Back to TopWhat Is Social Security Disability Insurance (SSDI)?
Social Security Disability Insurance, also known as SSDI or SSD, is insurance that provides income for individuals who have worked and paid Federal Insurance Contributions Act (FICA) taxes. The FICA tax is a United States payroll tax imposed by the federal government on both employees and employers to fund Social Security and Medicare. Social Security Disability benefits are payable to disabled workers, widows, widowers, children under age 18, or adults who have been disabled since childhood. SSDI also provides a variety of benefits to family members when a primary wage earner in the family becomes disabled or deceased.
Social Security Disability Eligibility Requirements
There are more than 4 million people under retirement age who receive Social Security Disability because their impairment or health prevents them from working. To be eligible to receive Social Security Disability benefits you or a qualifying family member must be fully and currently insured under the Social Security program. It is a very complicated formula to understand, but it basically means that you must have worked and paid your FICA taxes to the government. Fully insured requires you to have worked at least several years after the age of 21; how manyyears depends on your age. To be currently insured you must have worked and paid your FICA taxes for approximately 5 of the last 10 years. Most employees who receive a W-2 from their employer are paying the required FICA taxes out of the overall taxes they pay to the federal government. Self-employed workers and certain professions do not automatically pay into Social Security. If you or a qualifying family member has paid the required amount of Social Security taxes, and a doctor who says you simply can’t work anymore as a result of your impairment(s) has treated you, you’re probably eligible for disability insurance benefits.
Adults
The Social Security Administration (SSA) definition of disability is different than other programs, including worker’s compensation or VA benefit programs. SSA only considers total disability from employment, not partial or short-term disability. Under the SSA’s rules, you may be considered disabled if you satisfy the following requirements:
- Your disability has lasted or is expected to last for at least 12 months (one year). If your disability is expected to result in death before the 12 month requirement is met, you will satisfy this requirement;
- Depending on your age, you are unable to do any of the jobs that you performed in the past 15 years, or, if you are a younger individual, you are unable to do any type of work, notwithstanding whether you have performed that type of work in the past;
- The medical evidence supporting your claim convinces the Social Security Administration that your impairment is severe enough under their rules to prevent you from working. If your case is at the initial application or reconsideration stages, an analyst will make that determination. If you are at the hearing or Appeals Council stages, an administrative law judge will decide your claim.
For Adults Disabled Before Age 22 (also known as – Disabled Adult Child)
An adult who is disabled before age 22 may be eligible for benefits if a parent is deceased or starts receiving retirement or disability benefits. This benefit is commonly referred to as Disabled Adult Child’s benefits (DAC). The Social Security Administration considers DAC an “adult child’s” benefit because it is paid on a parent’s Social Security earnings record. The “adult child”(including an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild) must be unmarried, age 18 or older and have a disability that started before age 22.
What is Supplemental Security Income (SSI)?
Supplemental Security Income (SSI) pays monthly cash benefits to people who are age 65 or older, those who are blind or those who have a disability and who do not own much or have a lot of income. The requirements for SSI disability are the same as with Social Security Disability, however, to qualify for SSI a financial need threshold must also be met. An individual may collect both Social Security Disability Insurance and SSI if they are insured and their Social Security Disability Insurance benefit amount is less than their state’s maximum SSI benefit. However, unlike Social Security disability, SSI does not require the claimant to have worked and paid taxes. An individual can collect SSI benefits if they meet the disability and financial need requirements.
Process of Filing a Claim
The following are the stages of the claim process:
- Initial Application: When you initially file your application for Social Security disability and/or SSI, an analyst will review your claim and issue a determination. Most claims are denied at the initial level. You have 60 days to appeal to the next stage of the appeal process.
- Reconsideration: If your claim was denied or if the compensation does not meet your needs, you may appeal the decision. Reconsideration is a complete review of your claim by someone other than the person who made the original decision. The reconsideration stage is slowly being eliminated by the Social Security Administration, however, some states still have a reconsideration stage. If you live in a state that has reconsideration, your appeal from the initial denial is to the reconsideration stage of review. You must appeal any denial within the time frame allowed or you may lose a substantial amount of benefits. If you do not appeal timely, there are some exceptions that will allow your appeal to be accepted as late, but timely.
- Hearing before the Administrative Law Judge: If you are denied at reconsideration, or if your state does not have a reconsideration stage, your next level of appeal is to the hearing level. This appeal process is called a Request for Hearing. At the hearing stage, an Administrative Law Judge (ALJ) will provide you an opportunity to have a hearing at which you will appear in person with your representative to present your case.
- The Appeals Council: If your case is denied by the judge at the hearing stage, you must appeal to the Appeals Council (a review board within the Social Security Administration) which may issue its own decision, send the case back to the ALJ for another hearing or allow the ALJ’s decision to stand as the final decision of the Social Security Administration.
- Federal Court: If your appeal is denied by the Appeals Council, you can file a lawsuit in federal district court.
Why An Attorney?
The process of applying for Social Security Disability benefits and appealing denied claims is complicated and the chances of success are far greater with the help of an experienced Social Security disability attorney. Retaining an experienced attorney can increase your chances of obtaining your disability benefits and help avoid denials based on technicalities or other common errors. Most individuals who apply to the Social Security Administration for Social Security Disability and/or Supplemental Security Income benefits are initially denied. Many qualified claimants are denied because they do not know how to get their disability claim approved and do not seek guidance from qualified Social Security disability attorneys or advocates. In fact, in year 2015, the Social Security Administration adjudicated over 1.4 million initial filings and only 32% of claimants were found disabled. To make matters worse, most claimants have to appear before an administrative law judge at the hearing stage and while a higher percentage of claimants are awarded benefits, award rates by administrative law judges remain low at about 48% nationally and the average wait time for a hearing is 24 months! Also, waiting to file may cause you to lose benefits and in some instances if you wait too long you won’t be able to file at all, so don’t wait! Even if you start the process without an attorney, you can hire one at any stage of the proceedings.
At Pierre Pierre Law, you are guaranteed to be represented by an experienced Social Security Disability attorney, not a non-attorney representative who did not attend law school. After all, Social Security Disability is governed by a set of laws enacted by Congress, so you want a lawyer representing you against the government, not your neighbor, friend or a non-attorney representative. Pierre Pierre Law will work together with you to gather the required evidence, complete the necessary forms and argue your case before an administrative law judge at your hearing. Find out if you qualify now, and if you do, we will file your application and get the process started. We can represent you even if you have already filed your claim or been denied, if certain criteria are met.
