Frequently Asked Questions About Social Security Disability
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How are Social Security Disability Payments Calculated?
As an attorney specializing in Social Security Disability law, I often encounter clients seeking clarity on how the Social Security Administration (SSA) determines the amount of disability payments. It's crucial to understand that the calculation involves a complex process, considering various factors to ensure fair and accurate compensation for individuals facing disabling conditions. Here's a detailed explanation to address this frequently asked question:
1. Work Credits and Eligibility
To qualify for Social Security Disability Insurance (SSDI), individuals must have earned a sufficient number of work credits. Work credits are earned based on employment and income, and the exact requirements may vary depending on age.
2. Average Indexed Monthly Earnings (AIME)
The first step in calculating disability benefits involves determining the Average Indexed Monthly Earnings (AIME). AIME is the average of the highest-earning years adjusted for inflation using the Social Security indexing formula.
3. Primary Insurance Amount (PIA)
The AIME is then used to calculate the Primary Insurance Amount (PIA). PIA is the basic benefit amount a person would receive if they become disabled at full retirement age. The PIA is determined by applying a progressive formula to different income brackets.
4. Cost-of-Living Adjustments (COLA)
Disability benefits are subject to annual Cost-of-Living Adjustments (COLA) to account for inflation. This ensures that the purchasing power of disability payments is maintained over time.
5. Family Benefits
In some cases, family members of disabled individuals may be eligible for auxiliary benefits. This can include spouses, children, and even divorced spouses, each receiving a percentage of the disabled individual's PIA.
6. Maximum Family Benefit
The SSA imposes a Maximum Family Benefit limit to prevent family benefits from exceeding a certain threshold. This limit is typically a percentage of the disabled individual's PIA.
7. Waiting Period and Retroactive Benefits
There is a mandatory five-month waiting period for disability benefits. However, individuals may be eligible for retroactive benefits, allowing them to receive payments for the months they were disabled before the application date.
8. Trial Work Period
Social Security encourages individuals to return to work if possible. The Trial Work Period allows beneficiaries to test their ability to work for a limited time without losing benefits.
9. Substantial Gainful Activity (SGA)
Social Security defines the level of work activity that is considered substantial gainful activity (SGA). Earning income above the SGA threshold may impact disability benefits.
10. Consultation with a Social Security Disability Attorney
Given the complexity of the calculation process and the potential impact of various factors, consulting with a Social Security Disability attorney is advisable. An attorney can provide personalized guidance, ensure accurate documentation, and represent the client's interests in the disability claims process.
Understanding the intricacies of Social Security Disability payment calculations is crucial for individuals navigating the disability benefits system. While this overview provides a comprehensive guide, seeking legal counsel can greatly assist in navigating the complexities and ensuring the best possible outcome for those in need.
What should I expect at a Social Security Disability Hearing?
What Happens at a Social Security Disability Hearing?
A Social Security Disability Hearing is a crucial step in the appeals process if your initial application and appeal (Request for Reconsideration) for Social Security Disability benefits was denied. It is an opportunity for you to present your case before an Administrative Law Judge (ALJ) and provide additional evidence to support your claim for disability benefits. Here's a more detailed breakdown of what you can expect during the hearing:
1. Hearing Venue and Participants
- The hearing usually takes place via phone, video, or in person in a small meeting room. Since the middle of 2020 (COVID), the Social Security Administration has conducted most hearings either by phone or video (Microsoft Teams). In 2023, in-person hearings started again. Unfortunately, if you want an in-person hearing, it will likely take longer to get one scheduled. Even with in-person hearings starting again, it is likely SSA will continue the option of phone and video hearings for the foreseeable future.
- The participants will include yourself (claimant), your attorney or representative, the ALJ, a hearing assistant (who records the proceedings), and a vocational expert who will provide testimony during the hearing. On rare occasions, a medical expert may also testify.
2. Testimony and Questioning
- You, as the claimant, will be sworn in, and your attorney or representative may make an opening statement about your case.
- You will have the opportunity to testify about your medical condition, impairments, and how they affect your daily life and ability to work.
- The ALJ will ask you questions about your medical history, treatment, and any attempts you may have made to return to work.
- Your attorney or representative may also question you to elicit additional information that supports your claim.
3. Witness Testimony
- If you have witnesses who can provide relevant information about your disability or limitations, such as family members, friends, or coworkers, they may also testify.
- Witnesses will be asked questions by both the ALJ and your representative if you have one.
- It is rare to have witness testimony. The majority of the time, you, as the claimant, will be the only one to testify besides the vocational expert.
4. Vocational Expert Testimony
- In most cases, the ALJ will call a vocational expert to testify about job availability, your ability to perform other types of work, and the impact of your disabilities on your employability.
- Your New Mexico Social Security Disability Benefits attorney or representative may also question the vocational expert to ensure a clear understanding of the testimony provided.
5. Formality and Informality
- Social Security Disability Hearings are less formal than court trials, but it's essential to treat the process respectfully and truthfully.
- ALJs are experienced professionals who understand the challenges faced by disability claimants and aim to create a fair and supportive atmosphere.
- It's important to keep in mind that ALJ’s make decisions on Social Security disability cases for a living. These are the only types of cases they handle, and they have a very heavy workload. On the day of the hearing, it is likely the ALJ has four or five other hearings besides yours.
6. Hearing Duration and Decision
- Hearings can vary in length but typically last around an hour.
- After the hearing, the ALJ will review all the evidence presented and consider your testimony, medical records, and expert testimony before making a decision.
- The ALJ will not likely tell you the decision at the hearing. It typically will take a couple of months after the hearing to get the ALJ’s written decision in the mail. This length of time can vary dramatically depending on the ALJ and how backup up they are. This decision will explain whether your disability claim has been approved or denied and the reasons behind the decision.
Contact Our New Mexico Social Security Disability Attorney Today to Get the Guidance You Need
Remember that each Social Security Disability Hearing is unique, and the specific procedures may differ based on your location and the ALJ overseeing the case. Being well-prepared and honest about your medical condition and limitations is essential to give yourself the best chance of a favorable outcome. If you're unsure about anything during the process, seeking guidance from an experienced New Mexico Social Security Disability Benefits attorney or representative can be beneficial.
How long do SSDI appeals take?
Your application for Social Security Disability Insurance (SSDI) benefits could be denied even if you fill out the paperwork completely and are clearly eligible for benefits. Unfortunately, many residents in New Mexico who apply for SSDI are not approved for benefits by the Social Security Administration (SSA).
It could take you a long time to successfully appeal the SSA’s denial of your application. Here, we explain how long each stage in the process could take.
How Long the Stages in an SSDI Appeal Takes
The length of time it will take you to complete your appeal will depend on how far in the appeals process you need to go to win your case. Here is how long it could take for each stage:
- Reconsideration. You have 60 days to file a request for reconsideration after receiving a denial of your application. It will take the SSA three to four months to reach a decision. Most requests for reconsideration are denied in New Mexico.
- Appeal. The second stage in the process is to file an appeal. You have 60 days to file your appeal after you receive the reconsideration determination. It will take you approximately one year to have a hearing before an Administrative Law Judge (ALJ). It will take them 45 to 90 days after your hearing to notify you of their decision.
- Appeals Council. If you did not win your appeal, you have 60 days to request that the Appeals Council review the denial. If they agree with you, they could overturn the ALJ’s decision or send your case back to the ALJ for further review. This process could take up to one year.
- Federal Court. The final stage is to file an appeal in Federal Court. You must file it within 60 days of the Appeal Council’s decision. It can take anywhere from months to up to a year for the review of your case in Federal Court to be completed.
Are you applying for SSDI benefits? Do you need to file an appeal? Our experienced social security disability lawyers are here to help you every step of the way so that your application for SSDI benefits is approved as quickly as possible. To get started, call our Roswell office or start a live chat to schedule your free initial consultation today.
Will moving to another state affect my SSDI benefits?
Once you begin receiving Social Security Disability Insurance benefits (SSDI), you may decide to move to a different state. The good news is that your move will not affect your eligibility for SSDI, and you will not have to reapply for benefits in the new state you live in. However, you do need to notify the Social Security Administration (SSA) of your planned move.
How to Notify the Social Security Administration When You Move to Another State
You have a duty to notify the SSA of certain life changes when you are receiving SSDI benefits. This includes a duty to inform them of a new address and telephone number.
You should contact the SSA before you move. This ensures that you will receive your payments at your new address if they are mailed to you and any future communications from the SSA regarding your benefits. You can change your address in these ways:
- Online. The easiest way to notify the SSA of your new address is online through your Social Security profile.
- Local office. You can also go to a local Social Security Administration office and report your address change there.
What Happens If You Move in With Someone?
If you move in with a friend, partner, or family member when you relocate, you will need to report your change of address to the Social Security Administration. However, the fact that you will now be living with someone will not affect your right to SSDI benefits. That is because your eligibility is based on your work and income history and not on the income of those you live with.
Do you need help filing for SSDI benefits? Was your application denied? Our experienced Social Security disability lawyers are here to answer your questions and to assist you in obtaining the disability benefits you are entitled to. To find out more about how we can help you, call our Roswell office or start a live chat to schedule a free initial consultation today.
How do I send records to the Social Security Administration?
When you are applying for Social Security Disability Insurance benefits (SSDI), you will need to provide the Social Security Administration (SSA) with documents that prove that you are too disabled to work and otherwise qualify for benefits. You could also need to send them additional documentation while they are reviewing your application or if your medical condition changes after you begin receiving SSDI benefits. Here is how you can submit additional information to the SSA.
How to Provide the SSA With Your Documents
One way that you can make the process of getting your application for SSDI benefits approved go faster is to provide the SSA with your complete medical records and other documents you need to support your application. You can provide it to the SSA in the following ways:
- Initial application. When you initially apply for SSA or have additional documents to include before a claims examiner is assigned to your case, you can mail or drop off the information to your local SSA office.
- Claims examiner. After you apply for benefits, a claims examiner will be assigned to review your application. You will be notified of the contact information for your claims examiner and will need to provide additional information to them directly.
- Appeal. If the SSA denies your application, you have a right to appeal the decision. The notice of the denial will advise you of how to file your appeal and how to provide them with additional documentation of your disability.
- Approval. Once you begin receiving SSDI benefits, you still have a duty to update the SSA if your medical condition improves or worsens. In addition, they may periodically review your file to determine if you still qualify for benefits. The SSA would notify you of where to send your documents in the letter advising you that your application is approved or when they review your eligibility for benefits.
You should always keep a copy of any documents you send to the SSA for your records.
What Is the Best Way to Provide Your Records to the SSA?
If you want to be successful in obtaining SSDI benefits, you should retain an experienced Social Security disability attorney before submitting your application. An attorney can review it to be certain that it is completed properly and can help you collect the medical records and other documents you need to prove your right to benefits. They can also provide the SSA with necessary documents if you must file an appeal. Your lawyer may file many of your records electronically, which can be a safer and quicker way to provide them to the SSA.
Are you applying for Social Security Disability Insurance benefits? Was your application denied? Start a live chat or call our Roswell office to schedule your free consultation today.
How long do I have to file an appeal for a Social Security Disability denial?
If you file an application for Social Security Disability Insurance (SSDI) benefits, the Social Security Administration will review it and your supporting documents and make a decision on whether you qualify for benefits. If they deny your claim for SSDI benefits, you have a right to file an appeal of their decision. However, you must meet strict time deadlines for filing your appeal.
How Long Do You Have to File an Appeal If the SSA Denies Your Application for SSDI Benefits?
There are four levels of appeal of a Social Security Disability Insurance denial of benefits: reconsideration, ALJ hearing, Appeals Council, and Federal Court. Here are the deadlines you have to file your appeals:
- Reconsideration. Your first step would be to ask the SSA to reconsider their decision. You have 60 days from the date of your denial to ask that another claims examiner review the decision to deny your request for SSDI benefits.
- ALJ hearing. The next level of appeal would be to request a hearing before an administrative law judge (ALJ). You must file this type of appeal within 60 days of the denial of your request for reconsideration.
- Appeals Council. If the ALJ determines that you are not eligible for SSDI benefits, your next step in the appeal process would be to file a request for a review by the Appeals Council. You would have 60 days from the date of the ALJ decision to appeal to the Appeals Council. They have the ability to grant you an approval of benefits, remand your case for a second hearing, deny your appeal, or dismiss your case.
- Federal court. Your final stage in the appeal process would be to file a lawsuit in federal court. You would have 60 days from the date of the Appeals Council’s decision to file your appeal.
What Happens If You Miss the Time Period to Appeal?
You would lose your right to file an appeal if you miss the 60-day deadline to do so. You would be able to file a new application for SSDI benefits. However, this would be a lengthy process, and you would waste a lot of time and effort.
If you reapply for benefits, your application may be denied again for the same reasons. In addition, you lose the right to receive some of the back benefits you are entitled to if you are approved for SSDI the second time you appeal.
Was your application for SSDI benefits denied? You need the help of a knowledgeable Roswell Social Security disability attorney if you want your appeal of the SSA’s decision to be successful. To find out how we can help, call our Roswell office to schedule your free case evaluation today.
How long does it take to get approved for SSDI?
If you must apply for Social Security Disability Insurance (SSDI) because you cannot work due to a disabling medical condition, it can be stressful to wait for the Social Security Administration (SSA) to make a decision on whether you qualify for benefits. While some people are approved in as little as 30 days, others can wait a year or longer before they receive a final decision.
How Long Could it Take to Get a Decision on Your SSDI Application?
Understanding how long it will take to get through the different stages of a SSDI claim can relieve your stress and help you know what to expect. Here is how long it could take:
- Initial application. The average response time for the SSA to reach a decision after you apply for SSDI benefits is three to four months, but this time period could be extended to up to eight months.
- Reconsideration. If the SSA denies your request for benefits, you will need to file a request for reconsideration of their decision. It could take them three to four months to send you a decision on your initial appeal.
- Appeal. You will need to file an appeal and have your case decided by an administrative law judge (ALJ) if your request for reconsideration is denied. It could take six months to two years before your hearing is scheduled and the ALJ makes a decision on your claim.
How to Get a Decision Faster
You can take steps to speed up the process of receiving a decision from the Social Security Administration. Here are a few tips on what you can do:
- Fill out your application completely, and list all the doctors you have seen. You should provide their contact information and the dates you were examined by them.
- Include all of your medical records. This will avoid the SSA having to contact your physicians for this information, which could delay their initial decision significantly.
- Obtain letters from all doctors who are treating you for your disability. Their letters should explain your medical condition and how it prevents you from working.
- Check on the status of your application to be certain that the SSA does not need additional information and that they are reviewing your application. You can check this on the SSA website or by calling and speaking to a SSA representative.
What is the best way to be certain that your claim goes faster? Retain an experienced Social Security disability lawyer immediately. They can help you file your application properly, provide all the documentation needed for you to get a quick decision, and file your appeal if this is necessary. To learn how we can help, call our Roswell office to schedule your free consultation today.
What is a Consultative Exam?
When you apply for Social Security Disability Insurance benefits (SSDI), the Social Security Administration (SSA) will decide whether you qualify for benefits. They could schedule a consultative exam to help them make a decision on your claim. This is a medical examination that is scheduled by the SSA with a physician that they choose. This is a physical or mental examination that they will use when deciding whether you are unable to work due to your medical condition.
When Could You Be Required to Attend a Consultative Exam?
Whether the SSA will schedule a consultative exam will depend on your disability and the evidence you submit to support your application. Examples of when this exam may be required include:
- Additional medical information is needed that is not included in your medical records.
- There are gaps in your medical treatment, or you have not been treated by a doctor for a while.
- The SSA cannot obtain your medical records from your doctor for a reason beyond your control, such as your physician’s death or refusal to supply them.
- There are inconsistencies in your medical records.
- The SSA needs specialized medical evidence to decide your claim.
- You could experience a change in your medical condition in the future that may affect your ability to work.
Importance of Attending Your Consultative Exam
You must attend your CE Exam if the SSA requests that you attend one. If you fail to attend your exam, the disability examiner could determine that you are not being cooperative and deny your application.
Who Performs a Consultative Exam?
Your treating physician can conduct a consultative exam. Often it is performed by an independent doctor hired by the SSA. These doctors do not work for the SSA.
What Happens at a Consultative Exam?
The purpose of your exam is not to treat you. It is to determine how serious your disability is.
The extent of your consultative exam will depend on your disability and the questions that the SSA has about how it affects your ability to work.
However, there are specific rules on how long your exam should last. Here are some requirements that should be followed:
- A general physical exam should be for at least 30 minutes.
- A musculoskeletal or neurological examination should take at least 20 minutes to perform.
- A psychological exam should last at least 60 minutes and a psychiatric exam should last for at least 40 minutes.
- Other types of examinations are required to be for at least 30 minutes.
Once the exam is completed, the physician would submit a written report to the SSA.
Who Pays for a Consultative Exam?
The SSA will pay for a consultative exam and any diagnostic tests associated with it. You should not be charged for these services.
Are you considering filing for SSDI? Does the SSA require you to attend a consultative exam? Call our Roswell office to schedule a free consultation with our experienced Social Security disability lawyers who can help you obtain the SSDI benefits you are entitled to.
What to Do If the SSA Requests a CE Exam
A cumulative medical exam can be a quick procedure, but it can have a big impact on your SSDI application. It is important to remember that the doctor performing it does not work for the SSA, but is being paid by them. Here are important tips on how to handle your exam:
- Be polite and respectful during your exam.
- Expect to be asked about your symptoms by the examining doctor. You want to give him short answers and include concrete examples.
- You should be truthful when discussing your illness or medical condition. Do not exaggerate or downplay the symptoms that you are experiencing.
Retain an Attorney Immediately If You Receive a Notice of a CE Exam
One of the most important first steps you should take if the SSA notifies you of a CE Exam is to retain an experienced disability attorney. Your attorney can give you advice on how to best handle your exam and ensure that you receive the SSDI that you deserve. Call the Injury and Disability Law Center today to schedule a free consultation to learn how our skilled lawyers can help you with your SSDI claim.
Do I need an attorney to appeal a Social Security disability denial?
If your application for Social Security Disability Insurance benefits (SSDI) is denied, you do not have to hire a lawyer to file your appeal. However, if you want to win your case, your best strategy would be to retain an experienced Social Security disability attorney. Here are three reasons why having a lawyer represent you in your appeal will increase the chances of success.
Reason #1: Gathering Your Medical Documents
Your attorney will review your entire file and all the medical documents you provided that support your application. They will be able to identify gaps in your medical history and will be able to obtain the medical records you need to file with the Social Security Administration (SSA) to support your claim quicker than you could. They will also contact your doctors and have them write a written opinion that explains fully what your disability is and how this prevents you from working.
Reason #2: Understanding of Law and Procedures
A knowledgeable attorney will know how to file your appeal properly. They will also understand the rules and procedures that must be followed so that your appeal proceeds quickly and smoothly.
Reason #3: Preparing You for Your Hearing
One of the biggest benefits of having an attorney is that they will be with you at your hearing for your appeal. Some of the ways an attorney can help you include:
- Trial preparation. They will prepare you for the questions that the administrative judge will ask you at your hearing.
- Evidence. They would be certain that all your medical records, doctors’ opinions, and other evidence that supports your claim of disability are presented at your hearing.
- Witnesses. They will identify all the expert witnesses you need, such as a physician, and any other witnesses who can help you prove your disability and will prepare them to testify at your hearing.
- Cross-examination. A vocational expert would most likely testify on behalf of the SSA. After the administrative law judge questions this expert, your lawyer can effectively cross-exam them about their findings and show how they are inaccurate. They would also cross-exam any other witnesses presented on behalf of the SSA.
Was your application for SSDI benefits denied? Call our office to schedule a free initial consultation to learn how our skilled Social Security disability lawyers in Roswell can help you.
How are grid rules used to determine Social Security disability eligibility?
If you are applying for Social Security Disability Insurance (SSDI) benefits, it can be easier to get your application approved by the Social Security Administration (SSA) if you are 50 years old or older. The SSA considers it harder for older applicants to learn new job skills or move to a different type of work. If the SSA decides that you can no longer perform your former job duties, they will use grid rules to determine if you are eligible for benefits.
How the Grid Rules Work
The SSA refers to the additional difficulty an older worker has switching to a new type of job as a vocational adjustment and uses grid rules to determine these applicants’ claims. The SSA considers a number of factors that are applied to grids the SSA developed in deciding whether someone qualifies for benefits. The following factors are considered.
The SSA divides applicants into the following age groups: younger individuals (aged 18 through 49 years old), individuals approaching old age (50 through 54 years old), advanced age (55 years old or older), and approaching retirement (60 years old or older). It is easier for an older individual to get approved by the SSA under the grid rules.
Individuals who have a lower educational level are more likely to have their application for SSDI approved. The SSA divides educational abilities into the following levels:
- High school graduation or higher with additional training for skilled work
- High school graduation or higher with no additional training for skilled work
- Limited education, which is generally completing l1th grade or lower
- Inability to read and write
Past Work Experience
The SSA considers an individual’s prior work experience under the grid rules. Jobs are grouped into these classifications: unskilled, semi-skilled, and skilled. It is easiest for unskilled workers to qualify for SSDI using the grids.
Transferable Work Skills
The SSA will take into account whether semi-skilled or skilled workers have job skills that would transfer to other types of employment. Applicants who have more transferable job skills will have a harder time getting their application approved.
Residential Functional Capacity
A person’s residential functional capacity (RFC) is their ability to do work on a full-time basis. In determining what a person’s RFC is, the Social Security Administration will use medical evidence, such as from the applicant’s doctor, as to their ability to stand, walk, lift, push, and carry. RFC is divided into these categories:
- Sedentary work
- Light work
- Heavy work
- Very heavy work
Individuals classified as heavy work or very heavy work will be more likely to qualify for SSDI under the grid rules.
Do you have questions about your eligibility for SSDI under the grid rules? Do you need help appealing a denial of your application? Start a live chat or call our Roswell office to schedule a free consultation with our experienced Social Security disability lawyers.