1. What are Social Security Disability benefits?
2. What basic requirements do I have to establish to be eligible for Social Security Disability Benefits?
3. When should I apply for Social Security Disability benefits?
4. Where do I apply for Social Security Disability benefits?
5. What information should I bring with me when applying for Social Security Disability benefits?
6. I have money in the bank. Do I have to wait until this money is gone before applying for Social Security Disability benefits?
7. Can I file for Social Security Disability benefits while I am receiving Workers' Compensation benefits?
8. Can I receive both Workers' Compensation and Social Security Disability benefits?
9. What are the basic requirements to establish my claim for Social Security Disability benefits?
10. If Social Security determines that I am disabled, what type of benefits would I be eligible to receive?
11. What happens if Social Security denies my disability claim?
12. If my claim is denied on reconsideration, can I request another appeal?
13. What happens at the hearing?
14. When and where will the hearing be held?
15. Should I be represented by an attorney at the hearing?
16. When should you hire a Social Security Disability attorney?
17. How much does it cost to hire a Social Security Disability attorney?
18. What medical evidence should be presented at the hearing?
19. What will I be required to testify about at the hearing?
20. Can I have witnesses testify on my behalf at the hearing?
21. What is a vocational expert?
22. How and when do I get the results of the hearing?
23. What happens if I win at the hearing?
24. What happens if I lose the hearing?
25. After losing at the Appeals Council, can I appeal further?
26. What can I do if Social Security tries to reduce or stop the benefits I am now receiving?

1. What are Social Security Disability benefits?
A. Social Security Disability Benefits are referred to by the Social Security Administration as Disability Insurance Benefits (DIB) You are only eligible for these benefits if you have paid a certain amount of Social Security tax over a period of time. In general, you must have paid at least a certain amount of Social Security tax in at least twenty calendar quarters during the forty calendar quarters before your disability began. In other words, you must have worked and paid Social Security tax for about five out of the last ten years before you became totally disabled. There is a different rule for people whose disability began before age 30. Everyone must prove that he or she became disabled while disability insurance coverage was in force or they are not entitled to benefits, no matter how serious the medical condition is now.

2. What basic requirements do I have to establish to be eligible for Social Security Disability benefits?
A. To be eligible for Social Security Disability, you must show you are disabled. That means that a physical and/or mental impairment must keep you from working any regular, paying job. Your disability must last or be expected to last for at 12 least months, or be expected to result in death. You must show that you cannot do any kind of full-time work, taking into consideration your age, education and experience. Different rules apply if you are over 50 years old. You cannot get benefits if you are able to work, even if no one will hire you.

3. When should I apply for Social Security Disability benefits?
A. Apply as soon as possible after a disability occurs. You do not need to wait 12 months to apply. An application for Social Security Disability may also be filed after the death of a disabled worker. You must apply within three months of the worker's death.

4. Where do I apply for Social Security Disability benefits?
A. You need to call your local Social Security office (listed in the blue pages of your phone book or call Social Security's toll free number 800-772-1213, 24 hours a day) and schedule an appointment. If you are unable to travel to your local Social Security office, they can take your application over the phone.

5. What information should I bring with me when applying for Social Security Disability benefits?
A. You should bring the following documents when applying for Social Security Disability:

• The Social Security number and proof of age for each person applying for benefits. This includes your spouse and children, if they are applying for benefits.
• Names, addresses, and phone numbers of doctors, hospitals, clinics, and institutions that treated you and dates of treatment.
• Names of all medications you are taking.
• Medical records from your doctors, therapists, hospitals, clinics and caseworkers.
• A summary of where you worked in the past fifteen years and the kind of work you did.
• A copy of your W-2 (wage and tax statement) or if you are self employed, your federal tax return for the past year.
• Dates of prior marriages if your spouse is applying.
  

6. I have money in the bank. Do I have to wait until this money is gone before applying for Social Security Disability benefits?
A. No, if you have worked in recent years, it does not matter how much money you have in the bank. There is no reason to wait before applying for Social Security Disability benefits.

7. Can I file for Social Security Disability benefits while I am receiving Workers' Compensation benefits?
A. Yes, you can file a claim for Social Security Disability benefits while receiving Workers' Compensation benefits.

8. Can I receive both Workers' Compensation and Social Security Disability benefits?
A. Yes, however, your Social Security Disability benefits will be reduced so that the combined amount of your Social Security benefits and your Workers' Compensation benefits does not exceed 80% of your average current earnings.

9. What are the basic requirements to establish my claim for Social Security Disability benefits?
A. The evaluation of "disability" under Social Security follows a step-by-step process involving five questions:
(1) Are you working?
If you work and earn more than an average of $500.00 per month you are presumed able to work.
(2) Are there any medical impairments?
If you are not working but there are no medical impairments, you will not be considered disabled by Social Security.
(3) Are your medical impairments so severe that the test results alone, show you are disabled?

Social Security maintains a list of medically diagnosed conditions which are presumed disabling if objective test results show certain, severe levels of abnormalities. These conditions and test requirements are highly technical and require very complex medical judgments. If your medical records document all the required test results at the required level of severity, Social Security will automatically presume you are unable to work. Your physician's opinions about the significance of these test results and physical examination findings can be very important.

(4) Can you perform your past work?

If the test results are not severe enough to allow Social Security to presume you are unable to work, they will have to determine how severe your limitations are and how they impact or preclude your ability to do tasks which are basic to the work process such as walking, standing, sitting, lifting, carrying, pushing, pulling, concentrating, remembering, dealing with pressures, etc. Your doctor's opinion about your capabilities and limitations are important . If you still have enough capability to perform the work that you have done in the last fifteen years, you will not be considered disabled.

(5) Is there any other work you can perform?

Social Security may still determine that you are not disabled if they find that you can perform some other type of work other than your previous job. They will consider your age, education, skills you may have acquired, and the severity of the physical or mental limitations you may have because of your condition.

Social Security does not have to consider that you may not be hired for a job or that the job is not readily available. The only thing they will consider is whether you are physically and mentally capable of performing any job on a full-time basis.

10. If Social Security determines that I am disabled, what type of benefits would I be eligible to receive?
A. If Social Security finds that you are disabled, you will receive a monthly cash benefit. The amount of cash benefit is based on how long you have been working and the amount of money you made. It can be as low as $100.00 and as high as $1,180.00 per month. An average benefit, nationwide, is about $550.00.

In addition, if you have children under 18 years of age, your dependents can be eligible to receive "auxiliary benefits." Typically, your dependents will split a total benefit of 50% of the amount of your check.

You are eligible to receive retroactive, lump-sum benefits depending on when you applied for benefits and when you became disabled. Social Security cannot pay you more than one year prior to the date you applied. With very limited exception, Social Security cannot ever pay you for the first five full calendar months that your are disabled, even if they are within the year prior to the date you applied for benefits.

If you are found disabled, you are entitled to receive Medicare Health Insurance beginning after you have received 24 months worth of disability benefits.

11. What happens if Social Security denies my disability claim?
A. If you are denied at the initial level and do not anticipate returning to work in the near future, you should appeal by filing a "Request for Reconsideration." To get the Social Security Administration to reconsider your claim, you must write the local Social Security office within 60 days of the denial of benefits. You must also sign and give Social Security a form entitled Request for Reconsideration. Your case will be reviewed again and you will be notified by mail of the decision. Most of the time you will again be turned down. Do not be discouraged if your claim is denied at the initial level or on reconsideration. Many people win their cases at the hearing level.

12. If my claim is denied on reconsideration, can I request another appeal?
A. Yes, following the denial of the reconsideration, you have 60 days to request a hearing with an administrative law judge. This is done by filing a Request for Hearing form by either calling or visiting any Social Security office, or having your attorney do it for you. This appeal must be in writing on the correct form.

13. What happens at the hearing?
A. An administrative law judge will run the hearing. The judge will make an independent decision based on the evidence in your case. This evidence includes medical records, other documents and testimony given at the hearing.

The judge will question you about your disability. The hearing is private and is held in a small conference room. The only people at the hearing will be the judge, the judge's assistant, you, your representative and any witnesses. The judge will usually also ask a vocational expert to testify and sometimes also ask a medical advisor to testify. The hearing will be tape recorded.

14. When and where will the hearing be held?
A. After you request a hearing, it usually (but not always), takes 6 to 9 months for the Social Security Hearing Office to set a hearing date. Social Security will tell you the date and place at least 20 days in advance. The hearing will usually be held within 75 miles of your home. If the hearing is held more than 75 miles from your home, you and your witnesses will be reimbursed for reasonable travel expenses.

15. Should I be represented by an attorney at the hearing?
A. While it is not required to be represented by an attorney, most claimants do have an attorney at least by the time of the hearing. The Government's own figures show that benefits are awarded far more frequently to claimants with attorneys than those claimants who choose to handle their claims without the assistance of an attorney.

While more informal than a civil court hearing, the hearing before an administrative law judge is, nevertheless, a legal proceeding. An attorney experienced in Social Security Disability claims can assist you in various ways at the hearing level, thereby, maximizing the chances of your being awarded disability benefits:

An attorney can help you with:

• Gathering medical and other evidence.
• Analyzing your case under Social Security regulations.
• Contacting your doctor and explaining Social Security regulations to obtain a report consistent with the regulations.
• Referring you to specialists for further medical reports in answer to questions raised by the Social Security Administration.
• Sending you to a vocational expert for a report on your ability to work.
• Suggesting that the Social Security Administration send you to a doctor for a consultative examination.
• Obtaining documents from your Social Security file.
• Reviewing actions taken by the Social Security Administration.
• Asking that a prior application for benefits be reopened to obtain more retroactive benefits for you.
• Seeking waiver of a time limit.
• Requesting subpoenas to assure the appearance of crucial witnesses at your hearing.
• Presenting a closing argument at your hearing.
• If you win, making sure that Social Security Administration is paying you the appropriate amount of benefits.
• If you lose, requesting an appeal of your case to the Appeals Council.
• If necessary, representing you in a federal court review of your case.
  

16. When should you hire a Social Security attorney?
A. Most claimants wait until they apply for a hearing before they hire an attorney.

Mistakes are often made by claimants in the initial application stage that cannot be "fixed" by even the most experienced Social Security Disability attorney. A qualified Social Security attorney will know how to work together with you, your doctors, and your past employers to present the most complete information possible at the hearing.

It also makes "good dollars and sense" to hire an attorney before you apply for Social Security Disability benefits. You are only responsible to pay attorney's fees if benefits are recovered on your behalf at the administrative hearing level. You pay no attorney's fees, whatsoever. if you are awarded benefits at the "application" or "reconsideration" levels, even though the attorney was hired before your initial application was filed.

17. How much does it cost to hire a Social Security Disability attorney?
A. Most attorneys, including our firm, handle Social Security Disability cases on a contingent fee basis. Our fees are based on a percentage (usually 25%) of any back benefits that Social Security awards. If we are unable to secure any benefits on your behalf, you pay no fees whatsoever. The Social Security Administration requires attorneys to submit written fee petitions for their approval. Also, our office does not charge for telephone or personal consultations.

18. What medical evidence should be presented at the hearing?
A. You need to prove that you have a serious medical problem which keeps you from working, and will last for at least 12 months or longer. The Social Security Administration helps you gather medical information for your case, but sometimes they do not have all the medical information available. It is important that your Social Security file has all of the medical information in your case (from your treating doctor, medical specialists, any hospital records, etc.). If you think there is anything else the judge should see before making a decision in your case, you can ask the judge if you can add that information after the hearing.

19. What will I be required to testify about at the hearing?
A. Medical condition- The judge will ask you how your medical condition makes you feel. You need to tell the judge about symptoms you are experiencing such as pain, dizziness, numbness, etc.

Medical history- The judge may ask you how often you see your doctor; what type of treatment your doctor provides; what medication you are presently taking; and whether there are any side affects.

Physical abilities- The judge might ask you questions like: "How far can you walk without resting?; "How much can you lift?", etc.

Mental abilities- The judge will ask you about your ability to understand, carry out and remember instructions, to respond appropriately to supervision, co-workers, usual work conditions and changes in your work-setting.

Education and training- The judge will ask you how far you went in school; if you had any training in the military; if you can read and write; and if you had any job training.

Work experience- The judge will ask you about the jobs you have had during the past 15 years. If your condition caused you to miss a lot of work or caused you to stop working, you should explain this to the judge.

Daily activities- The judge will ask you a series of questions to find out how your disability affects your daily life. For example, how you spend your time during the day; how well you sleep; do you drive a car; what activities do you engage in; and what hobbies you may have.


20. Can I have witnesses testify on my behalf at the hearing?
A. You can bring relatives or friends to the hearing as witnesses. Good witnesses are persons who see you regularly and see how your medical condition affects you.

However, the best witnesses are usually not friends or relatives, but someone else who knows you such as a neighbor or former boss. Witnesses should talk about the activities that you are unable to do.

21. What is a vocational expert?
A. Usually the judge will ask a vocational expert to testify at the hearing at the Social Security Administration's expense. A vocational expert will testify whether or not your disabilities make a job too hard for you to do and which jobs you can do.

22. How and when do I get the results of the hearing?
A. After your hearing, you will receive a written decision in the mail. It is very unusual for a judge to announce a decision at the conclusion of the hearing. In Illinois, it usually takes between two (2) and four (4) months to receive a decision.

23. What happens if I win at the hearing?
A. If you prevail at the hearing, you will receive benefits retroactively depending on the date the judge says you became disabled.

24. What happens if I lose the hearing?
A. If you lose at the hearing, there is one last level of appeal inside Social Security itself, known as the Appeals Council. Like most other Social Security appeals, you must file for this within 60 days of the date of the judge's decision. Your file, any new medical evidence, or any written argument you want to send are considered.

However, the Appeals Council generally will not consider new evidence about your disability for the period of time after the hearing decision. It is very important to be fully prepared, and have all possible medical evidence ready when you appear before the administrative law judge.

Once again, the Appeals Council will mail you its decision. The Appeals Council may uphold the hearing decision, reverse the local judge's decision outright, or send the case back for a new hearing. Taking your case to the Appeals Council is a requirement if you want to have your case reviewed in United States District Court.


25. After losing at the Appeals Council, can I appeal further?
A. Within 60 days after you receive the Appeal Council's written decision, a formal lawsuit can be filed with the United States District Court for your area, seeking review of Social Security's final decision. The District Court is only permitted to review your medical evidence and a written transcript of the hearing. No additional evidence will be allowed. Your lawyer and the Government's lawyer file legal briefs arguing each side, and the District Court issues another written decision. In many federal courts, you never appear in court in person. This is all done on paper, or sometimes with just the attorneys making legal arguments in court. In general, the federal court can do one of three things; the judge can reverse Social Security's Decisions outright and order them to pay you benefits; the judge can uphold Social Security's decision denying you benefits; or your case can be remanded back to Social Security for a new hearing.

26. What can I do if Social Security tries to reduce or stop the benefits I am now receiving?
A. If you are presently receiving benefits, Social Security may review your case at some point in the future to see if your medical condition has improved and, as a result, are able to work. If Social Security Administration reviews your case, and you are still disabled, you need to get medical evidence from your doctor which shows that your condition has stayed the same or has worsened.

If Social Security decides to terminate your benefits, you can appeal the decision. You will have 60 days to make a written request for an appeal. However, if you make a request for an appeal within 10 days, you will continue to receive your benefits until you have a hearing and the administrative law judge has made a decision on your case. If you receive an unfavorable notice, you must appeal immediately. If you lose the appeal you may be asked to pay back benefits as an overpayment.

IMPORTANT NOTE: The legal and medical questions involved in stopping your benefits can actually be more complicated than when you first applied for benefits. If Social Security sends you a letter telling you that they are stopping your checks, it is a good idea to contact a Social Security Disability attorney immediately.

If you are disabled and believe that you are entitled to Social Security Disability Benefits or if your Social Security Benefits have been stopped, you need to contact Large & Associates, at 423-968-4969 for a free, no obligation consultation with one of our qualified disability attorneys. Or use our convenient "Do I have a case?" submission form.

Notice:

Each case is different and different facts may yield a result you would never expect from reading this brief Web page. The information on this Web site cannot replace the careful consideration of personal factors and changes in the law, which may apply to your legal problem. While this information may help you, do not rely on it as the final answer to a legal question.