The Skolnick Weiser Law Firm, LLC is ready to help you with your Social Security Disability and Supplemental Security Insurance (SSI) claims. Call us at 216-706-9722 for a free consultation.
Social Security disability and Supplemental Security Income (SSI) are programs run by the United States Social Security Administration for the benefit of individuals who have physical and/or mental impairments that limit their ability to work. The Social Security Administration also provides benefits under the SSI program to children who have physical and/or mental impairments that affect them.
Social Security disability
Social Security disability functions as an insurance program for workers. In order to qualify for this program a worker must have paid Social Security "taxes." A quick rule of thumb is that you must have made contributions in 20 out of the previous 40 calendar quarters, or put another way, 5 out of the previous 10 years. For most workers this means that you still have Social Security disability insurance coverage should you become disabled and unable to work for up to five years after you stopped working.
Supplemental security income (SSI)
Supplemental security income (SSI) is a welfare program run by the federal government for the disabled, blind and those who are over 65. Adults who do not qualify for coverage under the Social Security disability program may apply for SSI benefits. The definition of disability for SSI is the same as the definition for disability under the Social Security disability program, but unlike the Social Security disability program, there are also income and asset limits associated with SSI. Essentially, SSI is for people who don't have very much money. Children under the age of 18 may also qualify on their own for SSI benefits.
Adult definition of disability
For adults, disability is defined for purposes of the Social Security disability program as well as for the SSI program as being an inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
Because of your physical or mental impairments you must be unable to perform the work you did before and considering your age education and work experience you must be unable to engage in any other work.
Childhood definition of disability
A child under the age of 18 who has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months, may be eligible for SSI benefits. Under current regulations, in order to qualify medically for benefits, a child must establish "marked" limitations in two of the six "domains" or an extreme limitation in one "domain." The "domains" that are evaluated by Social Security in determining whether or not a child is medically eligible are as follows:
- Acquiring and using information;
- Attending and completing tasks;
- Interacting in relating with others;
- Moving about and manipulating objects;
- Caring for self; and
- Health and physical well-being.
When should I apply for benefits?
You should apply for benefits if you have been off work for over 12 months due to a physical or mental impairment. By putting off applying for Social Security disability benefits, you are potentially losing benefits that might be available to you.
Social Security disability benefits can be paid to a qualifying individual up to one year before the date of the disability application. For individuals applying for SSI, payment of back benefits can be made from the date of the application. If you have a severe impairment or combination of impairments that prevent you from doing your past work and keep you from doing any other work, you should apply immediately.
What kind of proof do I need to establish my disability?
The best way to establish your disability is to have medical records available from doctors who have been treating you for your physical and mental conditions over a period of time.
If you have not been seeing a doctor on a regular basis, you need to start doing so. For individuals without insurance, you need to locate a medical facility that will provide low-cost or free care for individuals with limited or no income. In Cuyahoga County, Ohio, residents should go to MetroHealth Medical Center to be "rated." After you are rated, you will be able to receive treatment at a reduced cost, or at no cost. Given the number of options available to individuals without insurance for low-cost or free treatment, the absence of insurance, as an excuse for your lack of treatment, will be ignored by the Social Security judge at the hearing on your eligibility for benefits. The judge knows that there are treatment options available for individuals without insurance.
Applying for benefits
You can apply for Social Security disability benefits online, over the phone with someone from the Social Security Administration, or in person at your local Social Security Administration office. Applications for SSI can only be made over the phone, or in person at the local Social Security Administration office. There is no online application for SSI benefits at this time.
The following is a short list of helpful tips for you before filing your Social Security Disability and/or SSI application:
To apply for Social Security:
1. Get treatment for physical and mental conditions. If you are not receiving medical treatment and live in Cuyahoga County, go to MetroHealth Medical Center and get rated. If you don't live in Cuyahoga County check the Internet for indigent medical providers in your county.
2. Call your local Social Security office (800-772-1213) and make an appointment to apply for disability benefits and SSI. You can also go to the Social Security office and set up an appointment at that time. You can also apply over the Internet at https://secure.ssa.gov/iCLM/dib. Remember, however, you cannot apply for SSI over the Internet. You must make that application in person at the local Social Security office, or over the telephone to a Social Security Administration worker.
3. When you are ready to apply, make sure to have the following:
- A complete list of all the doctors, hospitals, and clinics that you have seen including their names, addresses, phone numbers, patient ID numbers, and dates of treatment.
- Names of medicines you are taking and who prescribed them (should be listed on your medicine bottles).
- Names of medical tests you have had and who sent you for the test.
- A list of the five (5) most recent jobs you have held over the past 15 years. You will need to list your job title, the type of business it was, and the month and year you started the job and the month and year you stopped working at the job.
- Information about insurance or workers' compensation claims you filed, including the claim number(s) and the name and address of persons handling the claim for the BWC or insurance company.
- Be able to give the name, address, and phone number of someone Social Security can contact who knows about your medical conditions and can talk about your claim. This can be a family member or a friend. It should not be your doctor.
- Dates of marriages and divorces.
- The names and dates of birth of your spouse and minor children.
- If you were in the military, Military Service discharge information (Form DD 214) for all periods of active duty.
- Your tax return information from last year (W-2 Form or your IRS 1040 and Schedules C and SE if self-employed).
- Your bank information for direct deposit of your benefit checks, including the bank's 9-digit routing number and account number.
- Finally, I recommend writing out a short paragraph explaining why your limitations prevent you from working so that you will be able to tell the Social Security Administration personnel what prevents you from working.
If you have any questions, please contact us at The Skolnick Weiser Law Firm, LLC at 216-706-9722.
If you've been denied
Initial application review
Once you have filed your Social Security disability or SSI application, it will be sent to Columbus, Ohio to the Disability Determination Service (DDS). This agency will obtain your medical records, arrange for a consultative examination, if necessary, and make an initial disability determination. This process takes approximately 4 to 6 months after your initial application. You will either be granted benefits, or as in the vast majority of the cases (up to 70% of all cases) you will receive a letter denying your application.
If you are denied benefits, the letter you receive will tell you that you have 60 days to file a "request for reconsideration." It will also tell you that Social Security believes that you received the denial letter in the mail five days after the date shown on the letter, thereby effectively giving you 65 days from the date of the denial letter to file your request for reconsideration.
File your appeal immediately!
Although Social Security gives you 65 days to file your "request for reconsideration," DO NOT WAIT! There is no point in waiting to appeal this denial. Your goal should be to get your "request for reconsideration" filed and have your application reviewed at the next administrative level as quickly as possible. The longer you wait to file your request for reconsideration, the longer it will take to get to the ultimate determination of whether you are disabled or not.
Although individuals can file their initial application without the assistance of an attorney, once you have been denied call The Skolnick Weiser Law Firm, LLC at 216-706-9722 in order to get our assistance with gathering additional medical evidence to support your disability application. We can immediately become involved in assisting you with your appeal.
Approximately 6 months following the submission of your "request for reconsideration" you will again receive notification from Social Security that it has either granted your application, or that your request for reconsideration is denied. At this point you again have only 65 days from the date of the letter notifying you that your "request for reconsideration" has been denied in order to file an appeal.
Request for hearing by administrative law judge
If your "request for reconsideration" is denied, the next step in the disability application process is to file a request for a hearing in front of an administrative law judge. The Skolnick Weiser law firm at 216-706-9722, can help you prepare your claim for the all-important hearing in front of the administrative law judge. As with all appeals and requests to the Social Security Administration, it is important to immediately get your request for a hearing filed. DO NOT WAIT! Currently hearings in front of an administrative law judge are scheduled 8 to 12 months after your request for the hearing is filed.
Your hearing with the judge
Your hearing with an administrative law judge will either be done in person at the local Office of Disability Adjudication and Review (ODAR) located in Cleveland or Akron. An attorney from The Skolnick Weiser Law Firm, LLC 216-706-9722, will go with you to your hearing and help you present your case to the judge.
What you can expect at your hearing
Areas that are generally covered in the hearing:
- Introductory questions.
- Work activity.
- Why you cannot work.
- Description of treatment.
- Daily activities.
- Functional limitations.
- Problematic areas in your Social Security record.
- Expectations for the future.
- Vocational expert - an individual who has training in the area of jobs and job placement. This individual will testify to your past work and whether given your limitations there are other jobs that you could do in the national economy.
- Medical expert - a doctor who will testify about the medical conditions that are set forth in the medical records and in your testimony.
Hearing prep points
- Main issue - the main issue in your case is going to focus on your functional capacity for working, i.e., your ability to work. Although there are several arguments we can make to win your case, most cases at hearing are won by arguing that your capacity for work has been so reduced by your medical conditions that you would not be a reliable worker in even a simple, non-production oriented, sit-down job.
- During the hearing, we will identify the specific work type of activities that you cannot perform. For example, if you have a knee problem that prevents you from walking more than 30 minutes in any 3 hour period, this walking limitation would impact categories of jobs that require frequent walking or standing.
- When you are asked about your ability to perform various tasks - sitting, standing, walking, lifting, carrying, stooping, climbing, etc., don't answer with generalities. Saying "I can't walk very far" or "I can't lift very much" doesn't tell the judge anything. Saying "I can only walk 50 yards before I have to stop and rest," or "it takes all my strength to carry a gallon of milk from the refrigerator to the table" does convey specific information that can be translated into a job requirement.
- In almost every disability hearing, the judge will have a vocational expert there to testify. The vocational witness is there to identify the skill level and exertional level of your past work, and to answer hypothetical questions from the judge about other jobs you may be suited for. The more specific limitations we can persuade the judge to include in that hypothetical, the better your chances.
- Your credibility is one of the main things that the judge will be deciding. Factors that enhance your credibility are a long work history, (unsuccessful) work attempts, and a sense that you would much rather be working than waiting for disability.
- The medical record in your case will be the most important factor in determining if you have a good case. If your record contains reference to drug seeking behavior or malingering, you will most likely not win.
- Recognize that your lawyer cannot lead you when asking questions. Give detailed and specific answers to your lawyer's questions.
- If you are asked about pain, you can use a 1 to 10 scale, with 1 being a mild headache and 10 being a kidney stone. Don't say that your pain is always at a 10. A better answer - "my pain is always at a 5, but three or four times a week it spikes up to an 8 or a 9 - if I overdo it physically or if I am under a lot of stress."
- If you are going to testify that you can't sit for more than 15 minutes because of back pain, don't come to the hearing and sit quietly for 45 minutes. It is ok to stand up and move around during the hearing if you are uncomfortable.