Disability Benefit Lawyers

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 What Are Disability Benefits?

The acronym SSI refers to “Supplemental Security Income.” Supplemental Security Income benefits are paid by the federal government to qualified individuals, generally those who are aged 65 and over, and/or who are disabled. In order to qualify for SSI, applicants must have limited income and assets.

In terms of disabilities, SSI disability payments are reserved specifically for those who are disabled and have limited assets and income because of their disability. People who have worked for a period of time that is considered to be sufficient to qualify for social security retirement payments are not eligible for SSI disability payments. Additionally, SSI disability payments are different from Social Security Disability Insurance (“SSDI”) benefits payments.

In order to be eligible for SSDI payments, an applicant must be disabled as well as have worked for a sufficient length of time. Additionally, they must have paid social security taxes. Alternatively, those who receive SSI disability payments have not worked long enough to qualify for SSDI; in some cases, people who have never worked may be eligible for SSI disability.

Some examples of specific basic requirements include that applicant must:

  • Meet the Social Security Administration definition of disabled;
  • Have limited income and resources;
  • Be a citizen, a U.S. national, or an eligible non citizen; and
  • Reside in the U.S. or the Northern Mariana Islands.

What Are The Medical Eligibility Requirements?

In order to receive SSDI benefits, an applicant must be incapable of working due to a severe medical condition. This severe medical condition must have lasted (or be expected) to last one year or more, or be expected to result in death. Each state’s Disability Determination Service (“DDS”) uses an evaluation process in order to determine whether a person’s medical condition constitutes “severe” according to their definition.

Generally speaking, a severe medical condition is one that is substantially limiting. What this means is that the condition must limit the ability to perform basic work tasks, such as sitting and standing. This limitation must exist for at least 12 months, and be permanent.

Additionally, the DDS considers whether your disability is the medical equivalent of an impairment that is included in the federal government’s “listing of impairments.” This listing contains medical conditions that the federal government considers to be severe enough to prevent you from performing gainful work.

The DDS then considers whether your disability prevents you from performing work that you used to perform. If the disability or condition does not prevent you from performing such work, you are not considered to have a “severe medical condition.” If the disability does prevent you from performing this work, the DDS will then look at whether you can perform some other type of work. If you cannot perform any other type of work, you will qualify as an individual with a “severe medical condition.”

What Are The Work And Earnings Eligibility Requirements?

In addition to having a serious medical condition in order to obtain SSDI benefits, an employee also must have worked for a certain period of time. During a person’s working years, they earn social security work credits. Currently, for every $1,410 in wages earned, a person receives one credit. Up to four credits can be earned in a single year.

The number of credits that are needed for SSDI eligibility is measured by the age at which you became disabled. Generally speaking, an employee must have 40 credits, twenty of which were earned in the last ten years of becoming disabled.

In order to assess whether an employee has met these requirements, the government uses two tests: the “duration of work” test, and the “recent work” test. An example of this would be how according to these tests, if a person became disabled in 2020, they must have earned 40 credits overall. Of these forty credits, twenty must have been earned between 2011 through 2020, which is the year when the individual became disabled.

Younger workers who have fewer than 40 credits could still be eligible for SSDI, as the SSDI program recognizes younger workers who have not accumulated 40 credits when they become disabled, under specific circumstances.

How Are Benefit Amounts Determined?

The monthly SSI disability benefit amount is determined by the amount of assets and income that you have. The Social Security Administration has set rules which define what constitutes income. According to their definition, income is considered to be anything that an individual receives in the form of cash. Their definition of income also includes something “in-kind” that can be used to meet the basic needs of shelter and food. An in-kind payment is a good or service that someone uses as payment for something, instead of using cash.

The following types of income qualify as income for SSI Disability purposes:

Sheltered workshop payments are non-profit institutions that offer work opportunities to people with developmental, physical, or mental disabilities. Their intention is to prepare participants for gainful work in the economy-at-large. Sheltered work generally consists of basic, repetitive tasks which are accompanied by instruction regarding:

  • Life skills;
  • Personal hygiene; and/or
  • Physical rehabilitation.

Deemed income may count as income for purposes of SSI disability benefits calculation. An example of this would be when an eligible person has a spouse who is not eligible. Part of the spouse’s income may be counted when determining the SSDI disability benefit amount. Another example of this would be if a child is eligible for SSI disability benefits, and at least one of their parents does not receive these benefits. SSA may count a portion of the parents’ income when determining the child’s benefit amount.

Some examples of what is not included in SSI disability benefit determination includes, but are not limited to:

  • The value of Supplemental Nutrition Assistance Program benefits (food stamps) received;
  • Income tax refunds;
  • Home energy assistance and
  • Loans that the recipient must repay.

In order to determine the amount of the SSI disability benefit, SSA calculates a person’s gross income; or, money from all sources. SSA then subtracts all income it does not “count,” such as income tax refunds and home energy assistance. The resulting figure is known as countable income. SSI subtracts the countable income from the SSI disability federal rate, and the resulting figure is the amount of SSI disability payments to be received.

As of 2021, the maximum monthly amount that an SSI disability recipient can receive is $794 per month. If a person who is eligible has an eligible spouse, the figure is then $1,191 per month.

Essential persons are also entitled to a monthly benefit. According to SSI, an essential person is defined as someone who is living with an SSI disability beneficiary who provides essential care to that beneficiary. An example of essential people would be children who act as caregivers for their parents, and caretakers who reside at the beneficiary’s home. As of 2021, the maximum essential person monthly benefit payment is $397.

What Else Should I Know About Disability Benefits?

To apply for benefits, an application requires basic information such as:

  • Your social security number;
  • A birth certificate;
  • A description of the work you perform; and
  • Medical information such as doctor contact, medication, and lab results.

Once the program receives all of this information, they will either approve or deny your claim. If your claim is denied, you have the right to an appeal which may be filed online. A commonly used appeal is called a “medical reconsideration” appeal, in which the applicant appeals a determination that their medical condition was not severe enough.

Another example would be a “non-medical reconsideration,” in which the applicant appeals to a finding that their income was too high to receive SSDI benefits. The federal government provides additional levels of appeal. Additionally, they may periodically review your case in order to determine whether you still qualify for benefits. You will stop receiving these benefits if, according to the program’s definition, you are no longer considered to be disabled. However, the program will notify participants prior to reviewing their case.

Do I Need An Attorney For A Disability Benefit Claim?

If you have been denied disability benefits, or have any other issues associated with disability benefits, you should contact an experienced and local social security disability lawyer.

An area attorney can help you understand your rights and legal options, as well as how they may be affected by your state’s specific laws. Additionally, they will also be able to represent you in court, as needed.

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