Social Security Disability hearings are an important part of the disability claim process. Although many claims make it to the hearing stage, it is important to know what happens before the hearing and why so many cases are scheduled for a hearing.
What Happens in Order to Get to a Hearing?
When you apply for disability, the Social Security Administration (SSA) will review your medical records, your work history and information about your background. After reviewing this evidence, the SSA will make an initial decision either approving or denying you for disability. Typically, the only cases that are approved immediately are for people who have extremely severe medical conditions like terminal illnesses.
Because the vast majority of people filing for disability have their claims denied initially, an appeal is necessary to have a chance of being approved for disability benefits. Once a claim has been denied at the Initial stage, you will need to appeal and request Reconsideration of your evidence. At the Reconsideration stage, the SSA will conduct the same review as was done in the Initial stage but the file will be reviewed by a different Disability Examiner.
The Disability Examiners have the same procedures for reviewing disability claims and therefore, people who are denied at the Initial stage are likely to be denied at the Reconsideration stage. Appeals after Reconsideration go to the Hearing stage.
What’s Different About a Hearing?
At this stage, the claim is no longer reviewed by Disability Examiners; your claim is presented to an Administrative Law Judge (ALJ).
Appealing to the ALJ Hearing stage is generally the best place to fully present your disability claim. Statistically, you are more likely to be successful at the hearing than at the Initial and Reconsideration stages. You are also more likely to be successful at the hearing than at the Appeals Council and Federal District court, the two appeals stages after the hearing. To try to have a successful hearing, you’ll need to know what to expect and how to best prepare for the hearing.
Preparing for a Hearing
Once your hearing is scheduled, you’ll want to make sure that all of your medical records have been submitted to the SSA. For the judge to have a clear picture of your medical conditions and how they limit you, the judge will need to have all of your evidence. If you would like to ensure that all records have been submitted and if you have any additional evidence, like witness statements or witnesses that would like to attend the hearing on your behalf, you should speak with your attorney to prepare for the hearing date. It is important to ensure that all evidence and statements are prepared because the hearing itself is informal and quick.
Not a Day in Court, an Hour in a Hearing Office
ALJ hearings are informal hearings and therefore, the hearing will not be a trial that occurs in a courtroom. Once you receive your Notice of Hearing from the SSA, you will notice that the ALJ hearing occurs in the SSA’s Office of Hearing Operations (OHO). The SSA has numerous OHO locations and your hearing will be scheduled at the OHO nearest to your home.
The hearing occurs in a hearing room with you, your attorney, any witnesses you have, the judge, a Vocational Expert (VE), and a court reporter. The judge and VE may attend the hearing in person, by webcam or telephone. ALJ hearings typically take less than an hour.
What Happens During the Hearing?
The hearing starts with a swearing in and documentation of everyone participating in the hearing. The judge generally begins the hearing by reading a brief statement about your claim and then begins asking you about your background, your work history and your medical conditions and how they limit you.
Some judges ask the bulk of the questions and then ask your attorney to follow-up and some judges prefer that your attorney do most of the questioning and then the judge follows up. After testimony is complete, the judge will want to question the VE.
The Role of the Vocational Expert
The VE attends the hearing to give the judge their expert opinion on jobs available in the national economy and what jobs a person is capable of doing, despite limitations. The VE’s opinion is important because the judge’s decision will reflect the VE’s opinion of the work available and what type of a work a person with limitations similar to yours can do.
If your attorney deems it necessary, he or she may question the VE about their opinion. Remember, the goal of the hearing is to show the judge that the limitations you have prevent you from performing your past work and any other work. The VE is supposed to be an impartial witness who responds to hypothetical questions from the judge about what work can be performed by individuals with specific limitations.
The Decision, and More Waiting
Once the VE gives his or her opinion, the judge may ask you and your witnesses if you have anything else to say. At that point, you can tell the judge about any other ways in which your background, your medical conditions or your limitations stop you from working. However, do not be concerned if the judge doesn’t ask if you have something to add. The judge may have enough evidence through medical records, doctors’ statements, your testimony, and the VE’s testimony to render a decision.
After your hearing is complete, the judge will start working on making a decision in your claim. You will not get a decision on your case that day. Usually, you can expect to get a written decision from the ALJ within one to two months.
Your Social Security Disability Claim May Be Denied – Don’t Go Through Hearing Stage Alone!
An experienced Social Security Disability attorney can help you prepare you and your case for your moment before the Administrative Law Judge. This is the stage where you’re most likely to be approved, so having an advisor and advocate on your side for the hearing makes sense. If you or someone you know is filing for SSD, or has filed and been denied, call the Law Offices of James Scott Farrin at 1-866-900-7078 for a free case evaluation, or simple contact us online.
Before deciding to apply for disability benefits, many people wonder how much the Social Security Administration (SSA) actually pays for disability. It is smart to start thinking about your potential disability benefits payment amount before filing a disability application, because the type of disability you apply for will have an impact on your monthly payment amount.
Supplemental Security Income vs Social Security Disability Income
Supplemental Security Income (SSI) is the disability program that provides payments to people who have low income, assets, and resources in their name and in their household. To be eligible to apply for SSI, the disability applicant has to show that they are financially eligible for the program before the SSA will determine if they are disabled.
Social Security Disability Insurance (SSDI) is the disability program that provides payments to people who have earned enough work credits and are still insured by those work credits. To be eligible to apply for SSDI, the SSA will review your work history and the income taxes that you’ve paid in to determine your insured status before determining if you are disabled.
Not everyone is eligible for both SSI and SSDI, but it is possible to be eligible for both. Therefore, you want to determine your eligibility before submitting your application. Filing the wrong disability claim can lead to you getting less money than you could have had if your claim is approved, as the SSI payment amount is a fixed amount, called the Federal Benefit Rate (FBR), and the SSDI payment amount is based on your past wages, which can lead to a monthly payment higher than the Federal Benefit Rate.
Make sure not to confuse SSI and SSDI with SSA’s Retirement Benefit. SSI and SSDI are for people who are disabled before retirement age and if you are simply seeking to file for Retirement, you do not need to prove a disability or have an attorney. However, an experienced attorney could be a valuable asset in SSI and SSDI claims because you need to prove to the Social Security Administration that you are disabled and cannot work before you can be paid disability benefits.
It is also important to note that how much you may receive monthly is not based on how disabled you are like veteran’s disability through the VA. Once you are found to be disabled, your payment is based on the FBR, your past earnings and other benefits that you may be receiving.
Calculating SSI Benefits
Calculating your SSI benefit amount starts by looking at the FBR. The FBR is the maximum monthly payment amount that a disabled person can receive under SSI. The FBR changes annually as the SSA adjusts the amount to reflect cost of living increases and inflation. For 2020, the FBR is $783 for individuals that are eligible and $1,175 for eligible married couples. As stated, the FBR is the maximum payment from the SSA. However, there may be reductions in that payment amount or supplements to the payment amount, as discussed below.
Calculating your potential SSDI benefit amount starts by looking at your average lifetime earnings. There is no base rate for SSDI like there is for SSI. The SSA will utilize a formula to calculate your benefit amount that takes into account your covered earnings (earnings where you paid income taxes). Thankfully, you can get an estimate of your specific benefit amount on the SSA’s website by using one of their Social Security Calculators. For high earners, it is important to note that there is a maximum payment amount that also fluctuates annually. For 2020, the maximum monthly SSDI benefit amount is $3011 for an eligible individual. Like SSI, there can be reductions to the SSDI payment.
Other Factors that Affect Your Potential Payment
As discussed above, the SSI and SSDI benefits amounts start by looking at the FBR and average lifetime earnings respectively. From there, if you qualify, there can be reductions and supplements to that starting monthly payment amount. When calculating how much you will be paid monthly, the SSA will also look at things like other disability payments that you receive, if others provide you with financial support and which state you live in.
VA and Private Disability Insurance
One piece of good news is that VA disability and private disability insurance benefits, like a short-term or long-term disability policy, do not affect your SSDI benefits. The short-term or long-term disability insurer may seek reimbursement for payouts during the time that you also received disability from the SSA, but the SSA will not reduce your SSDI payment if you received short-term or long-term disability. However, those non-SSA benefits may affect your SSI payments if they are high enough to make you financially ineligible for SSI.
Workers’ Comp and State Disability
The bad news is that some benefits, like workers’ compensation and state disability benefits, do affect your monthly SSDI benefits and can reduce your monthly payment amount. If you receive workers’ compensation for a work-related condition or state or federal employee disability compensation, the SSA can reduce your monthly SSDI payment to ensure that the combination of all the benefits does not exceed 80% of your average earnings before you became disabled.
Long story short, the SSA will prevent you from making a profit off of being disabled. If you receive workers’ compensation and/or state or federal employee disability benefits, it is a good idea to contact the SSA to determine your average earnings to see if your benefits will exceed the 80% threshold. As with other benefits, workers compensation and state or federal employee disability benefits can make you financially ineligible for SSI. If you would like to read more about how Workers’ Compensation or State Disability Benefits impacts your Disability payment, the SSA has a publication available here.
When Kindness Is Income: Support From Loved Ones
For SSI benefits, the SSA can also reduce your monthly benefit amount if someone else is providing for you. For example, if a friend or family member buys your food or pays your rent, the SSA will consider that to be income. The SSA calls this In-Kind Support and Maintenance (ISM). If there is ISM, the SSA will total the value of the ISM and reduce your SSI payment by the amount given to you.
Upward Adjustments and Increasing Your Potential Benefit Amount
Thankfully, there can be supplements or increases to the monthly payment amount. As stated above, some disability applicants are eligible for SSI and SSDI. If your averaged lifetime earnings calculation would lead to you having an SSDI payment below the FBR and you are otherwise financially eligible for SSI, you can receive SSDI and SSI once approved. The SSI would supplement the SSDI benefit amount to bring you up to the FBR of $783. Also, the vast majority of states provide a State Supplement for SSI benefits. The supplemental payment ranges from an extra $100 to $400 per month and depends on where you reside. The amount will be determined by factors like your residence and care needs; i.e. being a resident in a nursing home or permanent care facility.
If You Think You May Not Be Getting the Benefits You Deserve, Contact an Experienced Social Security Disability Attorney
The Social Security system is complicated, and there are many, many moving parts. How do you know you’re filing in the right order and how do you try to ensure you get the benefits you’re entitled to receive? Contact the Law Offices of James Scott Farrin for a free case evaluation at 866-900-7078. We’re here to assist you!
When applying for disability, it is important to know not only what the Social Security Administration (SSA) is looking for while deciding on a disability claim, but also what benefits you’ll receive if it is approved. If you have done your research or spoken with someone that has received disability, you have probably heard of the term “backpay,” but you might not know what it is exactly, or how you receive it.
Social Security Disability Backpay, Defined
In short, Social Security Disability backpay is a lump sum payment for the time period that you were eligible to receive disability payments but were waiting to be approved for disability benefits. Because it can take people years to get approved for disability benefits, many people receive backpay and some people can receive a significant amount.
Once you are approved for Disability benefits, the SSA will then determine the following for backpay:
When exactly you became disabled
When you were entitled to start receiving payment
How much your monthly benefit payment will be going forward, and
How much backpay or retroactive disability benefits you are owed
Generally, your backpay amount is a calculation of your monthly benefit amount and how many months you were entitled to a payment before you were approved for benefits. There are many exceptions where backpay can be reduced.
However, generally speaking, the SSA will multiply the monthly benefit amount by the number of months that you were entitled to a payment before being approved and then will pay that total amount as one lump sum once you’re approved.
Before applying, it is important to know that your monthly benefit amount and how much backpay you may receive will be dependent on which disability program you apply under and the onset date of your disability, as determined by SSA.
For Social Security Disability Insurance (SSDI) Disability and Supplemental Security Income (SSI) Disability applicants, the SSA may grant backpay benefits back to the month after you applied for disability. SSA issues a backpay payment to compensate you for the time that you were disabled and eligible for payment but had to go through the SSA’s application process to get approved. It is important to note that although it is possible to receive backpay for the time that your claim was being processed, receiving backpay is not guaranteed. Additionally, if backpay is granted, the duration of time for which you will receive backpay and the amount of backpay are determined by the SSA.
SSDI and SSI Application Process: When Backpay Starts
When you submit your application for disability, you will tell the SSA that date that you believe you became disabled. This is called your Alleged Onset Date (AOD). After the SSA reviews your claim and finds you to be disabled, they will give you an Established Onset Date (EOD). The EOD is the day that the SSA has determined that you became disabled.
For SSI applicants, the earliest possible EOD that SSA will give is the day that you applied for SSI. This is why SSI backpay does not go back farther than the month after you applied for SSI.
For SSDI applicants, your EOD can be much earlier than the date of the application. For SSDI applicants with an earlier EOD, it is possible to get retroactive disability payments.
Disability Backpay vs. Retroactive Disability Payments
It is important to avoid confusing disability backpay and retroactive disability payments.
For SSDI applicants, it is possible to receive backpay for the period that you were waiting to get approved and retroactive disability payments for some of the time that you were disabled before you applied.
Retroactive disability benefits are paid for the time period after your EOD, after your entitlement date, but before you applied for SSDI. Retroactive disability benefits can be paid for up to twelve months (one year) prior to the submission of the SSDI application. To determine the amount of retroactive disability benefits, the SSA will set the EOD and the date of entitlement.
The date of entitlement is the date that someone approved under SSDI became entitled to monthly disability payments. This date is different from the EOD because under the SSDI payment rules, there is a mandatory five-month waiting period after the EOD before someone disabled under SSDI can start getting payments.
Whether you’re receiving backpay only or backpay and retroactive disability benefits, once the amount of benefits are calculated, you will receive the lump sum payment within two months of being approved for disability benefits.
Contact a North Carolina Social Security Disability Lawyer
Remember, backpay is not guaranteed and you can be approved for disability payments going forward without receiving an award for backpay or retroactive disability benefits. You should contact an attorney if you would like to know if you can receive backpay or retroactive disability benefits before you apply for SSI or SSDI. Please call our legal team at 1-866-900-7078 or contact us here if you have any questions.
Many people with serious medical conditions find themselves wondering, “What does it take for me to get approved for disability benefits?” Unfortunately, there is no quick answer. When the Social Security Administration (SSA) reviews disability claims, they look at many factors of the claim before making a decision.
The SSA will look at your age, your education level, your prior work history, your medical conditions and how your medical conditions affect you. Once they view the full picture, the SSA will make a determination as to whether they think your medical conditions stop you from working.
Because the SSA will look at factors other than your medical condition when determining if you are disabled, there is no exhaustive list of medical conditions that SSA considers disabling. However, there are some conditions that the SSA recognizes as severe. The disability claims containing those recognized severe conditions may receive special consideration while the disability claim is being processed.
The (Non-Comprehensive) Listing of Impairments and How It’s Used
The SSA does have a Listing of Impairments, also called the Blue Book, which contains a list of severe medical conditions that can be considered disabling and can qualify someone for disability. The Listing of Impairments establishes the criteria that need to be met for someone to qualify under the listing. Because the listing is utilized to quickly identify disabling conditions, the criteria can be extensive and hard to meet. To assess the strength of your claim compared to a listed condition, you can look to see if your condition matches the listing.
If your medical condition is included in the Listing of Impairments, you will want to carefully review the specific medical listing and the criteria to see what medical evidence the SSA will need to determine that your condition matches, or “meets” the medical listing. The criteria can be anything from lab results, procedures done by your medical team, the duration of time that you’ve had the condition and how the condition affects you day-to-day.
If you are not sure if you meet the listing, you can ask your medical provider to review it with you to see if all the criteria have been met. If you do not meet all of the criteria, you may be able to get approved if the SSA believes that your condition “equals” the listing.
Equal Versus Meet on the List of Impairments
Meeting the listing criteria means you have all of the evidence you need to prove you have the listed impairment. Equaling the listing means you may not have all of the evidence the criteria require, but are functionally the same.
Arguing that you equal the listing, or have medical equivalence, means that your medical condition has the same severity level of the listing criteria even if it does not meet the exact listing criteria. The SSA understands that the criteria are rigid and that someone may have the same condition at the same severity level but not check all the boxes. To evaluate your condition, the SSA may have a medical provider examine you to see if your conditions are severe enough to be equivalent to the medical listing.
Reviewing the List of Impairments and the Compassionate Allowances
Take a few minutes to review the Listing of Impairments on the SSA’s website. The medical conditions will be separated by type of illness. For example, if you have Asthma, you will want to look at Listing 3.00 for Respiratory Conditions or if you had a Stroke you will want to look at Listing 11.00 for Neurological Conditions.
Separate from the Listing of Impairments is a shorter, more specific list of conditions that the SSA has developed to easily identify conditions that are considered to be automatically disabling. The Compassionate Allowances list is a list of extremely severe conditions that are clearly disabling, and therefore require less evidence to process the claim.
A lot of terminal illnesses and cancers are on the Compassionate Allowances list. These conditions qualify for expedited claims where people can be approved for disability within a couple weeks. If you would like to see if your medical condition qualifies for a faster, Compassionate Allowance claim, you can view the Compassionate Allowances list here: https://www.ssa.gov/compassionateallowances/conditions.htm
Make Your Claim, and Speak to an Experienced Social Security Disability Attorney if You Have Questions
Remember that the SSA will look at your entire application when deciding on your disability claim. So if you do not meet or equal a Listing condition or qualify for a compassionate allowances claim, you can still be approved for disability.
The process can be confusing, and claims are often denied. Don’t be discouraged. Contact an experienced Social Security Disability attorney at the Law Offices of James Scott Farrin for a free case evaluation at 1-866-900-7078 or contact us online. We have a NC State Bar Board Certified Specialist in Social Security Disability Law and several people with experience working in the Social Security system. We’ll listen to you, review your information, and help you understand what to do next.
El COVID-19 ha forzado a gran parte del mundo a cambiar la manera en la que conduce sus negocios, y la Administración del Seguro Social (SSA por sus siglas en inglés) no es diferente. Para la mayoría de las personas que ya reciben beneficios, no habrá cambios a lo usual. Para aquellos que están solicitando beneficios del SSA, hay cambios importantes al proceso.
Las Oficinas del SSA están cerradas
A partir del martes 17 de marzo la Administración del Seguro Social cerró al público todas sus oficinas locales. Muchas están operando con personal mínimo para continuar procesando solicitudes, apelaciones y pagos. La única diferencia que los reclamantes pueden notar es que asuntos que anteriormente se realizaban en persona ahora tendrán que hacerse por teléfono o en línea. Por ejemplo, cuando se abra una reclamación, la SSA podrá enviar los documentos por correo en vez de solicitar firmas en persona.
Nota: Por favor consulte con su abogado/representante cuando reciba documentos por correo para asegurarse de que son auténticos. Pese a que no hay reportes de fraude, no se pierde nada con asegurarse que lo que usted está firmando y enviando es genuino y va al recipiente correcto.
La SSA tiene alguna de sus oficinas asistiendo otras áreas geográficas que han sido más afectadas por el COVID-19.
Los empleados del SSA están en lo que se llama una “Estación de Función Alterna,” lo que significa que se les han otorgado laptops y están trabajando remotamente o desde su casa, incluyendo los jueces.
La SSA espera que los reclamantes optaran por vistas telefónicas cuando sea posible, ya que esto ayudará a reducir la posibilidad de casos pendientes. A los abogados que representan reclamantes se les solicitó que les motivaran a aceptar vistas telefónicas, pero la decisión final queda en el reclamante.
UN APARTE: La SSA tiene una política de no llamar a las personas sin avisar. Por favor sepa, que si usted tiene una reclamación por incapacidad, nueva o pendiente, no es inusual que usted escuche de ellos. Esto no significa que usted debe bajar su guardia. La SSA tiene un protocolo de seguridad para asegurar que cuando usted les llame, o ellos le llamen a usted, ellos puedan verificar su identidad.
Por eso, usted debe saber que le harán al menos dos o más preguntas (tal como el apellido de su mamá o su lugar de nacimiento). Anticipe que le hagan estas preguntas ya que es su política. Para su seguridad, la SSA ha publicado una hoja de datos sobre como realizan sus conferencias telefónicas.
La Agencia de Determinación de Incapacidad continúa operando
Una vez la SSA ha aceptado una reclamación o procesado una primera apelación, el caso es enviado a la Agencia de Determinación de Incapacidad (DDS por sus siglas en inglés) para tomar la determinación médica sobre si un reclamante está o no incapacitado bajo la Ley del Seguro Social.
Todas las oficinas de la DDS están cerradas hasta nuevo aviso.
Los casos en proceso continuarán recibiendo correspondencia o llamadas telefónicas relacionadas con su caso si se encuentra en el nivel inicial o el nivel de solicitud de reconsideración. Usted puede recibir llamadas telefónicas del Examinador de Incapacidad sobre su caso. Nuevamente, si usted tiene un caso pendiente, no le debe sorprender que reciba una llamada sobre su discapacidad, historial de trabajo, o actividades del diario vivir.
Los casos continúan yendo a Vistas
La Oficina de Operación de Vistas maneja los casos al nivel de Vistas. Los Jueces y su personal continúan evaluando casos y exbibits en evidencia.
Por ahora, las vistas se llevaran a cabo por teléfono.
Los jueces administrativos estarán celebrando vistas desde sus casas a partir del 30 de marzo usando equipo telefónico y de grabación especial. Aquellos reclamantes que decidan aceptar las vistas telefónicas deben anticipar que dichas vistas se celebren en las fechas originalmente calendarizadas.
Los reclamantes no tienen que esperar a ser llamados si su vista está programada por teléfono, usted puede llamar a la oficina de vistas a la hora programada para la misma o puede esperar a ser llamado. Espere que las líneas telefónicas estén ocupadas.
Los jueces no están obligados a obviar la regla de presentar evidencia en 5 días, pero se les ha solicitado que sean comprensivos de la situación. (Los reglamentos requieren que los reclamantes o sus representantes presenten evidencia al juez 5 días laborables antes de la vista).
Nosotros continuamos abiertos, y continuamos trabajando en los casos de Seguro Social de nuestros clientes
Las Oficinas Legales de James Scott Farrin continúa operando durante la crisis del COVID-19, a pesar de que nuestros métodos han cambiado. Nuestras oficinas están abiertas, solo para citas, y mucho de nuestro personal se encuentra trabajando de forma remota para seguir las recomendaciones apropiadas para el distanciamiento social, para el beneficio de la comunidad en general.
Si usted entiende que tiene derecho a los beneficios del Seguro Social o Incapacidad, llame al 1-800-968-5342 inmediatamente, 24-horas al día, para una evaluación gratuita. Aquí estamos para usted y listos para luchar por sus derechos.
El Sr. Fleming se unió a Las Oficinas Legales del James Scott Farrin en el 2002. Se convirtió en accionista en la Firma en el 2008 y actualmente lidera el Departamento de Seguro Social. Está admitido a practicar ante el Tribunal Supremo de los Estados Unidos.
The COVID-19 crisis has forced much of the world to change how it conducts business, and the Social Security Administration (SSA) is no different. For the majority of people already receiving benefits, there will be no changes to life as usual. For those who are seeking benefits from SSA, there are important changes to the process.
SSA Offices are Closed
As of Tuesday March 17th the Social Security Administration (SSA) closed all of its local offices to the public. Many are running on a skeleton crew to continue to process applications, appeals, and payments. The only difference claimants may experience is that anything they might have normally done in person will now need to be done by telephone or online. For example, when a claim is opened, SSA may mail documents to sign rather than ask for in-person signing.
NOTE: Please consult with your attorney/representative when you receive documents by mail to ensure they are authentic. While there are no current reports of fraud, it does not hurt to be certain that what you are signing and returning is genuine and going to the correct recipient.
The SSA has some of its offices assisting with other geographic areas that have been most affected by COVID-19.
SSA employees are in what’s called “Alternative Duty Station,” which essentially means they have been issued laptops and are working remotely or from home, even judges.
The SSA is hoping that claimants will opt for telephone hearings when possible, as it will help reduce the possibility of a backlog of cases. Attorneys representing claimants were asked to encourage them to accept telephone hearings, but the decision ultimately rests with the claimant.
SSA has a policy of not calling people by telephone out of the blue. Please know that, if you have a new or pending disability claim, it would not be unusual for you to hear from them. This does not mean, however, that you should let your guard down. SSA has a security protocol in place to ensure that when you call them, or when they call you, they can verify your identity.
Because of this, you should know that they will ask you at least two or more questions (such as your mother’s maiden name or where you were born). Expect them to ask these questions as it is their policy. For your safety, SSA has published a fact sheet about their telephone calls.
Once SSA has taken a claim or processed a first appeal, the case is then sent to Disability Determination Services (DDS) to make the medical determination if a claimant is or is not disabled under the Social Security Act.
All DDS offices are closed until further notice.
Those with cases in process will continue to receive mailings and telephone calls related to their case if it is at the initial level or the request for reconsideration level. You may receive telephone calls from the Disability Examiner about your case. Again, if you have a pending case you should not be surprised if you receive a call about your impairment(s), work history, or activities of daily living.
Cases Continue to Be Heard
The Office of Hearing Operations handles cases at the Hearing level. Judges and their staff are continuing to review cases and exhibit evidence.
For the foreseeable future, cases will be heard by phone.
Administrative Law Judges will be hearing cases from their homes as of March 30 using special telephone and recording equipment. Those claimants who decide to accept telephone hearings should expect those hearings to take place as originally scheduled.
Claimants do not have to wait to be called, if you are scheduled to have your hearing by telephone, you can call the hearing office at the scheduled time of your hearing or you can wait to be called. Expect the phone lines to be very busy.
Judges are not required to waive the 5-day rule requirement for submission of evidence, but have been asked to be understanding of the situation. (Regulations require claimants or their representatives to submit evidence to the judge five business days prior to the hearing.)
An experienced Social Security Disability attorney will be able to help you understand the rules and ensure your case is properly presented.
We Are Still Open, and Continue to Work Social Security Cases for Our Clients
The Law Offices of James Scott Farrin continue to operate through the COVID-19 crisis, though our methods have changed. Our offices are currently open by appointment only, and much of our staff is working remotely to follow appropriate social distancing recommendations for the health of the community as a whole.
If you believe you are entitled to Social Security and/or Disability benefits, call 1-866-900-7078 immediately, 24-hours a day, for a free case evaluation. We’re still here for you, and ready to fight for your rights!
Many Americans believe Social Security won’t exist for much longer, but honestly, that couldn’t be further from the truth.
This past June, TheNew York Times posted a doomsday report on the future of Social Security. It claimed that a slow-moving crisis is approaching for Social Security, and that unless an urgent political solution is reached in the near future, Social Security would be depleted within 15 years.
The story doubtlessly scared a lot of seniors, imminent retirees, and the 10 million-plus Americans currently collecting Social Security Disability benefits, but the article is highly misleading.
USA Today presented a more accurate outlook: it declared that the system was not facing insolvency. Even if Congress fails to address the issue, Social Security would still be able to pay about 80% of payable benefits, which is a lot more than what The New York Times claims is looming ahead.
The Social Security Trust Fund has been built up over multiple decades, and it’s not going to just disappear. If Congress doesn’t take action, benefits could potentially be reduced — which is why the Social Security 2100 Act has been proposed. The Act aims to help ensure that Social Security benefits continue to be available to those who need them.
Social Security 2100 Act
Introduced by John B. Larson, Democratic U.S. Representative for Connecticut, in January 2019, the Social Security 2100 Act seeks to increase Social Security solvency over the next 75 years. It includes the following proposals:
Those who are currently receiving benefits will receive a raise equivalent to 2% of the average benefit.
The formula used to calculate yearly cost-of-living adjustments will be based on the Consumer Price Index for the Elderly.
Minimum benefits would be set at 25% above the poverty line.
The limit for non-Social Security income (before benefits start being taxed) would be $50,000 for individuals and $100,000 for couples. (The current thresholds are $25,000 and $32,000.)
How Could This Affect You?
To pay for these changes, payroll taxes will be raised on wages over $400,000. At present, wages up to $132,900 are taxed. Payroll contributions from workers and employers would gradually increase from 6.2% to 7.4% between 2020 and 2043. This increase will only cost the average American worker an estimated 50 cents more per week each year.
Coincidentally, the Social Security 2100 Act was introduced on January 30, which also happens to be the birthdate of President Franklin D. Roosevelt, who signed the Social Security Act of 1935 into law. He described the legislation as the cornerstone of a structure that is a work in progress, and for decades afterward, policymakers have carefully built on it. This new piece of legislation, if passed, can preserve the former President’s vision and ensure that all retirees or disability claimants continue to live with their dignity intact for decades to come.
Do You Need to Apply for SSD Benefits?
The Law Offices of James Scott Farrin has helped thousands of clients fight for the Social Security Disability benefits they need to meet their healthcare and living expenses.1Attorney Rick Fleming is a North Carolina Board-Certified Specialist in Social Security Disability law and a tireless advocate for injured and disabled North Carolinians. With a strong record of successful SSDI and SSI claims and appeals,1 Rick and the SSD team are ready to help you. For a free initial case evaluation, please call 1-866-900-7078 today.
Over the 15 years I have worked in Social Security Disability for the Law Offices of James Scott Farrin I have heard my share of false assumptions when it comes to applying for and being granted benefits through Social Security Disability. It helps when an applicant knows the right steps to the approval process.
Disability is a government-funded program that has strict guidelines. If there’s one thing I try to let our clients know, those working in Social Security Disability determination offices must be uncompromising. They have to be. They don’t work for the public, they work for the government. If your case doesn’t meet strict government guidelines, it won’t be approved.
How does the federal government define disability?
Disability, according to the government, is the unquestionableinability to perform work for at least 12 continuous months. It is important for clients understand that those 12 months must be ongoing or have already passed before someone applies. They also may qualify if it is highly likely that they will be expected to be unemployed for the next 12 months.
There must be a finding of a severe medical impairment.
The Social Security Disability Determination Services expects proof of impairment through medical records. Medical diagnosis and prognosis may be either physical or psychological and they are both covered under Social Security Disability. Clients are often concerned because they do not know what evidence they should use to prove they need Social Security Disability benefits.
Those suffering from disabilities are unable to participate in the kind of work they have done before, or any work in the national economy. When we ask clients if they have the ability to work in the national economy, it doesn’t just mean North Carolina, it means nationally, in all sectors of business in America. The reality is the job simply has to exist. It doesn’t necessarily have to be a job the applicant could actually get. The law wants to know if you have the ability to theoretically work if given the opportunity.
I get a lot of calls from prospective clients who are working and earning substantial wages yet wish to apply for disability benefits. Social Security Disability says that if you are able to work and earn a certain amount of money, then you are not disabled no matter what’s going on physically or psychologically.
Disability can be determined solely on annual income. In 2017, if you are able to earn $1,170 per month gross you are probably not disabled. Even with a physical or psychological impairment, working for that much money means you are likely not entitled to disability compensation.
Is there a difference in applying with an attorney vs. without one?
I would say yes.
It’s a complicated procedure that can be unclear to people because, let’s face it, we don’t grow up learning the Social Security Disability process. If someone has impairment, they may not comprehend all the things required in the application process or be in too much pain to even have the energy to put together a strong case.
They may miss items on the checklist and get something from Disability Determination Services (DDS) called a failure to cooperate denial. If an applicant receives one of these, they did not do all the things they were supposed to do in the application and may need to start over from scratch. That’s nothing to be ashamed of when you’re going through something of this magnitude, and you shouldn’t be penalized for it. This is can be an overwhelming situation to handle. A lot of times it helps to have someone else in your corner who’s making sure your i’s are dotted and t’s are crossed.
Our duty is to be a strong and knowledgeable advocate for you.
Do a client’s assets and resources have an impact on the outcome of the case?
There’s a complex answer there, but I’ll try to explain it simply.
There are two kinds of disability. Title II Disability, or regular Social Security Disability, is something you pay into through payroll taxes. When you look at your check you will see either a FICA or Old Age Survivor’s Disability Insurance (OASDI for short) deduction. Both the employer and the employee pay into this type of Social Security benefits.
If you have a Title II case, then what you own or have does not matter as long as you are applying for a benefit for which you’ve contributed throughout your working life. It’s like making a claim on your medical insurance or car insurance or homeowners insurance – you’ve paid the premium, and now you’re making a claim.
However, applicants under Title XVI (16) or SSI (Supplemental Security Income) are in a hardship or poverty program. This program is for people who have not worked enough or recently enough to qualify for Social Security Disability or Title II, and are poor enough to qualify due to a lack of assets or resources. Under Title XVI you cannot have more than $2000 in assets or other resources as a single citizen, and married couples must have less than $3000 in assets or other resources to qualify. As a side note for people married to a working spouse, you are reviewed with the income of your household. Assets of one spouse are legally deemed available to the other spouse. Married couples with two vehicles and anything worth more than $3000 exceed the asset quota, automatically receiving a technical denial.
We often get calls from parents or guardians who stay at home to take care of children or family members. If they’ve stayed at home long enough that they are no longer insured for Title II, their only option is SSI. If that is your situation, contact us at 1-866-900-7078 and have an experienced Social Security Disability attorney review your situation for free.
What determines the amount of money the client could potentially receive? Do disability benefits correlate to their last salary and benefit arrangement?
Social Security Disability benefits are based on work history. So if you are someone who made minimum wage, your benefit (if you qualify) will be lower than someone who earned six figures. Benefits also depend on how long you paid in to the system. Someone found disabled at age 26 after beginning to work at age 16 has only 10 years of contribution, whereas someone who has worked 30 to 45 years with high earnings is likely to have more money coming their way from Social Security Disability. That being said, Social Security benefits are modest and average only $15,329 a year for disabled workers.
When a client hires an attorney, does that speed up the claims process and potentially increase chances for approval?
It does not result in an automatic approval. Although, because we know what documentation and evidence to present and how to make sure it is completed properly and meet deadlines, it may potentially help get to an approval.
It may also hasten the process, in that we do everything we can to try to ensure nothing falls through the cracks. There should be open communication between the Social Security Administration, and the attorney representing the applicant or claimant. This networking and experience makes us confident in our ability to potentially win cases. We do our best to try to make sure things will not be forgotten, and therefore the process should go smoother and run more efficiently in most cases. Also, as an attorney I’m expected to frame the issues and use the correct kind of medical evidence that tries to build an unquestionable case of disability.
On our website readers can learn more about Social Security Disability wait times.
Do attorneys make the decisions regarding who is and is not disabled?
No. At the initial reconsideration level, the case goes to a place called Disability Determination Services and the case is assigned to a disability examiner, and either physical or psychological doctors, depending on the variables of the case. It’s that team at Disability Determination Services that makes the decision on the first and second level of appeals.
If the person is denied at both those levels, the case goes to the hearing level.
The hearing is where an administrative law judge (ALJ) holds a hearing that may include expert witnesses and is responsible for reviewing the applicant’s case and previous reasons for denial. After the hearing level, if the judge’s decision coincides with the lower determination and denies benefits, an applicant may seek to have their case sent to the appeals council where Administrative Appeals Judges (AAJs) make the determination. Here, it will again be decided if the case should be approved, denied, or remanded for a new hearing.
If you do not have success at this level, you can file a civil action in the United States District Court, where an Article III judge will make the decision. Afterward, those denied may apply to the circuit court, which for North Carolina residents is the Fourth Circuit Court of Appeals in Richmond, Virginia. If you’re not successful there, you can attempt an appeal to the U.S. Supreme Court in Washington, D.C.
When you are denied you, the applicant, or the attorney if you have one, have a duty to file an appeal within 60 days.
How long does each process take?
Wait times vary considerably depending on the level of your filing.
At the reconsideration level it’s going to be about six months for a decision.
At the hearing level it’s going to be about two years. At the district court level, it’s probably about one year, and the circuit court level it could be one to two years. The Supreme Court could have multiple factors determining the timing of decisions.
Some people are of the opinion that attorneys hold up cases to get more money. Is this true?
Of course not.
The truth is the Social Security Administration has too few employees and hundreds of thousands of cases to process. At present the backlog of cases awaiting a hearing before an ALJ is over one million. While our paralegals have a history of knowing how to work effectively in most situations, sometimes there’s nothing we can do, and these backlogs cause the process to take time.
What people don’t realize is that stalling the system doesn’t bring us or the client any more money because the government caps our fees.
In Social Security Disability cases fees are capped at 25% of back-due benefits or $6,000, whichever is less.
So if we did delay cases, we would actually be billing more hours than the fee cap provides. So if you’re talking about a case that lasts six months vs. 36 months, at some point we are losing money because we have more time and money in than we can possibly get out. Believe me, we would rather win sooner than later.
Since all employees are obligated to pay into the system, are they entitled to receive back taxes as disability benefits?
They will be entitled to retirement income in the form of Social Security, once they reach retirement age, but there is no entitlement to disability until you meet the strict requirements of disability under the Social Security Act. Think of it like health insurance or car insurance. Yes, you have paid for it, but they may deny it if your claim doesn’t meet the requirements.
Will applying for Social Security Disability assure payment?
No. Not one penny is received for disability until after you are seen as disabled under the law.
What are the keys you look for in a solid case, and what are the red flags.
Going back to some of the things we talked about before, there is a list I can use to initially screen an eligible candidate.
Are you working? Have you had a break in employment already or do you have an impairment that is so severe, it is reasonable to assume you will be out of work for at least 12 continuous months?
Does what you allege as a prospect, make sense medically? If you allege for example that you are blind, but you say you can drive to our office to meet with me to discuss the case, I’m going to know you cannot be found to be blind if you offered to drive to my office.
Do you have medical evidence? Social Security Disability is grounded in medical evidence and you, the claimant, have the burden of proof – you must provide medical evidence to support your case. If you have never been to a doctor in your entire life, then there is no medical evidence to support your allegations of a severe medical impairment. No proof, no disability.
Do factors like a history of drug use or criminal charges factor into receiving Social Security Disability?
This is a great question because it all depends on the perspective or reason for the disability claim.
If a client says, “I am disabled because I see and hear things,” and you see in their records they’ve tested positive for LSD then there is a problem. LSD causes one to see and hear things, thus drug use would be a factor to their disability and they could be barred from receiving any sort of benefits.
The flipside is if someone has a diagnosis of bipolar 1. Any psychiatrist is probably going to tell you that part of being bipolar is having some sort of a lack of impulse control, leading to some proclivity to drugs or alcohol use. So in that case it is different. It may be that it’s not the drug or alcohol causing them to be bipolar. Rather, substance abuse is a symptom of the bipolar disorder. One does not cause the other; this is to say that if the person stopped using drugs or alcohol they would not stop being bipolar.
Now criminal behavior is simple. If the injury was caused while in the process of a crime, they cannot receive any benefits. Let’s say, for example, during the course of a bank robbery the bank robber fell and broke both legs and tore the ACL in each knee. In this case the bank robber cannot claim disability for these impairments because it happened during the commission of a felony.
However, if their disabling impairment has nothing to do with the commission of a crime then they could potentially receive Social Security Disability benefits.
What is the cut-off age for receiving Social Security Disability?
For most of the population right now this means after 66+ years, the only benefit you can receive is retirement and not disability. If someone is working up until 70 and wishes to file for disability they can’t.
If a client dies from terminal illness, can their family assume the pending claim?
What we can do is file a special claim for the ill client. A claim marked TERI (terminal) which expedites the case to receive a quick decision. Assuming the case is approved, the disabled person would collect benefits until they passed. Then benefits would end. But if this client is a parent of minors, their children would be considered survivors of the deceased. This scenario brings Old Age Survivors Insurance in to play. When the client passes, their children are to receive benefits as a survivor under their parent’s social security number until their 18th birthday.
Another scenario is when a person dies while their case is pending. In some situations we can substitute in a proper party (a surviving spouse, parent, or child) and allow the case to proceed to a decision. Any benefit won would be for the time period prior to the death of the deceased claimant.
What would you say to those who say, “I know I’ll get some sort of compensation because my friend or relative got it for the same situation”?
We hear that a lot and it’s often that these people don’t know the specifics of their friend’s case. If for example the person has a low IQ, or met a certain listing, or if there is some fact that they don’t know about their neighbor, then they are comparing apples and oranges.
Are there any patterns you see in people who get accepted or denied?
No. Just that they meet the requirements of the statute. The most important thing is to have consistent medical evidence and support of doctors.
For people who have to take medicine for diabetes, thyroid, or other illness, is there a way they could be declared disabled?
No. Taking a lot of expensive medications is only part of the analysis. In and of itself it is not conclusive evidence of disability.
When people say their condition has caused their doctor to restrict them from driving, does this mean they are disabled?
No. You can take public transportation, catch a ride with a friend, or call Uber. Whether you can drive or not is irrelevant. As long as there is a job that exists that you could reasonably do you are not disabled Under the Social Security Act.
If people are working to put food on the table, but they feel like they are disabled, are they?
Not according to the government. People who think they should receive disability because they are only working to pay rent or to feed themselves or family are missing the point of disability.
It doesn’t matter why you are working, it only matters that you are working.
That’s where the analysis stops for a perspective client. The government does not care why you are working. This is probably the most common conversation we have, and it is sad. We understand these situations – we see them all the time. Essentially, the analysis ends there and they cannot apply. Get more information on working and applying for Social Security Disability benefits.
Before people contact us about a case what should they think about first?
I would tell them to ask themselves if they meet the conditions under the definition of disability.
If you can drag yourself to work two more days, six more months, five more years, or as long as you can, do it! You’ll probably get more money working than you will from Social Security Disability. The benefits are modest at best.
Do you have documented proof of your condition?
You need to have strong medical proof (documentation) of your disability and meet the guidelines set forth by the Social Security Administration. If you can provide evidence that you fall under the legal definition, you should expect proper compensation, and you have the right to!
What should people do if they want a case evaluation?
If you’ve become disabled, don’t be afraid to file for Social Security Disability benefits. It’s your right. Just as importantly, don’t think you will necessarily receive these benefits without a strong case that is backed with thorough medical evidence.
We offer FREE case evaluations and we are available 24/7. Our experienced lawyers and paralegals respond to the call of many clients statewide that have trouble dealing with their disability. Contact us online or call 1-866-900-7078 for a free evaluation of your Social Security Disability case.
P.S. Don’t feel like you can’t afford to hire Social Security Disability attorney. At the Law Offices of James Scott Farrin, we work on a contingency basis, so you don’t owe us an attorney’s fee if we don’t get you compensation for your claim.2
When you work, a portion of each paycheck goes into a federal insurance fund (FICA, which stands for Federal Insurance Contributions Act). This is a fund for SSDI. Just like medical insurance or car insurance, you hope you never have to use your SSDI. But if you’ve paid into it (which you are required to if you receive a paycheck) you will be covered for benefits if you become disabled and the Social Security Administration determines that you are unable to work.
Spotty Work History?
What if you were working but you stopped temporarily to raise your children through elementary school? Or what if you were laid off and subsequently unable to find a suitable job for several years? What if you’ve been out of work due to a work injury?
Whether you may get SSDI depends largely on the date you last worked.
The government considers this very important date as the last date you would potentially be eligible for SSDI. To determine whether you may be eligible you must pass a “recent work” test. There is only one question on this test, so you either pass or fail.
Have you worked five of the past 10 years (or in government jargon, 20 of the last 40 quarters?
If you become disabled after your date last insured (DLI) has passed, you cannot get SSDI benefits. It would be similar to getting in a car accident after you stopped paying for car insurance.
Here is an example of DLI. If you worked up until five years ago today, your DLI would be today’s date. If you worked up until two years ago, your DLI would be three years from now. If you haven’t worked for six years, your DLI passed one year ago and you are no longer eligible for SSDI unless you are found disabled before your DLI.
Show Me the Money
Occasionally we have seen instances in which someone assumed they were not eligible for SSDI. Yet upon closer inspection and reviewing their work and payment history, we discovered that a client’s employer failed to pay the employer and employee taxes and sought to correct the error. (Of course, payment is subject to IRS provisions on the ability to amend tax returns or file late.) While this doesn’t happen often, it serves as a reminder of how we have been able to help people uncover benefits they did not know were available to them.1
What if You Do Not Qualify for SSDI?
If you do not qualify for SSDI, you may be eligible for Supplemental Security Income or SSI benefits, provided you meet the extremely low income and asset requirements threshold.
SSI is for people who have never worked or haven’t worked enough to qualify for SSDI. You can only get SSI if your income and assets are extremely low.
For 2017, the federal benefit rate is $735 per month for individuals and $1,103 for couples (and this is subject to reductions). Some states supplement the federal amount. North Carolina is not one of them.
Think You Can’t Afford a Social Security Disability Lawyer?
Think again. Uncle Sam limits the contingency fees for all Social Security Disability lawyers to 25% of back-due benefits or $6,000, whichever is less.
Get a FREE Case Evaluation From N.C. Social Security Disability Lawyers
We know applying for Social Security Disability can be a confusing and lengthy process. (It can take nearly two years in N.C. just to get a judge to hear your case – 23 months in Charlotte, 22 in Greensboro, 20 months in Fayetteville, and 19 in Raleigh.)
We understand from firsthand experience what you are up against.
Nearly every person on our Social Security Disability team has worked inside the Social Security Administration.
We know how the system works, what they look for to accept a claim, the importance of filing the correct forms and meeting strict deadlines, and what medical records to present. And sometimes we know where to look for benefits you may not be aware of.
If you are considering applying for Social Security Disability, contact us as soon as possible or call 1-866-900-7078 for a free case evaluation about your unique situation. We’re available 24/7.
How many times have you heard from your children, “That’s not fair!” Too many to count? We can laugh it off when they’re young, and older brother gets to play football with the neighborhood kids while the little tykes are told to stay on the sidelines until they’re old enough to play.
But the reality is sometimes life is not fair. We see it every day fighting for our Social Security Disability clients. And it’s no laughing matter.
Many of our clients have been sidelined for life as they were going about their daily routines. One client was stopped in traffic on his way home from work and got rear-ended by a driver going above the speed limit. His injuries were so devastating he vomits three or four times a week. He has headaches so severe they wake him up several times a night, and he has photosensitivity to the point where he can no longer go outside and enjoy the sunshine.
Some of our clients have fought for our country and returned home physically or mentally unable to exercise their inalienable right to the pursuit of happiness – a right promised to all U.S. citizens in the Declaration of Independence. Sadly, these veterans are among the more than one million people on the Social Security Disability wait list whose delay in having their cases heard can be more than two years in many parts of the country!
Now that’s not fair!
Social Security Disability Wait Times in North Carolina
While Social Security Disability is available to help our citizens who have been sidelined by catastrophe, getting it can be very difficult for a number of reasons. One is the long wait time. According to the Social Security Administration, the wait times in North Carolina are currently:
Charlotte – 21 months
Fayetteville – 20 months
Greensboro – 21 months
Raleigh – 19 months
Some are forced to wait so long they have died before their hearing date because some are simply unable to pay for medication they need to live. We have seen this happen.
When they finally get a hearing many are denied benefits. More than two-thirds are denied the first time and 88% the second time. Of those who are accepted, it can take several more months in many cases to begin receiving payments and back benefits.
Sadly, some are denied because they attempted to navigate this overwhelmingly large bureaucratic aircraft carrier by themselves.
James Scott Farrin Social Security Disability Team of “Insiders”
These are the circumstances that motivate our Social Security Disability team to come to work every day. We know what you’re up against because most of us have worked on the other side.
This inside experience is helpful in knowing how the system works, including:
What they look for to accept a claim
The importance of filing the correct forms, filling them out correctly, and meeting demanding and unwavering deadlines
What medical records you need to produce – and which ones not to produce
Just the paperwork alone can be overwhelming for one person.
Not only can we help you complete it correctly, process it on time, and in the manner in which Social Security Disability requires, but we can also follow up in a timely manner and try to keep the process moving. We can also help you obtain your medical records so that when your case goes to hearing, we know we’ve tried to do everything possible to make sure your information will not be sent back because of a technicality, for example.
Of all the attorneys licensed in NC, fewer than 1% are board certified specialists in Social Security Disability law.3 I am one of them. I also chair the N.C. State Bar’s Social Security Disability Law Specialty Committee and I lead the committee charged with writing and grading examinations for attorneys who wish to specialize in Social Security Disability law.
Capped Fees for Social Security Disability Clients
Some people may mistakenly think they cannot afford us to help them through this daunting process. If you are one of them, you are mistaken! This is one area where the federal government is your friend. Not only do we work on a contingency basis, like all Social Security Disability lawyers, the federal government has capped legal fees in order to help keep costs low for you.2
The contingency fee for Social Security Disability clients is limited to 25% of back-due benefits, or $6,000, whichever is less.
NC Social Security Disability Lawyers Offer FREE Case Evaluation
If you need to apply for Social Security Disability benefits, or if you have applied and were denied, contact us online or call 1-866-900-7078 Our attorneys and team of former “insiders” will fight to try to improve your chances of getting the benefits you may deserve.
(We think that’s a fair offer.)
3Percentage from the NC State Bar as of December 2016