Social Security is not a handout or a giveaway, despite what certain political parties may say. It is just what it is called. Security. A Safety net. We commonly see Social Security as a retirement program. But there are two other contexts in which we encounter Social Security. SSI (Supplemental Security Income), which is an alternate source for one who may not have earned enough credits under the system, and DIB (Disability Insurance Benefit) which is available someone who can no longer work because of illness or disability. Both of these are funded by special taxes taken out of every worker's paycheck (and equally matched by every employer) You worked for your Social Security benefit!
The sad fact is that people become disabled for a multitude of reasons. Some of our bodies age faster than others. Others of us have hard, difficult jobs which wear our bodies down. Some of us develop chronic diseases, physical and/or mental, which we either cannot adequately afford to treat, or which overwhelm us despite proper treatment. For whatever reason, we cannot work no matter how much we would like to continue working. Yet we need to continue living. So what to do? Well, that's why Social Security exists. We pay for it with our taxes.
There's just one catch. If you are not of retirement age, the government is not happy to give workers a benefit (again, contrary to certain propaganda from a certain political party). If you are under retirement age, you must prove your disability. You do so through objective medical evidence which shows the existence of a disability that is severe and has lasted, or is expected to last, for longer than one year. You then next have to prove that the disability has so affected your life that you cannot work throughout an eight hour workday and even have great difficulty carrying on the ordinary activities of daily living.
The steps involved in the Social Security Disability process are:
- Initial Application
- Request for Reconsideration
- Request for Hearing before an Administrative Law Judge (ALJ)
- Appeals to the Disability Counsel
- Appeals to the Federal District Court and above
Our attorneys usually get involved at the third step, the request for hearing. The reasoning behind this is that if we become involved before this step, it is quite possible that Social Security may make a favorable decision for you at the reconsideration stage. If so, we haven't really had a chance to do our work, but Social Security would pay us anyway. This isn't a fair outcome for you, therefore we usually advise that you go through the first two steps unrepresented. If, however, you are denied at reconsideration, let us know and we will begin our work.
The Social Security Administration utilizes a five-step sequential evaluation process in determining whether you are disabled under the federal rules. They follow the sequential evaluation in a set order (with certain exceptions). If Social Security can find that you are or are not disabled at a step, they make their determination at that step and go no further. If they cannot make a determination at that step, they will proceed to the next step. Before Social Security will go from step three to step four, they first assess your residual functional capacity. This assessment is used in both steps four and five when evaluating your claim at these steps. The five steps are as follows:
- Step 1: Your work activity, if any. If you are doing substantial gainful activity (SGA), Social Security will find that you are not disabled -- A person who is earning more than a certain monthly amount (net of impairment-related work expenses) is ordinarily considered to be engaging in SGA. The amount of monthly earnings considered as SGA depends on the nature of a person's disability. The Social Security Act specifies a higher SGA amount for statutorily blind individuals; Federal regulations specify a lower SGA amount for non-blind individuals. Both SGA amounts generally change with changes in the national average wage index. This value can be found in a table on the Official Social Security Website.
- Step 2: The duration requirement. You must have a severe medically determinable physical or mental impairment that meets the duration requirements (at least 12 months), or a combination of impairments that is severe and meets the duration requirement, Social Security will find that you are not disabled (e.g. is your impairment medically severe and has it lasted for, or is it expected to last for, 12 months).
- Step 3: Social Security also considers the medical severity of your impairment(s). If you have a severe medically determinable impairment, does it meet or equals one of the "listings" in the Code of Federal Regulations? Does it meet the duration requirement? If so, you will be found disabled.
- Step 4: If you do not meet or equal a listing, Social Security will assess your residual functional capacity and your past relevant work. If you can still do your past relevant work, you will be found not disabled.
- Step 5: If you cannot do past relevant work, Social Security will assess of your residual functional capacity along with your age, education, and work experience to see if you can make an adjustment to other work. If you can make an adjustment to other work, you will be found not disabled. If you cannot make an adjustment to other work, you will be found disabled.
As you can see, the process is quite elaborate. And while the system is not "adversarial," you should keep in mind that the system does not want to unnecessarily spend the tax dollars they collect from your paychecks.
That is why you should consider seeking legal help in negotiating the shoals of the Social Security Disability system. Our job is to collect the medical information to help the adjudicator make a fair determination. We know the law and the rules and can point out to the Judge those factors which may sway the decision in your favor.
Social Security sets the amounts of fees that may be collected by attorneys in obtaining Disability benefits for their clients. The representative is entitled to 25% of any back-due benefits (up to 18 months) or $6,000.00, whichever is less. The Social Security Administration prescribes the form of contract entered into between a claimant and attorney, so all contracts are essentially standardized. Lastly, if we do not succeed in obtaining benefits for you, we cannot collect any fee at all, so you have nothing to lose in letting an attorney help you to receive your social security benefits.
If you are disabled, call John B. Harle, Jerry S. Scheff or Jan S. Allen today. Consultation costs you nothing and we may be able to help you obtain the benefits you so richly deserve for your hard work over your lifetime.