Workers pay into Social Security Disability Insurance (SSDI) when working. This provides benefits for when an individual becomes disabled and is unable to work. A number of medical conditions will qualify a disabled individual for monthly benefits. However, the application process can end up denying benefits for some disabled individuals. If you were denied SSDI benefits or had your benefits taken away, talk to an experienced Pennsylvania Social Security Disability lawyer for help.
Social Security Disability Claim Benefits
Social Security Disability (SSD) benefits, or SSDI, are based on your “covered earnings,” or the amount of income you paid Social Security taxes on before becoming disabled. Eligible individuals can check their Social Security Statement to see their benefits estimate. However, other benefits, including workers' compensation or state benefits, may reduce SSD benefit payments.
Do you qualify for SSDI?
There are a couple of requirements to qualify for SSDI benefits. In order to qualify, individuals have to:
- Work long enough and recently enough to qualify for benefits, and
- Be considered “disabled,” according to the Social Security Administration.
There may also be special situations for benefits for disabled children, wounded warriors, veterans, worker's surviving spouse, blind/low vision, and adults disabled before age 22.
Work Qualification for SSD
The work qualification requirement changes year to year by the Social Security Administration. Generally, an individual needs 40 credits to qualify for benefits, with 20 credits earned in the last 10 years before becoming disabled. However, the number of credits required can be lower, based on the age when the individual became disabled.
For example, if someone becomes disabled at age 23, they need to have earned 6 credits in the 3-year period before the disability began. Someone age 45 needs to have 23 total credits. At age 62 or older, an individual needs to have 40 work credits to qualify.
The amount needed for a work credit is based on total yearly wages (or self-employment income). Individuals can earn up to 4 credits per year. The amount needed for a credit changes each year. In 2019, individuals need to earn $1,360 for one credit and an individual would earn the maximum 4 credits after earning $5,440.
Disability Definition for SSDI
To be ‘disabled,” according to the SSA, your condition must limit your ability to do basic work for at least 12-months, including:
- Sitting, and
If your disability is caused by one of the listed medical conditions, then the SSA is supposed to consider you eligible to receive benefits. These medication conditions may include certain types of cancer, cerebral palsy, multiple sclerosis, cystic fibrosis, chronic heart failure, and chronic obstructive pulmonary disease (COPD).
If your disability is NOT one of the listed conditions, the SSA decides if your impairment prevents you from performing any of your past work, or if there is other work you could do, based on age, education, past work experience, and skills.
What To Do If Your Social Security Disability Claim Was Denied
If your Social Security Disability claim was denied, you have 60 days to file an appeal. If you do not file in time, you must show good cause for missing the deadline. There are four levels of appeals for an SSD claim:
- Administrative Law Judge Hearing
- Appeals Council Review
- Federal Court Review
Appealing Your Disability Case in Pennsylvania
The majority of initial disability claims are denied. If your claim is denied, you can request a reconsideration online, or by contacting your local Social Security office in person or by phone.
You can request a reconsideration for a medical determination and/or a non-medical determination. A reconsideration is a new review of your claim, looking at the evidence submitted for the initial claim and any new evidence submitted.
You should consider talking to an experienced SSDI attorney immediately after an initial denial. This will provide another chance at a full review of your claim and can avoid having to go through the longer process of an administrative hearing after a reconsideration is denied.
If your reconsideration was also denied, you generally have 60 days to file a hearing request before an Administrative Law Judge. It may take a long time (months) before the administrative law hearing.
The next level of appeal involves requesting an Appeals Council review. The Appeals Council may deny a request if the council believes the hearing decision was supported by Social Security laws and regulations.
If your request was denied by the Appeals Council or if the council does not review your case, the last step is filing a civil lawsuit in federal court.
At each level of review, it may be more difficult to reverse the decision to get your benefits. An experienced Northwest Pennsylvania SSD attorney will review your case, application, evidence, and claim denial. Your lawyer can identify possible problems with your claim and submit the necessary evidence to support your claim for approval.
Benefits of Using an Attorney for your SSD Case
There are a number of benefits to using an attorney for your SSD case. The SSDI application process can be complicated and any mistakes, errors, or accidental problems can be a reason for denial. An experienced attorney will do an in-depth review of your case to identify all the potential problems for why your claim could be denied.
Trying to handle your case by yourself can be overwhelming, with a lot of incorrect information online about how to get approved. It can also take a lot of time to appeal your case, which can mean going without benefits for months or longer. An attorney can efficiently handle your case and work to get your claim approved.
In most situations, your lawyer has a contingency fee agreement for SSDI cases. This means your lawyer will only get paid if you win your case. Contingency fee agreements for SSDI cases must also meet SSA fee agreement guidelines, which limits the amount of money your lawyer can be awarded.
Crawford County Social Security Disability Attorney
Crawford County attorney Jason Reagle at the Shafer Law Firm has been representing clients in Social Security Disability, personal injury, and workers' comp cases across Northwest Pennsylvania. Experienced. Proven. Contact Jason Reagle in Meadville or Titusville today for a free consultation.