Social Security Disability Attorney Medford

There are two basic questions that must be answered to determine whether you can get monthly disability benefits. First, are you disabled according to the SSA Administration (SSA) rules? Second, are you eligible for one of the SSA programs?

FIRST QUESTION: ARE YOU DISABLED?

There is a five-step assessment SSA will use to determine whether you are disabled. This is also known as the “Sequential Evaluation.”

STEP ONE: Are You Performing Substantial Gainful Activity? To be found disabled under the SSA rules you cannot be earning, on average, more than $1,040 gross income per month. If your average monthly gross earnings are $1,040 or more, SSA will find that you are performing substantial gainful activity. There are special rules that apply for determining your gross income if you are self-employed. There are also separate earning allowances if you are legally blind.

STEP TWO: Do You Have a Condition(s) That SSA Will Consider Severe? If you are earning less than $1,040 gross income per month, SSA will then ask if you have a “severe” impairment. A severe impairment is one that significantly interferes with your basic work-related activities. If your impairment is severe you move to Step 3.

STEP THREE. Is your condition on the SSA “Listing of Impairments”? You have an opportunity to be found disabled at step three. If you are not earning $1,040 or more gross per month (Step 1) and your condition is severe (Step 2), you will be found disabled if your condition meets or equals the requirements of what is called a listing. A listing is a set of specific diagnostic criteria set forth by SSA for different medical conditions.

To view the listing for adults go to: www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

Even if your condition does not meet or equal a listing, you can still be found disabled. SSA will move to Step 4.

STEP FOUR. Can You Perform Your Past Relevant Work? SSA will determine whether your impairment(s) prevents you from doing what is called your “past relevant work.” Past relevant work is defined by SSA as the work you have done in the 15 years prior to you becoming disabled. If SSA determines that your impairment(s) prevents you from performing your past jobs, then they will move to Step 5.

STEP FIVE. Can You Do Any Other Type Of Work? During the final step, SSA will evaluate your physical and/or mental condition(s), age, education, work experience, and skills you have acquired that could be transferred to other jobs. Given all of these factors, if SSA determines you cannot do other types of jobs that exist in significant number in the national economy, SSA will make a determination of disability.

SECOND QUESTION: ARE YOU ELIGIBLE FOR BENEFITS?

Even if you prove you are disabled, you still must qualify for a program to receive SSA Disability Benefits. There are five types of SSA disability programs you or your loved ones may qualify for:

  • Disability Insurance Benefits (“DIB”)
  • Supplemental Security Income (“SSI”)
  • Adult Child Disability Benefits
  • Widow(er)’s Benefits you
  • Child Benefits

 

For each program there are technical requirements you must meet to be eligible for benefits.

Disability Insurance Benefits (“DIB”)

The key word for this program is “insurance.” To qualify for this insurance program, generally you must have worked a minimum of five years within a ten-year period, paying taxes into SSA. If you have not worked the equivalent of five full-time years, or you have not paid into the system, you will not qualify for this benefit.

DIB can get complicated. There are two important questions when looking at DIB benefits. They are (1), have you worked long enough to qualify for the insurance, and (2), when does your disability insurance expire. Just like car insurance, once you stop working and paying into SSA, insurance under the DIB program lapses.

Any disability insurance you qualify for through working and paying into the system will typically lapse 5 years after you stop working. To qualify for DIB, you must prove you met the rules of disability before your disability insurance lapses. If you think you have paid into the SSA system long enough to qualify for this benefit, please call me to discuss the specific timeframes in which you are personally required to prove your disability. These timeframes are calculated for each individual based on his/her specific work history. Rennie Law, LLC can help you determine if you are eligible for these benefits. Just call 541-414-0300 for a free evaluation.

Supplemental Security Income (“SSI”)

Supplemental Security Income (SSI) is for low or no-income individuals. It provides money for basic needs. SSI, at its core, is a welfare program for the disabled. An individual must have less than $2,000 in resources. A married couple must have less than $3,000 in assets. When calculating the assets for a married individual, SSA will count the working spouse’s income toward the $3,000 asset limit.

To see if you might be financially eligible for SSI, please call today for your FREE CONSULTATION – (541) 414-0300.

Children’s Benefits

If under the age of 18, your child can qualify for benefits if he or she meets SSA’s definition of disability for children, and if his or her income and resources fall within the eligibility criteria. In many ways this program was designed similarly to SSI. The child must have a physical or mental condition, or a combination of conditions, that result in “marked and severe functional limitations.” This means that the condition(s) must very seriously limit your child’s activities. This means that the condition(s) must very seriously limit your child’s activities.

Disabled Widows Benefits

If you are a disabled widow(er), age 50 or older, you may be able to receive benefits based off how much your spouse (or former spouses) paid into SSA, regardless of whether you have worked yourself.

Your spouse needs to have earned a minimum of 40 credits (40 credits is 10 years of work) from working in jobs that pay SSA taxes. You may be entitled to benefits even if you were divorced from your spouse when s/he passed.

Disabled Adult Child Benefits

Disabled Adult Child Benefits go to the children of persons who are deceased, or who are drawing SSA Disability or Retirement benefits. You must prove that the adult child’s disability began on or before the child’s 22nd birthday.

SOCIAL SECURITY APPLICATION PROCESS AND TIMELINES

If you are eligible for one of the above programs, it is important to understand how to apply, and how the overall process works. The process from the date of filing an application to appearing at a hearing can differ from state to state. Rennie Law, LLC represents clients in Oregon.

Application

The first step is to file an initial application. There are different applications depending on which program you may qualify for. We are happy to assist you with this process. However, for an initial SSI application, you will have to contact SSA in Medford at (800) 772-1213.

It takes an average of four months to hear back from SSA on your application. Approximately 60-65% of people are initially denied benefits. If you are denied benefits, you have 60 days to file an appeal to have your claim reconsidered. Rennie Law, LLC will handle all appeal filings on your behalf. If you do not file the appeal on time, you may have to start your claim over and in certain circumstances you may become ineligible for DIB benefits you originally qualified for. For these reasons, we take no chances and typically file your appeal the same day you are denied or shortly thereafter.

Reconsideration

Once you appeal your initial denial, SSA will reconsider your application. It typically takes an average of an additional four months to receive a decision on your appeal. In Oregon, approximately 86% of people are denied at the reconsideration level. If you are denied a second time, do not give up hope. The statistics are in your favor, as approximately 60% of claimants are awarded benefits at the hearing level. If you are denied this second time, you have 60 days to file a Request a Hearing before an Administrative Law Judge. Rennie Law, LLC will file the Request for Hearing on your behalf if we receive a second denial of your claim.

The Hearing

Once you request a hearing, it takes a long time before you actually appear in front of a judge. For hearings held out of the Eugene, OR hearing office (which is the office that handles Jackson County claims) the wait time is 13 months.

Other than you and your representative, the following people will appear at the hearing: (1) an Administrative Law Judge, (2) a hearings reporter, (3) a vocational expert and, (4) in some cases a medical expert or two. You may also call a witness to testify in your hearing if it is requested prior to the hearing.

The SSA Disability hearing is usually the most stressful part of the process for people. This is normal and is a result of having to talk about how your life has been impacted by your condition. One of the many goals at Rennie Law, LLC is to fully prepare you for your hearing. We will meet and go over how the hearing is run, go over sample questions, figure out what medical records SSA is missing and make sure to get copies of all pertinent medical records for the Judge to review prior to your hearing, discuss the strengths and weaknesses of your case, and prepare any witnesses who may testify on your behalf.

At the hearing, your attorney will be responsible for asking you questions to clarify your answers to the judge, or to add additional information the judge did not ask about. In addition, an attorney will cross-examine the vocational expert who is there to express their expert opinion on whether you could sustain employment at various jobs. If there is a medical or psychological expert, s/he will give their opinion on the medical/psychological issues of the case, including whether your condition meets or equals a listing.