At the Pennsylvania law firm of QuatriniRafferty, our staff handles several hundred Social Security cases per year. In the course of our representation, there are questions that repeatedly arise. Here are some questions that we hear most often:
What is the difference between SSD and SSI?
The Social Security Administration pays disability benefits under two programs. Social Security Disability (SSD) are benefits paid to disabled workers and their families. SSD benefits are determined by the work you’ve done and the money you’ve paid into the Social Security system. Your SSD benefits are calculated from your earnings.
Supplemental Security Income (SSI) are benefits paid to a disabled individual who qualifies financially due to a lack of resources and income and who has no significant work history.
How will Social Security decide if I am disabled?
- Your medical condition must have lasted, or be expected to last, at least one year, or be expected to result in your death.
- You must be unable to perform any type of work you did in the past 15 years before the onset of your disability.
- You must be unable to perform any other type of work on a full-time basis because of your medical condition.
Social Security has a very strict definition of disability.
How long does it take to get a decision?
It takes about four to five months to get an initial decision. Approximately 64 percent of the applications are denied. You can appeal that denial to an Administrative Law Judge. The overall process usually takes longer than a year from the time you file your application until the date of your hearing.
If I am already receiving another type of disability payment, can I automatically get Social Security benefits?
No. Social Security Disability laws differ from the rules governing most other programs. Entitlement to workers’ compensation benefits, short-term disability, long-term disability, or a private disability pension does not automatically entitle you to Social Security benefits.
My neighbor is getting benefits for a condition similar to mine; why can’t I?
Every case is different and is individually evaluated based on age, education, and work experience. You should not compare your case with another case.
Will I be entitled to health insurance if I am approved for benefits?
Under SSD, Medicare is available after you have received benefits for two years. At this time, there is virtually no prescription coverage available to SSD recipients.
Under SSI, Medicaid is available for those receiving at least $1 in monthly SSI benefits. Medicaid does include prescription coverage.
While my application for SSD benefits is pending, can I work?
There are many factors involved in this decision. Any work you do while filing for benefits will be examined closely by the Social Security Administration. Deciding whether work will adversely affect your case depends on the type of work you do, the hours of work, and your rate of pay.
After my application for SSD benefits is approved, can I continue to work?
Generally, if you work and earn more than $590 per month, you enter a trial work period. After the trial work period, if you earn more than $830 per month, your benefits will end.
Will I ever receive an increase in my Social Security benefits?
SSD and SSI benefits increase each year based on the cost of living increase (in 2005, this increase was 2.7 percent).
How much will it cost for you to handle my claim?
There is no fee for our services in your SSD or SSI case until we are successful in obtaining benefits for you. If we are successful, the Social Security Administration generally allows a fee of 25 percent of the past due benefits in your case, up to a specified maximum amount. Under some special circumstances, an hourly fee may instead be charged, but all fees must be approved by the Social Security Administration.
Can I receive both workers’ compensation and Social Security Disability?
Yes. In Pennsylvania, if you’re receiving workers’ compensation benefits, it may seem that filing for Social Security Disability benefits is unnecessary. Nothing could be further from the truth. For someone who may not work for at least a year, there are significant reasons to consider filing for Social Security Disability benefits, even before workers’ compensation benefits end.
Social Security Disability benefits are insurance benefits, so eligibility for receiving them has a time limit. Generally speaking, you must prove you are disabled within five years of ending your employment. For example, someone who is injured in 2010 and stops working for wages that year, must usually establish disability by some time in 2015. Waiting until the workers’ compensation claim is resolved in 2017 will make it more difficult to obtain the medical evidence and testimony necessary to establish disability before 2015. Therefore, if you expect to be out of work for more than a year due to your disability, consider filing for Social Security Disability benefits as soon as you stop working.
Another reason to apply for Social Security Disability benefits at that time is to protect your Social Security retirement benefits. Payroll taxes support the payment of Social Security Disability benefits, and payment of these taxes ends when you stop working. This means that if you leave the workforce before age 62, your retirement account will show a number of years of “zero” income. However, when you are declared disabled by the Social Security Administration, your retirement account is not affected by those years of zero income because your earnings record is “frozen” by your receipt of Social Security Disability benefits.
Additionally, if you are awarded Social Security Disability benefits, you become entitled to Medicare two years after you begin receiving those benefits. Even while receiving workers’ compensation payments, Medicare eligibility can provide access to valuable medical insurance and prescription benefits for nonwork-related conditions.
Finally, an award of Social Security Disability benefits can provide you with income protection if your workers’ compensation benefits are terminated. Also, an award of Social Security Disability benefits gives you the opportunity to resolve your workers’ compensation claim for a lump sum, knowing that you have another source of income.
Contrary to what you may have been told, it is a good idea to explore the possibility of filing for Social Security Disability benefits as soon as you leave the job market due to illness or injury.
If you are unable to work and believe that your disability may be long-term in nature, having an attorney to represent you through the process of filing for Social Security Disability does increase your chances for success. Contact QuatriniRafferty at our Greensburg offices today and let us help you get started.