Social Security Disability Resources

Social Security Disability Insurance Benefits, (Title II), applies to individuals who have worked in recent years (usually five years out of the last ten years in most cases) who are disabled.  It does not matter whether the disabled individual is rich or poor.  Benefits are paid based upon a Social Security earning record (how much you have worked and earned in the past.)

Disabled Widow’s and Widower’s Benefits are paid to individuals who are at least 50 years of age and became disabled within a certain amount of time after the death of their spouse.  The deceased spouse must have worked enough under Social Security requirements to be insured.  It does not matter whether the disabled individual is rich or poor.  Benefits are paid based upon a Social Security earning record (how much the late spouse worked and earned.)

Disabled Adult Child Benefits go to the children of persons who are deceased or who are drawing Social Security disability or retirement benefits.  The child must have become disabled before age 22. It does not matter whether the disabled individual is rich or poor.  Benefits are paid based upon a Social Security earning record (how much the parent worked and earned.)

Supplemental Security Income (SSI or Title XVI) is paid to individuals who are poor and who are also disabled.  It does not matter for SSI whether the individual has worked in the past or not.  Effective January 2021, the SSI payment for an eligible individual is $794.00 per month and $1,191.00 per month for an eligible couple. This amount has increased over the years.  For example, in January 2014, the SSI payment for an eligible individual was $721.00 per month and $1082.00 per month for an eligible couple.

Supplemental Security Income for Children is paid to children under the age of 18 who meet the special eligibility rules for children that address functional limitations.  A family’s income is considered for this low income program.

COULD I BE ELIGIBLE?

Are you disabled?  Under the Social Security Act, “disability” means “inability to engage in any substantial gainful activity by reason 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.”

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SOCIAL SECURITY EMPLOYS A 5-STEP PROCESS TO DETERMINE ELIGIBILITY.

1. Are you employed?  If the answer is yes, is your employment substantial gainful activity (SGA)?  The SGA amount for 2021 is $1,310.00 ($2,190 if Blind) a month. Therefore, if you are making $1,310.00 a month ($2,190 if Blind), you are considered SGA and Social Security will find you not-disabled.

2. Do you have a severe impairment? Social Security will consider your impairment(s) severe if your impairment interferes with basic work related activity.  If they find your condition not “severe,” they will find you not disabled.

3. Do you have a “listed” impairment?  If your condition is on Social Security’s list and severe enough to meet the requirements of a listed impairment, you will be found disabled.  If your impairment is not on the list, Social Security will determine if your condition is equal to the severity of one of the listed impairments.  So, if Social Security finds that you meet, or equal, a listed impairment, you will be found disabled if you meet the requirements of that particular listing.

4. Can you do your prior work?  If Social Security decides you can perform your past work, they will find you are not disabled.  If Social Security decides that you cannot do work that you did during the past 15 years, then you go to the next step.

5. Can you perform other work?  If Social Security determines that there are a significant number of jobs in the local or national economy that you can do, then you will be found not disabled.  At this step, social security will consider your age, education, past work experience and whether you have skills that might transfer to other jobs.  If Social Security finds you can adjust to another type of work, they will find you not disabled.  If Social Security finds you cannot adjust to other work, you will be granted Social Security disability.

EXHAUSTING YOUR ADMINISTRATIVE REMEDIES

Climbing a Ladder – From the initial filing of the claim to the final resolution, you are more or less “climbing a ladder.” You can’t get to another level of the process until you have completed the current level.  This is called "exhausting your administrative remedies." You file your claim for disability benefits at your local Social Security Office. If you are applying for Title II benefits, you may also apply online. If you are denied, you Request Reconsideration. If you are denied at Reconsideration, you then may Request a Hearing.

How long does it take to get Social Security benefits? There is no clear cut answer. Each person has his or her unique set of medical facts. Some individuals with severe medical and/or mental conditions may have claims that are approved at the initial or reconsideration levels while others may have to pursue their Social Security claims to a hearing before an Administrative Law Judge.

Filing a claim – you can apply for Social Security disability benefits online at www.socialsecurity.gov or you can go to your local Social Security office and apply in person.  You can also call the Social Security office and make an appointment to either come into the office or arrange for a telephone interview. 

Initial Application – in most cases Social Security makes the first decision within about four to six months. Your claim will be assigned to a Disability Examiner (DE) at The Disability Determination Section (DDS) in Nashville, Tennessee. The DE will request your medical records from your medical providers and hospitals where you have been treated. This, of course, will take a considerable amount of time. Also, the DE may have to wait for recent medical procedures to take place before requesting the medical records. Often, the DE will send you out for a mental or physical consultative evaluation. After all records are received at DDS, the claim is evaluated by staff doctors.  Statistically, the odds are stacked against getting approved for disability at this level. In Tennessee, most of the claims are denied at the initial level. However, if you are approved, you will soon start receiving your benefits. If you are denied, you must appeal by Requesting Reconsideration. You have only 60 days from the date of the denial to appeal. Failure to appeal within the 60-day time frame will most likely mean that you have to start your claim over again.

Reconsideration – in most cases Social Security makes the reconsideration within about four to six months. Once again, your claim will be sent to Nashville and assigned to a DE at DDS. Your file will be developed as it was at the initial level. Statistically, the odds are still stacked against getting approved for disability at this level as well. In Tennessee, over 90% of the claims are denied at the Reconsideration level. However, if you are approved, you will soon start receiving your benefits. If you are denied, you must appeal by Requesting a Hearing. Again, you have only 60 days from the date of the denial to appeal and failure to appeal within the 60-day time frame could cause you to have to start your claim over again.

Hearing – after you complete forms to Request a Hearing, your file will be sent to the local Office of Hearing Operations (OHO). There are OHO offices in Knoxville, Kingsport, and Chattanooga. Which office your claim is sent to depends on where you live. You will receive notification within approximately six weeks that OHO has received your file.

Disability hearings are scheduled by OHO. There are thousands of people waiting to get their hearings scheduled. In the Knoxville area, the wait is approximately 12 months. 

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Whether you are thinking about filing a claim, or have already requested a hearing, we can assist you wherever you are in your claim for disability benefits. Call us today for a free consultation.

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