Understanding Social Security Disability

Disabled workers may be eligible for Social Security benefits prior to retirement age, under the Social Security Disability insurance program (SSD). Our office handles the filing of cases for Social Security Disability (SSD) benefits. To qualify for Social Security Disability benefits, you must have worked long enough and recently enough under Social Security paying taxes into the system. One can earn a maximum of four work credits per year. The amount of earnings required to fulfill a credit increases annually as the general wage level rises. Family members who qualify for benefits on the claimant's work record do not need work credits themselves to be eligible for benefits under the worker's account. The number of work credits needed for disability benefits depend on the age when the worker became disabled. Generally, you need 20 credits earned in the last 10 years ending with the year you became disabled. However, younger workers may also qualify with fewer work credits. The general rule is that you must work at least 5 out of 10 years prior to becoming disabled, unless you are under 31 years of age.

In order to file for benefits (SSD), the applicant must be out of work and anticipate being out for at least twelve continuous months. There is a five-month waiting period before any payment of benefits can begin. Benefits are paid twelve months before the application date or five full months after work ceases, whichever is later. A delayed application can mean less retroactive benefits for the workers and their dependents.

Disability can be based on a work related or non-work-related injury or illness, be it physical, emotional, or a combination. The impairment must prevent the performance of any sustained work and be verified by a physician who has provided treatment to the claimant during the period of disability. It is important for the claimant to be seeing a medical doctor. Chiropractic evidence alone is not sufficient proof of disability.

It must be established that the applicant is unable to engage in any substantial gainful activity due to a medically determinable impairment. Claimants under age 50 must prove they are totally disabled from all forms of work. When a claimant reaches age 50, factors such as age, education, language and work experience are taken into account, and total disability for all work is not always required.

A common case is a back or neck injury. An MRI or CT SCAN demonstrating a herniated disc, bulging disc, degenerative disc disease, spinal stenosis, or advanced arthritis, is required to prove this type of case. Disability may also be based on asbestosis, silicosis, heart conditions, strokes, knee injuries and other physical conditions as well as emotional impairments.

Social Security Disability may be received concurrently with Workers' Compensation, Long Term Disability, State & Municipal Disability Retirement, or Union Disability, subject to certain ceilings. Medicare coverage is provided for Social Security Disability recipients after 24 months of benefits have been paid. Medicare does not cover dependents; however a non-working spouse and minor children are covered for monthly benefits on the disability applicant's account.

Our office handles cases from initial application, as well as filing for reconsideration, hearing and appeals if necessary. We at Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP take care of all correspondence from the Social Security Administration and your doctors.

The first step in beginning this claim for Social Security Disability is to be seen by a Legal Assistant from our office who will interview you asking detailed questions regarding employment and medical information.

After the initial interview is conducted, an application will be filed by our office and submitted to your local social security district office. It will then be sent to the State Agency for medical development. A member of the State Agency will solicit and review all medical information in your file to decide if you are disabled. It is very common for your claim to be turned down at this initial stage.

Denials fall into two general categories: denied because the individual could not meet the insured status requirement or had not worked long enough under Social Security, or denied because the claimant is not considered "disabled." By a wide margin, the majority of denials fall in the second category.

When an initial determination is found unfavorable, claimants are sent a letter notifying them that their claim has been denied. Your attorney should receive a copy of the same letter as well. There are 60 days given in which an appeal must be filed. This appeal is known as a Request For Reconsideration. Many times this appeal is often found unfavorable as well. Claimants and their representatives will receive another notice advising them of the unfavorable decision again giving 60 days to file a Request For Hearing where your case will heard before an Administrative Law Judge. In certain counties, an application denial goes directly to a hearing request appeal and skips the reconsideration stage.

While waiting for a decision on your case, our office works with your doctors to prepare and develop your medical evidence. Your attorney will present this evidence to the Social Security Administration or to an Administrative Law Judge, if a hearing is required. Claimants are required to present information as to how their daily activities are affected by their conditions. This is done by way of forms and/or testimony.

Though less often an occurrence, if your case is not successfully decided in court at the Hearing, a request for review can be filed with the Appeals Council in Falls Church, Virginia. Denials of benefits from the Appeals Council must be appealed to Federal Court.

By completing the screening form that follows, our office can get a general idea if we will be able to assist you in filing for Social Security Disability benefits. A member of our trained staff will then contact you to discuss the possibility of scheduling an interview in one of our convenient locations to begin the process of this claim for disability. We are not authorized to collect a fee unless we are successful in obtaining benefits on your behalf.

Over the years our firm has helped thousands of New York workers get the Social Security Benefits that they deserve, serving our fellow workers in Manhattan, Brooklyn, Kings and Queens Counties, Staten Island, The Bronx, Rockland, Westchester and Nassau and Suffolk Counties.