Frequently Asked Questions About Social Security Disability
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What is a cumulative medical 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 cumulative medical exam to help them make a decision on your claim. 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 Cumulative Medical Exam?
Whether the SSA will schedule a cumulative medical 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.
Who Performs a Cumulative Medical Exam?
Your treating physician can conduct a cumulative medical 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 Cumulative Medical Exam?
The purpose of your exam is not to treat you. It is to determine how serious your disability is.
The extent of your cumulative medical 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 Cumulative Medical Exam?
The SSA will pay for a cumulative medical 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 cumulative medical 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.
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.
Am I entitled to Medicare if I am getting SSDI benefits?
If you are approved for SSDI benefits, you also qualify for Medicare. However, you are not are eligible for Medicare right away. Here, you can learn how this complicated waiting period for benefits works.
How Long Is the Waiting Period for Medicare?
There is a two-year waiting period after the first month you are eligible for your monthly SSDI payments before you can receive Medicare. However, not everyone who applies for SSDI has to wait two years before being entitled to Medicare. Here is how the waiting period rules work:
- The two-year waiting period for Medicare starts running from the date you start receiving your monthly SSDI benefits. The date when you are eligible for SSDI payments is the date of your disability plus a five-month waiting period.
- If it takes you a long time to get your SSDI application approved, which is common, you may have already gone through much or all of the two-year waiting period for Medicare during the application and appeal process.
- Because the Social Security Administration (SSA) only pays 12 months of retroactive SSDI benefits, the earliest date that you can qualify for Medicare is one year after you apply for SSDI.
Exceptions to the Two-Year Waiting Period for Medicare Eligibility
Currently, there are two exceptions to the rule that you must wait two years before receiving Medicare. You may be entitled to Medicare immediately in these situations:
- End-stage renal disease with kidney failure. If you need ongoing dialysis or a kidney transplant due to end-stage renal disease, you can obtain Medicare coverage the third month after you begin dialysis.
- Amyotrophic lateral sclerosis (ALS). You are eligible for Medicare as soon as you are eligible for SSDI if you suffer from ALS.
Do you need help figuring out when you qualify for Medicare? Are you filing your SSDI application? Call our Roswell office or start a live chat to schedule your free consultation today with our experienced Social Security disability legal team to get your questions answered and learn how we can help you.
How much does it cost to hire a Social Security disability attorney?
When you are applying for Social Security Disability Insurance (SSDI) benefits, you are more likely to get your application approved by the Social Security Administration (SSA) if you are represented by an attorney. However, you may be concerned that you cannot afford to pay a lawyer when you are not working because of your disabilities. Here’s why you do not need to be worried about this.
How Lawyers Charge Their Fees in Social Security Cases
Social Security disability attorneys charge their attorney fees on a contingency fee basis. Under this type of agreement, you would not owe any up-front attorney fees. Here’s how payment of the fees works:
- You would only owe attorney fees if you win your case. If you do not receive SSDI benefits, you would owe no attorney fees.
- Your lawyer cannot charge you more than 25% of your back pay or $6,000, whichever is less.
- Your attorney will be paid their attorney fees out of your back pay award before you receive your payment.
Retainer Agreements in SSDI Cases
Your lawyer must enter into a written retainer agreement with you, stating how much you will be charged. They must also file a petition with the SSA to obtain approval of the fee agreement. Once the SSA approves it, they will pay the attorney fees directly out of the backpay award.
How Costs Are Charged in Social Security Disability Insurance Cases
In addition to the attorney fees you will owe, you must also pay the costs associated with your case. These costs can include copying costs for your medical records and reports from your physicians.
Some lawyers will require you to pay these extra costs as they are incurred while others will pay them and get reimbursed when they are paid their attorney fees. Your retainer agreement should spell out how you must pay these costs.
Experience Matters When Selecting Your Attorney
While the attorney fees you will owe is a consideration when hiring a lawyer, it should not be the only factor you consider. You need an experienced Social Security disability lawyer who has a track record of success if you want to win your case.
Are you applying for SSDI benefits? Do you need to file an appeal? Call our Roswell office to schedule a free consultation to learn how we can help you.
What should I do to prepare for my Social Security disability hearing?
If your application for Social Security Disability Insurance (SSDI) is denied by the Social Security Administration (SSA), you will need to file an appeal and attend a hearing. Providing a good testimony at your hearing will be crucial to getting your SSDI application approved. Here are five tips on how to prepare for it.
What You Will Testify to at Your Hearing
Understanding what you will need to testify about can help you as you prepare for your hearing. You will need to answer questions about the following:
- Your medical conditions that have caused you to become disabled and the symptoms you experience
- Limitations in your physical and mental conditions caused by your disability
- Your medical treatments and medications for your medical condition
- Your education and training
- Your work history
- Your day-to-day activities and how your disabilities have affected your ability to do them
Five Tips to Prepare for Your Hearing
Being prepared for your hearing is essential if you want to win your appeal. Here are five ways you can get ready for it:
- Review your file. You need to review your application, your medical records, and any correspondence with the SSA. This will help you to remember what you have told them about your disability and issues in your case that you will need to address at your hearing.
- Prepare a cheat sheet. You can bring documents to your hearing that will help you remember all the important details about your disability. Collect these documents, such as your application, medical records, and notes to yourself regarding common questions you can expect to be asked.
- Provide recent medical records. It is important that the administrative law judge has all your current medical records when deciding your case. Submit any up-to-date medical documents with the SSA before your hearing so that they are in your file and can be reviewed by the judge at your hearing.
- Obtain a written doctor’s statement. One crucial type of evidence you will need is your doctor’s statement about your medical condition and how it affects your ability to work. Even if you filed this statement when you applied for SSDI, you should obtain a more recent one from your physician once you receive the notice of your hearing from the SSA.
- Retain an attorney. The best way that you can ensure that you are fully prepared for your hearing is to retain an experienced Social Security disability lawyer. They can help you file your application correctly, provide the SSA with all the medical records and other evidence they need, prepare you for your hearing, and attend it with you.
Do you need assistance preparing for your Social Security disability hearing? Call our Roswell office to learn how our skilled Social Security disability legal team can help.
What should I do if my SSDI check is late?
If you are eligible for SSDI benefits, you will receive a monthly disability payment. The Social Security Administration (SSA) no longer mails out checks and instead will directly deposit your payment into your bank account. While payments are usually paid on time each month, on occasion, your payment could be late. Here’s what you need to do to report a late payment so you get paid.
When You Should Expect to Receive Your Check Every Month
When your initial application is approved, it could take a few months for you to receive your first payment, especially if you are also receiving back pay. The SSA sends out monthly payments on a schedule based on your date of birth. Here is their current schedule of payments:
- Your payment will be on the second Wednesday of the month if you were born on the 1st through the 10th.
- Your payment will be on the third Wednesday of the month if you were born on the 11th through the 20th.
- Your payment will be on the fourth Wednesday of the month if you were born on the 21st through the 31st.
There are exceptions to these rules. If you started receiving disability payments before 1997, you should receive your payment on the 3rd of the month. If your payment date falls on a holiday, your payment would be made the day before the holiday.
Why Your Payment Could Arrive Late
Your payment might be late for a number of reasons, such as:
- You changed your bank or had a change of address and did not notify the SSA.
- The bank account used by the SSA to make your payment changed.
- If the SSA office that is responsible for processing your payment has a slower process, it may take longer for you to receive your check.
What to Do If Your SSDI Payment Is Late
If you are worried that your payment was stolen, you should contact the SSA immediately. Otherwise, they request that you wait at least three business days after the date you should have received your check to contact your local office or call them at 1-800-772-1213 (TTY 1-800-325-0778) on Monday through Friday from 7:00 am to 7:00 pm.
You should receive your first payment within 90 days of being approved for benefits. If you do not get it within this time period, contact your Social Security disability lawyer if you have one or the SSA.
How does an applicant’s death affect a pending SSDI application?
It can take a few years for an application for Social Security Disability Insurance (SSDI) benefits to be approved by the Social Security Administration (SSA). Unfortunately, it is not uncommon for an applicant to die while his application is being considered by the SSA or he is going through the appeal process. However, this does not necessarily mean that he no longer has a right to disability benefits.
Who May Be Able to Pursue an Applicant’s SSDI Claim After His Death
An SSDI claim can be continued after an applicant’s death to collect the payments he should have received before his death. The SSA refers to this as “an underpayment.” Only certain family members are entitled to collect these benefits. Family members can pursue the applicant’s right to benefits in the following order of preference:
- Surviving spouse. A surviving spouse who was entitled to SSDI benefits or living with the applicant in the month of his death has the highest priority to collect the underpayment.
- Children. Children of the applicant who were entitled to SSDI benefits in the month of his death have second priority to collect the benefits he was entitled to.
- Parents. Parents who were entitled to SSDI benefits in the month of the applicant’s death can collect his benefits if he did not have a spouse or children.
If no family member qualified for the underpayment, the estate of the applicant may be able to recover the benefits.
When Do SSDI Payments Start and Stop?
There is a five-month waiting period after the date of the onset of the disability before an applicant would be entitled to SSDI benefits. The payment of SSDI benefits would not start until this time period expires in an underpayment case. The payments could continue until the date of the applicant’s death. In some cases, a spouse and dependent children may also be entitled to survivor benefits.
How to Proceed With a Family Member’s Application After His DeathIf your loved one died while his SSDI application was pending, you need to notify the SSA by filing his death certificate and other required SSA forms. An experienced Social Security disability lawyer can help you file the required legal documents and fight for the benefits your family member deserved. He can also advise you on your right to survivor benefits. To find out how we can help, start a live chat to schedule a free consultation today.
How are SSDI payments calculated?
When you apply for Social Security Disability Insurance (SSDI), one of your top concerns most likely is how much your monthly payment will be if you are eligible for benefits. You need this information so you can be certain that you have sufficient income to survive. However, how your monthly payment is determined is complicated.
How Your SSDI Payments Are Calculated
The severity of your disability will not affect the amount of SSDI benefits you receive. The Social Security Administration (SSA) will determine your payment based on your lifetime average earnings before you became disabled. Your benefit amount will be calculated using your covered earnings. These are your earnings at jobs where your employer took money out of your wages for Social Security or FICA.
Your SSDI monthly benefit will be based on your average covered earnings over a period of time, which is referred to as your average indexed monthly earnings (AIME). The SSA uses these amounts in a formula to determine your primary insurance amount (PIA). This is the basic amount used to establish your benefit.
SSDI payments range on average between $800 and $1,800 per month. The maximum benefit you could receive in 2020 is $3,011 per month. The SSA has an online benefits calculator that you can use to obtain an estimate of your monthly benefits.
Other Income That May Reduce Your SSDI Payment
If you receive other government benefits, your monthly SSDI benefit could be reduced. Sources of income that could affect your payment include:
- Worker’s compensation
- Public disability benefits
- Pension based on work not covered by Social Security, such as a government or foreign government pension
Can You Receive Retroactive Payments?
Once the SSA approves your SSDI application and calculates your monthly benefit, you may be entitled to a back pay award. How many months of payments you will receive will depend on the date you applied for benefits and your disability onset date.
If you are applying for SSDI benefits, you need the assistance of a skilled Social Security disability lawyer to get your application approved and receive the benefits you deserve. To schedule a free consultation with a member of our legal team, fill out the online form on this page or call our Roswell office today.
What is a trial work period for Social Security disability recipients?
If you are eligible for Social Security Disability Insurance (SSDI) and are receiving monthly benefits, you may want to try to go back to work if your medical condition improves. However, you may be afraid to do this because you do not want to lose your benefits. Fortunately, the Social Security Administration (SSA) allows you to return to work without jeopardizing them during a trial work period.
Your Right to a Trial Work Period
SSDI recipients are entitled to a nine-month trial work period without risking their SSDI benefits during a 60-month rolling period. There is no limit on the amount of income they can earn during the trial work period. The months that a person attempts to return to work do not have to be consecutive.
While an individual may make a conscious decision to try to work again under this program, this time period can also be triggered if he makes too much total monthly income. The amount that triggers the trial work period is set by the SSA and changes yearly. Here are monthly amounts that start a trial period:
- 2018: $850
- 2019: $890
- 2020: $910
If a person is self-employed, he will be considered in the trial work period if he works 80 hours or more in any month.
How Many Trial Work Periods Can You Have?
An individual is only entitled to one nine-month trial period during a five-year period. Once it is exhausted, a recipient is not entitled to a new trial period unless his SSDI benefits end and he either qualifies for SSDI benefits by filing a new application or through an expedited reinstatement.
What Is the Extended Period of Eligibility?
Once a recipient completes his trial work period, he enters into a 36-month Extended Period of Eligibility. During this time period, he can continue to receive SSDI benefits as long as he remains disabled and does not earn more than the Substantial Gainful Activity (SGA) amount set by the SSA every year. For non-blind individuals, the SGA is $1,220 in 2019 and $1,260 in 2020.
Do you have other questions about the trial work period or your eligibility for SSDI benefits? Call our Roswell office today to schedule your free consultation with our experienced Social Security disability lawyers to get the answers you need and to learn how we can assist you.