The Clauson Law Firm

The “inability to engage in any substantial gainful activity because of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.” Unlike Worker Compensation, or VA Disability, under Social Security you are either completely disabled, or not disabled. There is no such thing as partial, or percentage, of disability.

For disability purposes, what you have to prove at a hearing is the same regardless of whether the case concerns SSI or Disability: you still have to go through the five-step sequential evaluation process. The programs differ in their technical requirements for disability.

Supplemental Security Income benefits (SSI) is a disability program for those who have little or no income or resources, except for an automobile, a home and furnishings, and are disabled. If you receive either money (earned or unearned) from any source, or assistance in the form of food, clothing, or shelter, that amount may be reduced.

Disability Insurance benefits (DIB) is a disability program for persons who have worked and paid Social Security Taxes for 20 out of the last 40 quarters, generally speaking, and are disabled. It also pays for dependents of the disabled to a certain extent. The amount of DIB is computed based upon average monthly earnings according to a computer program created by Social Security, and is unaffected by any other income you might get. If you are eligible for both types of Disability benefits—as some of my clients are—your payments will be subject to a complicated formula called the Windfall Offset, which reduces your SSI payments by the amount that should have been paid had the DIB been paid first.

The hearings are not like any court proceeding, in that the normal rules of evidence do not apply, although you will be sworn (or affirmed) as a witness for testimony, and medical evidence will be admitted formally to a written record referred to as your official file for purposes of the hearing. Typically attending are the Administrative Law Judge (ALJ), a court reporter and you and your representative. In some cases, the ALJ has a medical doctor (a medical expert or “ME”) or vocational expert (“VE”) present to testify at the hearing. In some cases (where a client alleges that they have seizures, for example), there may be other witnesses your attorney will want to have present to testify on your behalf, but this is rare.

No, you can file as soon as you become disabled. Most people make the mistake of waiting too long to file for benefits. If you and your doctor believe that you won’t be able to return to work for at least a year, or your doctor or therapist advises you to seek disability benefits, or you have been to Vocational Rehabilitation and they have said you are too sick to be able to benefit from their services, it is time to file for disability. In fact, if you wait more than a year after becoming disabled before filing for benefits, you may be losing valuable months of past-due benefits.

Unless you are homebound, go to your local Social Security office and apply in person. Even if you have an appointment, you may have to wait several hours before you actually meet with a claims representative who will take your application. If you cannot appear in person, call 1-800-772-1213 and schedule a telephone interview with a claims representative who can take your claim over the phone. This is not as satisfactory as actually sitting in front of a claims representative, but will get the job of filing done.WHEN YOU FILE YOUR CLAIM, BE SURE TO BRING ALL THE INFORMATION SOCIAL SECURITY NEEDS, INCLUDING THE NAMES AND CONTACT NUMBERS FOR YOUR TREATING DOCTORS AND MEDICAL CLINICS. ALSO, ANSWER SOCIAL SECURITY’S QUESTIONS THOROUGHLY AND COMPLETELY SO AS NOT TO MISLEAD THE EXAMINERS. See “giving incomplete information,” under “Mistakes Claimants Make,” above.