Who's Entitled to Social Security Disability?

Under the Social Security disability law, qualified individuals can receive benefits based on their disability or need.  The Social Security Administration (SSA) has two disability programs through which individuals may apply for benefits.

Disability Insurance Benefits (DIB)

These are benefits extended to disabled workers who have obtained sufficient credits. To be eligible for this benefit, a worker must have worked at least five of the past ten years, with earnings above the base threshold and must have paid his FICA taxes. Some of their dependents may also qualify for DIB benefits.

Supplemental Security Income (SSI)

This is a program designed to provide relief to the elderly, the blind and the disabled. To receive benefits, your disability or impairment must fall under the SSA definition of a disability and you must also demonstrate financial incapacity.

Concurrent Eligibility

A disabled worker may qualify for both SSI and DIB benefits, which is known as concurrent eligibility.

Qualifications

To be eligible for these benefits, a worker must first qualify as a disabled under the SSA rules which defines disability as the following:

• the inability to perform substantial gainful activity by reason of a medically determinable physical or mental impairment
• the condition must have lasted or is expected to last at least 12 consecutive months or  result in death
• you must be unable to engage in a “work for pay”
• you must have medical evidence to support your disability and to document the duration of your condition

In determining one’s disability, SSA takes into consideration a person’s age, education, and work history. Under the law, a qualified claimant may receive any of the following Social Security benefits, depending on his needs and condition:

• disability benefits under the Social security disability insurance
• Supplemental security income
• Widow/Widower’s benefits
• Retirement benefits
• Medicare/ Medicaid benefits

Filing for Benefits

A disabled worker may apply for these benefits in three ways:

1. he/she may obtain an Application For Benefits in a local SSA office
2. he/she may apply online through the SSA website
3. he/she may call the SSA to schedule an appointment to make an application by phone

Denial of Application

Most applicants are denied the first time they apply for social security benefits and they have to go through the appeals process. Although one does not need a lawyer to file for disability benefits, you will surely need the services of a lawyer to file for reconsideration or to represent you in the appeals hearing.

Reconsiderations and Appeals

Generally, social security claimants are entitled to make a reconsideration or appeal on their benefit claims.  A social security appeal has four levels, depending on the issue being disputed.

Stages of A Claim

1. Reconsideration: When a claim is denied in the initial stage, a claimant may ask for a review of the case by requesting for reconsideration.
2. ALJ Hearing: A claimant may disagree with the reconsideration decision and may request hearing with the Administrative Law Judge (ALJ). During the hearing, a claimant may present new information and expert witnesses.
3. Appeals Council: In the Appeals Council, which is the final administrative review, a claim may either be re-evaluated or denied. The Council may either decide on the case or return it to the ALJ for further review.
4. Federal Court: If the Appeals Council decides not to review a case or the claimant disagrees with their decision, the claimant may file a lawsuit with the federal district court.

Taking the services of an experienced social security disability lawyer can significantly improve your chances of receiving your social security benefits.

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