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What You Need to Know About Social Security Disability Claims

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Help from Social Security Lawyers: Information You Need to Know

In the alphabet soup of government programs available to injured workers, two of the most common acronyms are “SSI” and “SSD” (also known as “SSDI”). These stand for “Supplemental Security Income” and “Social Security Disability Insurance,” respectively. While both of these programs are administered by the Social Security Administration, they are based on different eligibility criteria and serve largely distinct groups of people. If you have questions or concerns about your eligibility, contact our Social Security lawyers today.

Supplemental Security Income

The Supplemental Security Income (SSI) program provides federal benefits to individuals who have limited income and resources and who fall into one of the following categories:

  • Aged 65 or older
  • Blind
  • Disabled

For the purposes of the SSI program, an adult is “disabled” when he or she has a physical or mental impairment that:

  • Results in an inability to do any substantial gainful activity and
  • Can be expected to result in death, or
  • Has lasted or can be expected to last for 12 months or more.

The upper limit of resources an applicant can own and still qualify for the program is $2,000 for an individual and $3,000 for a couple. However, the SSA does not consider all income and resources to be countable. For example, the value of an applicant’s home and the land it sits on do not count toward the resource limit, while income tax refunds do not count toward the income limit. Any income and resources that are countable, but are below the limit, are offset from the applicant’s SSI benefit.

Social Security Disability

The Social Security Disability (SSD) program pays cash benefits to individuals and certain members of their families who suffer an injury or illness that prevents them from engaging in substantial gainful activity. Under this scheme, an individual is considered to be “disabled” when:

  • They cannot transition to other work because of their illness or injury, and
  • The disability is expected to last for a year or more or result in death

The applicant must also have worked for a certain length of time (known as “work credits) and paid Social Security taxes. Once an applicant is deemed to qualify for the program, the benefits available vary according to the recipient’s average lifetime earnings before his or her disability began. The SSA uses a complex formula to determine this amount, but the maximum monthly benefit per person in 2019 is $2,861.

How to Expedite Your SSDI Claim

Applying for Social Security disability (SSDI) benefits can be a lengthy, and often quite complex, process. If your initial application is denied (as most are), the appeals process can stretch on for months or even years. And if you are lucky enough that your application process goes smoothly, there is still a five-month waiting period before the Social Security Administration (SSA) will actually begin paying you your benefits. Recognizing that delays of this nature take a greater toll on some applicants than others, the SSA is willing to expedite the claims process in certain cases.

Below are some of the situations in which the SSA may expedite SSDI claims. For more detailed information about any of the topics presented herein, please contact our social security lawyers.

Our Social Security Lawyers Can Expedite Your Claim if There’s a Dire Need

In some cases, the SSA may expedite a claim if it determines that the claimant is in “dire need.” The most common dire needs are housing-related — i.e., foreclosure, eviction, imminent threat of homelessness, threat of utility shutoff, etc. Dire need can also arise in cases where the applicant lacks access to food or vital medical care. Claimants alleging dire need should submit evidence supporting their case as part of a “dire need letter,” such as an eviction notice, a notice from a utility company stating that it is going to terminate services, or a letter from a lender stating that foreclosure proceedings are beginning.

Terminal Illness Designations

If the claimant suffers an illness that is untreatable, cannot be reversed, and is expected to result in death, the SSA may expedite the claim as a “TERI” claim. A TERI designation may apply in the following cases:

  • The claimant suffers:
    • ALS
    • AIDS
    • Chronic pulmonary or heart failure
    • Cancer that is metastatic, Stage IV, persistent after therapy, or inoperable
    • Esophageal cancer
    • Liver cancer
    • Pancreatic cancer
    • Gallbladder cancer
    • Mesothelioma
    • Small cell or oat cell lung cancer
    • Brain cancer
    • Acute myelogenous leukemia or acute lymphocytic leukemia
  • The claimant is awaiting a heart, lung, liver, or bone marrow transplant
  • The claimant is receiving inpatient hospice care

Compassionate Allowance Program

The SSA prioritizes and expedites claims for claimants who suffer from specified severe conditions known as “compassionate allowances.” The SSA considers these conditions to meet the statutory standards for disability benefits by definition, thus reducing waiting times for claimants with the most severe conditions. Some of the more than 200 conditions that qualify for the compassionate allowance program include:

  • Breast cancer
  • Adult non-Hodgkin lymphoma
  • Acute leukemia
  • Liver cancer
  • Malignant multiple sclerosis
  • Thyroid cancer
  • Dravet syndrome
  • Aplastic anemia
  • Kidney cancer

Served in the Military? You May Qualify for Expedited Processing

Veterans and active duty service members who become disabled while on active duty are eligible for expedited SSDI processing, even if the disability is unrelated to the claimant’s military service.

How to Overcome a Denial of Social Security Disability (SSD) Benefits

Was your SSD claim denied? We can help. The social security disability lawyers at Turley Redmond Rosasco & Rosasco will review your application, advise you on how to proceed with appealing the Social Security Administration’s (SSA) decision and help you recover your rightful benefits. Our attorneys understand your frustrations and concerns, and will take proactive steps to effectively overcome denied SSD claims. We assist clients throughout New York and Long Island, including Riverhead, Ronkonkoma, Shirley, Garden City, and New York City.

Top Reasons for SSD Denial

Individuals often retain us upon receiving a denial letter from the SSA. In many cases, the reason for SSD denial was entirely preventable and we can fix it on appeal. In other cases, the person was ineligible at the time of filing, but the disqualifying factor has changed. Commonly, the applicant submitted inadequate evidence or misunderstood the procedures or criteria.

Top reasons for denial include:

  • Your medical condition did not meet the definition for disability
  • You provided insufficient medical evidence of the severity or duration of your condition
  • SSA determined you were able to perform the tasks required of you in your former job
  • SSA decided that you could adapt your education, experience and transferable skills to another job
  • You earned income above the maximum allowable amount
  • You did not provide paystubs, tax returns or other evidence of earnings
  • You received too much in workers’ compensation, veterans benefits or other programs
  • You received a large personal injury settlement that disqualified you from benefits.
  • You failed to include income from a non-job source for the SSD to consider.
  • You committed a technical error.

What Should You Do If Your SSD Claim Was Denied?

Denied social security claim.

Getting a denial letter is heartbreaking. You may have been counting on the SSD benefits to pay for crucial living expenses, and the delay may present financial challenges at a time when you should be focused on your health and future. The uncertainty can increase anxiety during an already stressful period of your life.

What should you do if you receive the dreaded denial letter?

  • Do not panic. The SSA denies 70 percent of initial SSD applications, many of which are ultimately approved. Therefore, do not get discouraged or upset. You have other options, such as filing an appeal. 
  • Read the letter carefully. The letter explains why your claim was denied. The information contained in the letter will dictate the best course of action for gaining approval on appeal.
  • Collect more evidence. You may need to submit additional evidence of your eligibility. For example, if the SSA claims your medical condition did not meet the definition of disability, you may need to provide more proof of its severity, expected duration or impact on your ability to perform certain job-related tasks.
  • File your appeal right away. You have only 60 days from the date you receive the letter to file your appeal. If you miss the deadline, you must start the entire process from scratch.
  • Retain legal counsel to help. An experienced disability attorney can strategize a plan to increase your likelihood of approval on appeal.

Filing an Appeal After Being Denied Social Security Disability (SSD) Benefits with Top Social Security Lawyers

Did you know that 70 percent of Social Security Disability (SSD) applications are initially denied? If you applied for SSD benefits and were rejected, our disability attorneys can help you file an appeal. Turley Redmond Rosasco & Rosasco wins approval of most applications upon reconsideration by a Social Security Administration (SSA) agent or a hearing before an administrative law judge, and succeeds with many at the Appeals Council or federal court stages. A denial letter is not the end of the road. We can help you get the SSD benefits you are entitled to.

Prepare Your Appeal Immediately

If you received a denial letter from the Social Security Administration, you need to take action immediately. You have only 60 days to file your appeal with the SSA. If you miss this strict deadline, you waive your right to an appeal and must start the application process over.

Our disability lawyers in New York are often able to obtain approval at the first appellate stage. However, we can also file appeals of wrongful denials to higher level courts.

Reconsideration

An SSA agent not involved in the original decision will review your case. We have the crucial opportunity to submit new evidence and address the reasons for initial denial and have your claim reconsidered. Typically, the SSA does not require you to be present. Our attorneys will handle this process on your behalf.

Administrative Law Judge Hearing

A judge will review the original decision and reconsideration at a hearing. The judge may ask you to submit more evidence before the hearing date. Likewise, you can elect to submit evidence in support of your case at the hearing. Evidence often includes expert testimony of doctors, vocational therapists, physical therapists and other witnesses.

The hearing is generally held within 75 miles of your home. You may also be granted the option of having a video hearing, which allows you to appear before the judge if your injury interferes with your ability to travel to a hearing location to attend in person.

Appeals Council Review

You can request a review of the judge’s decision by the SSA Appeals Council. The Appeals Council may take three actions. Upon a finding that the judge’s decision was correct, the Appeals Council may deny your request for a review. Alternatively, the Appeals Council may review your claim and either affirm or reverse the denial. Or, the Council may return your case to the administrative law judge with instructions to review it further.

Federal Court Review

Filing a claim in federal court is the last option for an SSD applicant. These cases typically involve a flawed decision made by the SSA, administrative law judge or the Appeals Council. Although SSD claims rarely reach this level, our social security lawyers have the trial skills to analyze whether doing so makes sense in your case and can make a compelling argument to the court in support of our position.

Contact the Social Security Lawyers at Turley, Redmond, Rosasco & Rosasco for More Information

For more information about SSI, SSD, and how you might qualify for either program, please contact the New York Social Security disability lawyers at Turley, Redmond, Rosasco & Rosasco by using our online form or calling us at 877-693-2529. We serve New York City and Long Island, including Nassau County and Suffolk County.

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