James R. Auffant, Esq. / FAQs
Frequently Asked Questions
What does Social Security mean by “totally disabled”?
Social Security disability benefits are often available to people who are suffering from medical problems which produce symptoms so severe that they can not sustain any type of work. The Social Security Act requires that the medical proof document the inability to work for a period that has lasted, or is expected to last, at least 12 months, or result in death. This is the basic requirement for the two disability programs – SSDI and SSI.
What is SSDI?
Social Security Disability Insurance (SSDI) benefits are available for those people who have worked and paid FICA taxes for a sufficient number of quarters, and who are suffering from medical impairments which make it impossible to sustain any type of work activity. Basically for SSDI you must have paid FICA taxes while working for ten years in your life, and for five of the ten years prior to the date that you became totally disabled. The requirements are adjusted for people who are less than 28 years-old. SSDI benefits may also be available for disabled widows/widowers more than 50 years-old and who became totally disabled within 7 years of their spouse’s death; and for persons who can prove that they became totally disabled before age 22 and who have a parent on SSDI or on the SS retirement program.
What is SSI?
Supplemental Security Income (SSI) benefits are available for people who are totally disabled and who are “indigent.” “Indigent” is based upon your assets and income and essentially means that you have no money coming into the household other than child support or TANF benefits for children, and for a single person, less than $3,000 in assets not counting your house and one car. The base SSI grant is reduced if you are living with someone who is paying the rent for you.
What diseases qualify for SSDI or SSI?
Any “medically determinable impairment” which makes it impossible for you to work for at least 12 months can qualify for disability benefits. At Jeffrey A. Rabin and Associates we have successfully represented people with many different medical problems including Chronic Fatigue Syndrome, Fibromyalgia, Lupus, Reflex Sympathetic Dystrophy, Multiple Sclerosis, Ankylosing Spondylitis, Chronic Headaches; Depression, Hepatitis C, PTSD, Bi-Polar Disorder, Multiple Chemical Sensitivities, Congestive Heart Failure, Asthma, Emphysema, Diabetes, Cancer, Huntington’s Disease, Rheumatoid Arthritis, and other Chronic Pain disorders.
How do I apply?
There are a number of ways to start a Social Security disability claim. You can contact our law firm for a free brochure describing the application process. If your claim is only for SSDI you can file on Social Security’s web site at http://www.ssa.gov/. If your claim is for both SSDI and SSI, or for SSI only, you must either go to your local Social Security District Office, or call SSA at 1-800-772-1213. Our lawyers prefer to be retained as soon as you have filed your application. Statistics show that people with quality representation have a greater chance of having their application approved. Our experience shows that the earlier in the process we get involved, the stronger the claim.
Why was my application denied?
Most claims are denied because the medical proof is not sufficient to prove that you are totally disabled. This could be because you are not seeing the proper specialists, because of inadequate medical records, because the doctor does not understand the legal requirements or because Social Security’s reviewers misinterpreted the medical records. Social Security rarely denies you have a medical diagnosis, or that you are impaired, but does deny that you proved the legal requirement of being “totally disabled.” Our lawyers and staff work with our clients’ medical providers to make certain that the medical proof is as strong as possible.
How long will this take?
The backlogs are serious at all levels of the application and review process. The severity of the backlog varies nationwide. While SSA is working on this problem it can easily take as long as 18 months to go from initial application to an Administrative Law Judge hearing.
How much will I get?
The amount you receive on SSDI is based upon multiple factors including your work earnings, your FICA taxes, and the number of quarters you worked. It is a fairly complex formula. You should have received a Personal Earnings Statement in the last year which confirmed your yearly earnings and told you how much you would receive for retirement benefits and for disability benefits. If you have not received a PES you should contact Social Security and order one. You can do this at www.ssa.gov. When you receive it, check it carefully to make sure that the earnings are correct.
How do I get Medicare?
Medicare is the federal government’s health insurance program and is available to people on retirement or on SSDI. If you are on SSDI you will become Medicare eligible on the 30th month after your onset date, that is, the date that Social Security says you became totally disabled.
How do I get Medicaid?
Medicaid is the joint federal-state health insurance program which covers certain categories of people. One of those categories is the “totally disabled” so that when your SSI claim is approved you will be Medicaid eligible. SSDI beneficiaries may also be Medicaid eligible, however, Medicaid is based upon total family income and assets so you will need to check your State’s guidelines.
Are Social Security disability benefits taxable?
SSDI benefits may be taxable depending on your total family taxable income. For example, a person filing as an “individual” with a combined income between $25,000 and $34,000 would have to pay income taxes on 50% of the SSDI benefits. If the combined income is more than $34,000 then 85% of the SSDI benefit is taxable. You should consult with an experienced tax expert when your claim is approved to make certain that you plan for any tax liabilities.
How do you get paid?
We work on a contingency fee basis – that means no money up front, no hourly fees. In most cases our fee is limited to the lesser 25% of your back back benefits up to a maximum of $5,300.00 in 2004. Our fees must be approved by Social Security and we file our fee agreement with SSA in every case.
How can I get more information?
Call, email or write to us. There is no fee for an initial phone consultation – our office telephone number is 407-894-4779; You can email to us from this website.
Over 80% of first-time applicants are denied by the Social Security Administration.
Disability & Social Security is our specialty.
We will help you complete the application for FREE. Other attorneys won’t.
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