The Work Credit Requirement

To be eligible to receive SSDI, an applicant must have “Insured Status for Social Security,” meaning he/she must have worked enough during the years preceding the filing of the SSDI application and have contributed a specific amount to the Social Security system. Generally, the SSA will look to see if the applicant has enough work credits, which are based on the applicant’s earnings. While this amount changes annually, for 2018, a worker must earn $1320 to gain one work credit, with a possibility of four work credits maximum over the course of a year.

The Determining Tests

An applicant becomes eligible for SSDI benefits when he/she has earned a predetermined number of work credits. Further, in order to meet this predetermined number, the applicant must satisfy two tests – the Recent Work Test and the Duration of Work Test.

The Recent Work Test focuses on when the work occurred, and includes:

• For those who become disabled after 42 years of age, they must have earned one work credit for each calendar year from the age of 21 to the year before the onset of the disability. Forty is generally the number most workers need to qualify;
• For those who become disabled between ages 31 and 42, they must have earned a minimum of 20 work credits;
• For those who become disabled between ages 24 and 30, they must have worked half the time from the age 21 through the quarter the disability began; and
• For those who become disabled before the age of 24, they need only six credits earned during the three-year period ending with the quarter in which the disability began.

The Duration of Work Test focuses on how long an applicant has worked. Essentially, an applicant must have worked for a specific number of years, or have earned a minimum number of credits, to qualify for SSDI. The table below sets out the minimums:

Get Help

If you are considering filing for SSDI benefits, but are curious about the requirements, contact a disability benefits attorney as soon as possible. Submitting a claim for SSDI benefits with the help of an experienced disability benefits attorney can be the difference between acceptance and denial, or a long, drawn-out appeal. The legal team at Farrell Disability Law has the experience to help you win benefits. We will analyze your claim, and help you develop a strategy to get you the benefits you deserve as soon as possible. Contact our Jacksonville office today.

Resource:

ssa.gov/planners/disability/qualify.html

The Social Security Administration Fairness Act

Senator Sanders’s bill is intended to address the long wait times those applying for SSDI disability benefits must endure before receiving SSDI benefit payments. Specifically, this bill would eliminate the five-month waiting period approved SSDI applicants approved for SSDI benefits must complete before becoming eligible for benefits. Additionally, Senator Sanders’s bill will also eliminate the two-year waiting period that SSDI beneficiaries must wait to qualify for Medicare, the health insurance program SSDI recipients may use for medical issues.

First Waiting Period

As alluded to above, the first waiting period represents the time between the date of disability onset and the date in which that applicant receives his/her first SSDI benefit payment. This waiting period is very similar to the elimination period that is offered from typical private insurance policies. Note that due to the long stretches of times it takes to get approval for most applicants, this five-month waiting period is routinely satisfied long before approval is granted. In fact, most successful SSDI applicants are eligible for back payments starting in the sixth month after the disability began to the time the disability claim is approved.

Second Waiting Period

The second waiting period, as alluded to above, concerns a wait for successful SSDI applicants before they can qualify for concurrent Medicare benefits. According to Senator Sanders, eliminating this waiting period will speed up the time it takes for senior SSDI beneficiary recipients to receive both SSDI and Medicare benefits. In reality, however, the majority of such individuals do not actually have to wait the full two years after being approved for SSDI benefits for their Medicare benefits to kick in. This is because the two-year wait starts from the time an individual is, in fact, eligible for SSDI benefits (disability onset date + five-month waiting period). Usually, this is a date that is in the past and, as a result, the two-year wait is often served, in part, during the pending application period, though only the preceding 17 months from the date the SSDI application is filed will be considered for payment eligibility and Medicaid purposes. This two-year waiting period is part of a cost savings measure by the SSA< so without federal legislation saying otherwise, this policy is unlikely to change.

Get Help

If you are contemplating filing an SSDI application, or have already begun the application process, and are curious about what you can expect from the process, contact an experienced SSDI benefits attorney as soon as possible. The legal team at Farrell Disability Law has the experience necessary to analyze your potential claim, and, if we believe you will be successful, will help you develop a strategy, and help navigate your application through the SSDI process. Contact our Jacksonville office today.

Resources:

fool.com/retirement/2018/09/03/bernie-sanders-newest-social-security-bill-calls-f.aspx

congress.gov/bill/115th-congress/house-bill/6251/text

Disability Benefits for Employees

As alluded to above, if a disability leaves an employee unable to work, he/she may be entitled to one of the following three primary sources of disability income – SSDI, LTD, and WC. Each of these programs provides different benefits and has different requirements. Accordingly, it is important to assess all options to ensure that a disabled individual is seeking support from the maximum number of available disability benefits sources. An experienced attorney can help to ensure this is the case.

SSDI

To qualify for SSDI, employees must have worked for five of the past 10 years, be below full retirement age, and suffer from a severe injury, illness, or disability that will last at least a year or result in death. If approved, the amount received from the SSDI program varies based on the amount the employee paid in FICA taxes during his/her career, and the years he/she had been in the workforce. Among the benefits, SSDI automatically transitions to Social Security retirement benefits when the employee reaches full retirement age.

LTD

LTD, which may be offered by an employer, or may be purchased privately, is similar to SSDI in that it provides income replacement if an employee suffers a severe medical condition. However, unlike SSDI, the qualification requirements are generally less strict. Further, benefits typically constitute a fixed percentage of an employee’s salary, an amount substantially higher than SSDI benefits in most cases. Finally, there are typically time limits to the benefits one can receive from LTD, a limitation not faced by SSDI recipients. And, in some cases, LTD policies require an employee to apply for SSDI (or another benefit plan, such as WC or veteran’s benefits), and any benefits received from that program will offset the benefits received by the LTD policy.

WC

Unlike SSDI and LTD, workers’ compensation is a type of insurance that provides wages and medical benefits if an employee is injured while on the job. This is the key difference between WC and the other benefits – that the injury must have been a direct result of a work-related task. Also, unlike SSDI and LTD, WC is intended to be a temporary source of income for the employee while he/she is recovering from the injury. If the injury does become permanent, however, the employee may be eligible for either LTD or SSDI benefits. Although workers may be able to collect SSDI/LTD and WC simultaneously, there are some limits as to the amount of the benefits, and an offset may be in play.

Get Help

If you have suffered a disability, and are unable to continue in your present occupation, contact a disability benefits attorney as soon as possible. The legal team at Farrell Disability Law has the experience necessary to analyze your potential claim, and, help you develop a strategy to obtain the benefits you deserve. Contact our Jacksonville office today.

Resource:

gao.gov/products/GAO-18-248

New Conditions

As alluded to above, the SSA, the entity that examines SSDI applications, recently added five new conditions to its Compassionate Allowance Program. Specifically, the following conditions are now part of the Compassionate Allowance Program:

• Fibrolamellar Cancer;
• Megacystis Microcolon Intestinal Hypoperistalsis Syndrome;
• Megalencephaly-Capillary Malformation Syndrome;
• Superficial Siderosis of the Central Nervous System, and
• Tetrasomy 18p.

The Compassionate Allowance Program

The Compassionate Allowance Program came about in response to complaints by SSDI applicants regarding long delays in the disability determination process. Essentially, the Compassionate Allowances Program provides a fast track for applicants having a predetermined disability. In such a case, an SSDI application, and the associated benefits, can be quickly approved to disability applicants whose medical conditions are so serious that they would qualify as disabled under an SSA impairment listing. Consequently, this Program allows the SSA to quickly target obviously disabled applicants and grant them benefits soon after applying. By way of example, the average processing time for a Compassionate Allowance applicant is 19 days.

As with any SSDI application, the applicant will still need to provide medical evidence to prove that he/she in fact has one of the conditions listed on the Compassionate Allowance Program list. In some cases, this may be the most time-consuming aspect of such an application, as it can sometimes take weeks or months for medical professionals to submit the necessary documentation to the SSA examiner. Engaging a disability benefits attorney prior to filing an SSDI application can help to ensure that the proper documentation is on hand when the application is filed. In any event, if an applicant is found to have a condition listed on the Compassionate Allowance Program list, then that applicant is placed on a fast track for approval.

One thing to keep in mind, however, is that, while the Compassionate Allowances Program allows a disability determination to be made more quickly, SSDI beneficiaries still have to wait at least five months after the onset of his/her disability to begin receiving benefits (and 24 months after the onset date before Medicare benefits begin).

Get Help

If you have suffered a disability which prevents you from continuing in your present occupation, contact a disability benefits attorney as soon as possible. Whether you are contemplating filing a claim for SSDI benefits, or have already begun the process, and are curious what your chances are, the  legal team at Farrell Disability Law has the experience necessary to analyze your claim, and help you develop a strategy to get you the benefits you deserve. Contact our Jacksonville office today.

Resources:

doverpost.com/news/20180821/social-security-adds-5-compassionate-allowance-conditions

Applying for SSDI Benefits – Medical Consultation

As alluded to above, the actual SSDI application is not the first step in applying for SSDI benefits; in other words, a disabled individual should not think that all he/she needs to do is fill out a form and money will be forthcoming. Rather, the applicant should do the necessary legwork to gain the knowledge and obtains the pertinent information that can potentially lead to a successful SSDI application. Thus, the first issue that must be resolved is whether an applicant’s condition qualifies as a disability for purposes of SSDI.

For this, the first person the application should consult is his/her medical professional (or, potentially, his/her medical professional team, especially if he/she has been seeing a number of specialists for a chronic issue) to see if he/she will support the applicant’s SSDI claim. This support is essential to success, because the SSA will require documentation of the applicant’s disability in the form of medical evidence. Thus, informing the medical professional of the applicant’s intention to file an SSDI application is necessary to this process, and should be accompanied with a request for a copy of the applicant’s complete medical file.

Additionally, requesting the medical professional to provide a detailed statement of the applicant’s medical condition is a beneficial step, as is a request that the medical professional provide his/her opinion of the depth of the applicant’s disability, especially as it relates to the applicant’s occupation. In fact, in situations in which the medical professional may be unfamiliar with SSDI protocol, it may be worthwhile to provide the medical professional with documentation regarding what the SSA looks for when determining the extent of an applicant’s injury.

Legal Assistance

Additionally, it is crucial to speak to an attorney experienced in SSDI procedures. While, they cannot speak to an applicant’s medical situation, they can provide the applicant with a roadmap for a potentially successful application, which the applicant can then provide to his/her medical professional. It is also important for the applicant’s legal counsel to understand the situation, so that when at the hearing, which is almost guaranteed given the percentage of disability denials, they can speak from a basis of knowledge when attempting to persuade the SSA judge of the merits of the applicant’s SSDI application.

Get Help

If you are considering submitting an application SSDI benefits, are at the pre-application stage, and what to be sure that your application has the best chance at success possible, contact an experienced SSDI benefits attorney to help you begin the process. The attorneys at Farrell Disability Law have the experience necessary to help you not only prepare a successful SSDI application, but also to navigate your application through the SSA. Contact our Jacksonville office today.

Resource:

lawfirmnewswire.com/2018/07/applications-for-social-security-disability-benefits-drop-amid-economic-growth/

Code of Federal Regulations

As is the case with all federal agencies, while Congress sets out the law, which provides a general understanding of the purpose of the agency, it is the agency itself that creates rules and regulations, which serve to fulfill the objectives of the law. These rules and regulations are set forth in the Code of Federal Regulations (CFR), and the SSA is no exception.

Most relevant to an applicant for SSDI benefits, the amended rules and regulations now require that a Claims Representative, the name given to the person representing another individual in front of the SSA, must:

• Disclose whether an employee or independent contractor of the Claims Representative drafted, prepared or issued the medical or vocational option of the applicant; and
• Disclose whether the Claims Representative suggested that the applicant seek an examination by any individual who provides an opinion as to the state of the applicant relevant for the purposes of the SSDI application.

Effect of the New Rules and Regulations

While, at first glance, these new rules and regulations may appear to be commonsensical, in reality, it can potentially poison the dynamics between the various players at the SSDI hearing. Specifically, at the SSDI hearing, currently, while there are three separate “sides” – the applicant represented by the Claims Representative, the SSA, and the ALJ, the intent is that all three sides will work together to achieve the correct result, whether that result is a denial or an approval of SSDI benefits.

However, as some commentators to the proposed new rules and regulations have indicated, requiring the Claims Representative to provide the notices listed above may have the effect of tainting this dynamic, and turning it into more of the adversarial process that is present in courtrooms across the country. Disclosing the above-referenced information could color the Claims Representative in the eyes of both the ALJ and the SSA, thereby severing any trust between these sides. Obviously, this could potentially have the effect of seeing more applications denied.

Get Help

If you are considering submitting an application for SSDI benefits, and want to be sure that your application has the best chance at success possible, contact an experienced SSDI benefits attorney to help you navigate the process. The legal team at Farrell Disability Law has the experience necessary to help you not only prepare a successful SSDI application, but also to shepherd your application through the SSA, especially in light of these new rules and regulations. Contact our Jacksonville office today.

Resource:

thinkadvisor.com/2018/07/26/supreme-court-ruling-to-shake-up-social-security-d/

Residual Functional Capacity

During an SSDI application, the SSA examiner will endeavor an analysis of the applicant’s ability to work. That is, the examiner will determine, taking into account the limitations of the applicant’s condition, what level of exertion the applicant is capable of performing, and how existing restrictions limit the jobs he/she, in fact, can perform. An individual’s RFC determines whether he/she can be expected to perform at the following levels of work:

• The ability to lift no more than 10 pounds at a time, and occasionally lift or carry things like files or small tools.
• The ability to lift up to 20 pounds occasionally, and frequently lift or carry up to 10 pounds.
• The ability to lift up to 50 pounds at a time, and frequently lift or carry up to 25 pounds.
• The ability to lift up to 100 pounds at a time, and frequently lift or carry up to 50 pounds.
• Very Heavy. The ability to lift objects that weigh more than 100 pounds, and frequently lift or carry 50 pounds or more.

An RFC will also include any non-exertional restrictions, such as not being able to stoop, or use one’s fingers. Additionally, an RFC will encompass mental faculties as well, such as whether the applicant can:

• Maintain concentration and attention at work for extended periods of time;
• Understand and remember instructions and carry out duties throughout the day;
• Get along with others in the workplace;
• Cope with changes in the workplace; and
• Respond appropriately to supervisors, co-workers, and usual work situations.

The Struggles of Elderly on RFC Denials

As alluded to above, prospects for elderly individuals who are denied benefits due to RFC are dim. Although studies have shown that most of these applicants worked five years before applying for SSDI benefits, but very few worked five years afterwards. As a result, employment rates fell. In fact, unemployment rates fell most steeply for the rejected applicants who came closest to qualifying; that is, those deemed to be too severely impaired to do their past work, but still considered capable of switching to other work. An experienced SSDI attorney can help to ensure that the applicant is given his/her best shot at securing the financial support for his/her disability.

Get Help

If you have been denied for SSDI benefits, and are curious about any options you may, contact an experienced SSDI benefits attorney to help you navigate the application and appeals process. The legal team at Farrell Disability Law have the experience to analyze your case, and, if we believe there is a legitimate chance at approval, will help you develop a strategy and get you the benefits you deserve. Contact our Jacksonville office today.

Resource:

mathematica-mpr.com/our-publications-and-findings/publications/do-older-ssdi-applicants-denied-benefits-on-the-basis-of-their-work-capacity-return-to-work

SSDI Initial Examination Success Rates

While many Americans apply each year for SSDI benefits, unfortunately, about 70 percent of these applications will be denied. Further, although many applicants will successfully appeal this initial decision, the appeals process can, unfortunately, take years to complete. This may mean months or years without a source of income, which has the potential to cause serious financial strain. Fortunately, there are a few items that can be addressed that may improve one’s chances to be successful at the initial stage of the SSDI process.

Factors to Increase the Likelihood of Approval

First, prior to applying for SSDI benefits, an applicant should consult with his/her medical professionals to ascertain whether they will support the application. Typically, a medical professional will be asked to provide a written statement supporting the existence of the applicant’s condition, as well as the severity and whether it, in fact, prevents the applicant from being able to work. Additionally, consultation with one’s medical professional will help to ascertain whether the medical professional understands the SSDI procedure. In other words, an applicant should be sure that his/her medical professional is, in effect, on board with the SSDI application.

Second, it is important to have a complete set of an applicant’s medical records prior to submitting the application. While it is true that the SSA may obtain medical records for the applicant, ensuring that the applicant has a complete set, and providing this set with the application, will ensure that nothing vital is missing from the records, and avoid additional delays.

Third, it is understood that the SSA will review the treatments that have been prescribed, as well as how well or poorly the applicant responded. Thus, it is imperative that the applicant, in fact, follows through with completing all treatments prescribed by any and all medical professionals, especially the primary treating physician. Failing to follow through with a prescribed treatment will damage the applicant’s chances of receiving SSDI benefits.

Fourth, it helps to be accommodating. Specifically, given that, as stated above, many Americans apply for SSDI benefits every year, cooperation with the SSA examiner will go a long way towards a possible granting of benefits at the initial stage. Responding to letters as soon as possible, and ensuring that the examiner has every bit of information at his/her disposal, will help, as will attending any medical examinations requested by the examiner.

Fifth, it is important to follow up with an application to ensure that the SSA is not missing any important information. This will also ensure that no request, which may get lost in the mail, will go unaddressed. By requesting a status update, the applicant will ensure that all requested information is provided.

In each of these examples, retaining the services of an experienced SSDI attorney is a great asset, as they will ensure that each of these examples are satisfied. Having an attorney often serves to relieve the stress on the applicant, as the attorney will shoulder many responsibilities.

Get Help

If you have filed or are considering filing an SSDI application, the services of an attorney having experience with SSDI applications can be the difference between approval and denial. The legal team at Farrell Disability Law has the experience necessary to strategize with you and help you present the best possible case at your hearing. Contact our Jacksonville office today.

Resource:

tampabay.com/news/business/workinglife/A-longer-wait-Some-now-try-nearly-3-years-to-get-disability-insurance-_162603194

Obesity, Generally

An individual having a body mass index (BMI) of 30 or more may be considered obese, while a BMI of 40 or more may be considered morbidly obese. These numbers are not absolute, however. When considering obesity, a medical professional will also look at excess fat, as someone with a large percentage of their weight coming from muscle may have an elevated BMI but not be obese. Conversely, a person may have a healthy BMI, but if a small percentage comes from muscle, they will most likely have an unhealthy percentage coming from fat. Generally, obesity manifests itself with regard to a low metabolism, which involves, among other symptoms, a large waist, insulin resistance, elevated triglyceride levels, and high blood pressure.

Previously, obesity was considered a disability for SSDI benefits, but, in 1999, the SSA deleted the listing, although it still must be considered in the evaluation process. What this means is that, to qualify for SSDI benefits, an individual needs more than a low metabolism. Rather, the obesity must contribute to or cause damage to another disease, and also lead to limited mobility or functional abilities, such that the individual’s situation constitutes a disability.

The Listing of Impairments

Because obesity is not listed in the Listing of Impairments, the SSA will only consider obesity under the Listing if its limitations on the individual are equivalent to another category in the listing or it causes or contributes to another listed impairment. As an example of the former, if obesity makes an individual unable to walk (i.e., the individual can only move through the help of a wheelchair), then the condition may qualify as being equivalent to an individual who cannot walk due to amputation. As an example of the latter, when obesity is a cause of diabetes, it may be deemed to be contributing to that disease. Thus, an individual can be awarded SSDI benefits for obesity, but only if he/she can demonstrate that the physical symptoms as a result of the obesity prevent him/her from working.

The Medical-Vocational Allowance

If obesity cannot qualify under the Listing of Impairments, the SSA will then assess an individual’s residual functional capacity. In other words, obesity can limit one’s ability to function, based on where the excessive fat is carried. For example, an obese individual may have trouble walking, standing, sitting, balancing, lifting items, and bending over, among other activities. Thus, if an obese individual suffers from walking, standing for long periods, or even sitting for long periods, the SSA may consider the pain to be a limiting symptom as part of one’s residual functional capacity.

This analysis of one’s residual functional capacity will then be used to determine what jobs one can do, if any. If the SSA determines that there are some jobs an obese individual can do, they will deny the SSDI claim. However, if the SSA determines that, due to obesity and its symptoms, there are no jobs that can be performed, an individual may be awarded medical-vocational allowance benefits.

Get Help

If you have filed (or are considering filing) a claim for SSDI benefits, and you feel that your obesity may contribute to your disability, contact the experienced disability legal team at Farrell Disability Law as soon as possible. It is crucial to have someone on your side as experienced as their attorneys are who can maneuver through the process in such a way to best present your evidence and give you the best chance for success. Contact our Jacksonville office today.

Resources:

newhealthadvisor.com/is-obesity-a-disability.html

ssa.gov/disability/

Differences between VA Disability and SSDI

Qualifying for SSDI benefits involves two major factors that can cut off a person’s ability to receive benefits under the program: income and level of disability. SSDI strictly limits how much a person can earn monthly, and requires recipients to be totally disabled before benefits are available. By contrast, disability benefits from the VA do not have income limits, and it will pay benefits for less than a total disability. Further, unlike SSDI, VA benefits are based upon the percentage of disability assigned to a particular veteran by VA doctors, which ranges from zero (no compensable disability) to 100 percent (total disability). In addition, unlike SSDI, which mandates that the disability be expected to last for at least a year or result in death, VA disability benefits may be awarded on a more temporary basis.

Military Service, Discharge and Misconduct

SSDI benefits are awarded based upon a person being totally disabled, and paying enough taxes into in the system over the past ten years. Thus, the amount of military service or whether the disabling event occurred during or after a release from active duty is irrelevant to the SSDI process. Relatedly, the type of discharge from military service, including dishonorable, also has no impact on the Social Security Administration’s (SSA) decision on a disability claim. Further, misconduct, even if it directly resulted in the disabling condition or was connected to one’s military service, is not factor in the final determination. In other words, an explanation about the specific circumstances that led to the disability is not necessary, expected or even considered to receive SSDI benefits.

Fast-tracking SSDI Decisions for Veterans

Finally, in recognition of the sacrifices soldiers make for this country, expedited processing of SSDI claims are available to those injured while on active duty on or after October 1, 2001 (Wounded Warriors), and for veterans with a 100 percent permanent and total disability rating. However, note that this rating does not guarantee a veteran will meet the SSA’s definition of disability, though denial is unlikely. While the SSA is supposed to automatically expedite these claims, this does not always happen, which underscores the need for an experienced disability insurance attorney to handle claims, so an applicant is treated properly and fairly.

Get Help

Managing a disability is a daily challenge that does not need to be compounded by financial concerns. To avoid unnecessary financial hardship, investigate the possibility of qualifying for disability benefits with an experienced disability insurance attorney. Farrell Disability Law understands the stresses you are facing, and will fight for the benefits you deserve. Contact the Jacksonville or Orlando offices for a free consultation.

Resource:

ssa.gov/people/veterans/