, this is the best choice for you.
An online application can be completed from any computer, does not need to be completed all at once, and allows you to check the status of your application after you submit it.
When Can I Expect A Decision?
The Social Security Administration estimates that most initial applications will be assessed within 90-120 days, but it often takes longer — sometimes as long as six or eight months. Approximately 70 percent of initial applications are denied, so it is safest to assume you will have to go through the appeals process.
A reconsideration — the first level of appeal — takes an average of three to four months, though a case could be decided much sooner or much later. We'll do everything we can to help you win benefits earlier rather than later in the appeal process. The sooner you contact us after you apply for SSI or SSD benefits in the Portland area, the sooner we can help, so it is a good idea to seek help if your initial application has been denied.
What Can I Do If My Claim Is Denied?
The first step in the appeals process is called a reconsideration. Once you receive your denial, you have 60 days to request a reconsideration. It is important to observe this deadline — if you miss it, you lose your right to an appeal and must file a new application.
How Long Does An SSD Or SSI Appeal Take?
The second level of appeal — an appeal to an administrative law judge (ALJ) — usually takes at least six months, but the wait for a hearing is as long as 18 months in some parts of the country. It is very difficult to generalize, but our lawyers can give you a better idea given the particular details of your case. Some factors that affect appeal time include:
- Your location
- The workload of your local claims examiners
- The condition of your medical records
- The type of claim you are making
If you have a very severe illness with a clear diagnosis, you may be able to get an expedited decision through one of Social Security's expedited disability benefit programs.
How Is My Disability Benefit Claim Evaluated? What Evidence Is Considered?
The medical evidence needed to assess your disability may include:
- Examination and treatment notes from your doctor(s)
- Bloodwork panels and other tests results
- Reports of imaging studies (MRI, CAT scan, and X-rays).
- Mental health records
You can save yourself a lot of time and frustration by gathering this medical evidence from the doctors who a treating you. Presenting sufficient evidence when you apply for SSI and SSD benefits in Portland will help you get a faster determination on your disability claim.
Will I Have To File More Than One SSD Appeal?
Unfortunately, if you are denied on your initial claim for disability benefits, odds are that you will be denied on your first appeal (reconsideration) as well — which means you will have to proceed to the next step in the appeals process. SSDI and SSI claims that are denied at the initial level will almost always need to be heard by an administrative law judge (ALJ) at a hearing before they can be approved.
According To Workers' Comp, I Am “Totally And Permanently Disabled.” So Why Can't I Get SSD Or SSI?
Social Security disability benefits are entirely separate from the workers' compensation system. The criteria for evaluation are very different, so being compensated in one system does not guarantee you compensation in the other. Workers' comp is a type of insurance, applies only to work-related illness and injuries, and assesses the severity of the injury to determine your ability to return to work. Social Security, on the other hand, is primarily interested in your ability to pursue “substantially gainful activity” (SGA), and covers any illness or injury that will prevent you from holding SGA for at least 12 months.
Can Certain Medical Conditions Get You Approved For Disability Automatically?
Yes. Disability claimants who fulfill the severity criteria for one of the conditions on the List of Impairments (“the listings”) can be approved for benefits somewhat easily. However, the disability evaluation process, even for these “listing-level” impairments, is never automatic, and with Social Security, nothing is ever guaranteed.
Can I Work While Receiving Social Security Disability Benefits?
Yes, but be aware of the “substantially gainful activity” (SGA) requirement. If you can earn more than $1,070 per month (gross) when you apply for SSI and SSD benefits in the Portland area, you will be considered capable for SGA and therefore not disabled. The idea is that your health conditions have not risen to the level of “disability” if you can earn at least that much.
Part-time jobs, short-term jobs, and work that earns you less than $1,070 per month are less likely to affect your claim. Be cautious about extensive volunteering or any work-like activity which could (if paid) earn you more than that amount.
SSDI recipients are entitled to test their ability to work and continue to receive full benefits regardless of whether they make more than the SGA amount, for a nine-month trial work period. For 2014, the SSA considers any month where a person has a monthly income of more than $770 a trial work month.
Do I Need A Lawyer To Win My Disability Case?
Statistically, the vast majority of people who apply for SSI and SSD benefits in Portland and across the United States are denied at the initial claim and reconsideration levels. This means that most claims will need to go to a hearing in front of an administrative law judge (ALJ) before a claimant can hope to receive disability benefits.
It is at the level of an ALJ hearing that having a disability attorney can really help win a claim. While we can't guarantee that a claimant will be awarded Social Security Disability or SSI benefits, our lawyers can ensure that a case will be properly “developed” prior to a hearing date. We can also help prepare you for the hearing, which might otherwise be an intimidating experience.
How Much Will It Cost To Hire A Lawyer For My SSD Or SSI Claim?
Nearly all disability lawyers work on contingency: They do not charge up-front fees or require a retainer to work on a Social Security disability case, and they will be paid a fee only if they win the case. Additionally, the SSA regulates the fees we may collect for our services. Typically, they are limited to 25 percent of the past-due benefits you are awarded, up to a maximum of $6,000, plus any out-of-pocket expenses. What out-of-pocket expenses will be charged to you, and how much they typically are, should be discussed with your attorney during your initial consultation meeting.
For experienced disability attorneys who can help your successfully apply for SSI and SSD benefits in the Portland area, call JP Law at 503-245-6309 or contact us online.