Denied Social Security benefits? Consider this before hiring a lawyer
September 25th, 2024 by admin
The Social Security system is an insurance system created not only to help people after retirement, but also to help them throughout life. The benefits take the place of wages. But there are benefits when workers are disabled as well as when one retires.
There are two main disability programs that may provide benefits:
- Disability Insurance Benefits.
(DIB) are for disabled workers and certain dependents who have worked enough (generally five out of the last ten years) to obtain the number of credits required to be eligible for benefits. In addition to the length of time, one must also have earned a certain amount of money each year. This money comes from FICA taxes withheld from your pay to receive credits.
- Supplemental Security Income.
(SSI) is a public assistance program. SSI benefits are needs based and based on the Medicaid criteria. Benefits are awarded to people with disabilities, people sixty-five and over, and visually impaired individuals who have income and resources below specific amounts.
Who qualifies for Social Security Disability Benefits
The Social Security Act defines disability as the inability to perform substantial gainful activity for at least twelve continuous months by reason of physical and/or mental impairment. This can mean an impairment that has kept you out for a year or is likely to keep you out for a year.
Factors Considered: Age, education, past relevant work experience, years worked, and salary received.
Types of disabilities (non-exclusive list): There are several disabilities which may allow you to receive benefits. Some examples, and this is a non-exclusive list, are: breathing problems, chronic heart disease, obesity, mental health issues (bi-polar, depression, schizophrenia, for example), blindness or deafness, autism, mental processing disorders, rheumatoid arthritis, seizures, despite use of medication, cancer, immune system disorders, extreme psoriasis involving hands and feet, multiple sclerosis, HIV positive, and other severe medical conditions. The issue is whether one or any combination of mental health issue(s) physical issue(s) keeps you from working for eight hours a day, five days a week.
The Application Process
It is long and frustrating, usually taking over two years from the time you file to the time you receive benefits if you prevail. A case can be resolved at any one of the three stages below. But if you are denied at any point, you MUST appeal in the time allotted, or your case starts over again unless you have “good cause.” Good cause is not freely granted.
Initial Application (first level). This can be done over the phone by contacting the Social Security Administration (www.ssa.gov/disability). It will take approximately three months to hear from the SSA. A substantial number of claims are denied initially.
Reconsideration (Second Level). This is an appeal of the initial denial, and it involves filing out a form provided by the SSA. This will take another few months. Many claims are also denied at this level.
Hearings (Third Level). This is often the most important stage. Federal Administrative Law Judges in Greensboro, Raleigh, and Charlotte hold hearings. Medical evidence, along with letters from doctors, is essential to a favorable result.
Benefits if you prevail
You may be eligible for back benefits, which takes the place of wages for the time you were waiting. If you cannot work in the future, you may be able to receive benefits for the remainder of your life.
Should you hire an attorney?
Attorneys are not required, but they can be helpful. If you are uncertain, consider contacting the North Carolina Bar Association Lawyer Referral Service (919.677.8574). A knowledgeable attorney will consult with you for no more than $50 to tell you whether you should consider hiring an attorney. But if you have been denied benefits and you must go to a hearing (third level), it probably makes sense to think seriously about employing an attorney.
Remember: An informed choice is a smart choice.
Mike Wells is a partner with Wells Law, PLLC in Winston-Salem. His email address is mike@wellslaw.us and his telephone number is 336.283.8700. His legal column has been published continuously since 2003.
Posted in: WS Journal Articles