What Are Disability Benefits?

Private insurance disability benefits are financial assistance payments provided to individuals who suffer from a disability caused by illness or long-term injury. Disability benefits can be short-term, lasting for only six months; however, they may also be long term and last the rest of your life. Disability insurance helps bridge this gap in time by providing benefits when you are unable to work.

What Information Do You Need to Provide?

Disability insurance claims require detailed medical records and personal information about your condition, including what work you were doing when it occurred or first began experiencing symptoms. Disability insurance also requires proof that the injury will prevent you from working during the duration of the claim.

Notably, disability insurance providers will require a diagnosis from your doctor and supporting documentation such as X-rays or medical records to prove that you cannot perform your job because of an injury or illness.

Are There Any Other Requirements?

Under most policies, you will only receive disability benefits if an injury or illness prevents you from working in your current job over a period of 24 months and after 24 months in any capacity.  The benefit and requirement of your particular policy can only be determined by a careful look at the provision of your policy.  This is best done by an experienced lawyer of your choosing.

As a result of disability benefits, many people have successfully received the financial support they need to pay for necessities and continue living a normal life. You too may be able to receive these benefits if you meet the requirements and submit all of the necessary documentation, including your doctor’s diagnosis.

Differences Between the Two Programs

There are several main ways that Social Security Disability and Supplementary Security Income are distinct from each other. These include:

• Eligibility
• Benefits start date
• Average monthly benefits
• Maximum monthly benefits
• Health insurance type

Determining Factors for Different Types of Coverage

With SSI, the determination of benefits comes from a person’s age or disability as well as how limited they are in finances and resources. SSDI, on the other hand, puts into consideration a person’s work credits along with their disability.

People who receive SSI benefits are automatically qualified for Medicaid in most states, including North Carolina. SSDI recipients instead qualify for Medicare once they’ve been receiving disability payments for 24 months. There are some special circumstances, like with ALS patients, where their Medicare coverage starts immediately upon receiving SSDI.

In some cases, a recipient can be on both Social Security Disability and Supplemental Security Income simultaneously. This happens when a person has both a work history as well as limited funds and means.

Each program has its own set of considerations that come into play when deciding benefits. Then, once those factors are weighed, each program offers different benefits both in type and amount. In order to ensure that you get the benefits package that’s best for you, it’s helpful to know how each of these programs works.

How Claims Are Approved

All SSD claims begin with an application process that will address the health condition of the applicant and how it affects their everyday life in general. All applicants should understand that the Social Security Administration rarely approves a claim in the first decision issued following application acceptance even when the claimed medical condition is on the SSD Bluebook list of known approved mental disorders. Most cases are established through the appeals process.

Professional Healthcare Evaluation Evidence

Proving a mental disorder disability claim commonly requires depositions from mental health professionals that can be submitted along with other medical information to the SSA administrative law judge for reconsideration based on a totality health claim. While some claims are won because of a single proven mental health condition, others are often approved based on the overall health of the claimant and similarities to other prior approved disorders. Each verified health issue can help a SSD attorney build a comprehensive case for approval.

Having an experienced North Carolina disability attorney is essential when a claim is going through appeal. The question will basically be the degree of impairment for the claimant due to the mental order when attempting to complete job responsibilities. Applicants who are under age 50 are often denied based on their age and the SSA claim defense that the mental condition is not severe enough to justify approval until all possible avenues of employment are exhausted.

So how does someone become eligible for benefits under either of these two programs?  Over two million people apply annually, and most applicants are denied, at least upfront.  Claim examiners evaluate every applicant’s claim on five basic criteria: 1) are you working; 2) is your condition “severe;” 3) is your condition found on the list of disabling conditions; 4) can you do the work you did previously; and 5) can you do other work.

Each of these questions can be difficult to answer and comes with its own set of challenges. If you are wondering if you need an attorney who is experienced in handling Social Security Disability claims, ask yourself, “Am I unable to work because of an injury, disease, illness, or condition?” If so, it may be something that resolves itself quickly, or it may become something that changes your life.  Either way, we recommend you seek representation, and you will likely benefit from having an experienced guide to help you navigate this complex process.  Less than one-third of claims are approved the first time they are filed.  Those who have knowledgeable representation, however, are in a better position to be successful, and ready to pursue every legal option if necessary.

Call Baddour, Parker, Hine, and Hale today if you are unable to work.  We offer free consultations, and you may pay no fees unless your claim is successful.  Your family depends on you, and you can depend on us to help you claim the benefits you’ve earned.

Call Baddour, Parker, Hine, and Hale today.

Factors That Can Increase SSD

One of the variables that can increase an individual’s SSD payments is their work history. During their working lives, most Americans pay into Social Security. Someone who has worked and paid into Social Security for 10 years or longer may be eligible to collect more in SSD benefits.

If a close family member is deceased, that can also sometimes increase the amount of Social Security Disability benefit a person can collect. For example, if an adult child who helped support a disabled parent has died, that surviving parent may be eligible for an increased SSD payment.

Other family members who can affect the benefit amount include spouses and ex-spouses. If they have passed away, some of their benefits may be transferable to the disabled partner. The Social Security Administration provides a tool, called BEST, where people can check and see if they’ve maximized the benefits they’re collecting.

Even with the benefit eligibility screening tool, the process can be confusing. It’s a good idea to think about getting help when communicating with the bureaucracy. There are attorneys who have lots of experience helping disabled Americans get the benefits they deserve.

Access Is Everything

In an age of online apps, the Social Security Administration still requires a wet signature from claimants on paperwork. Some physically disabled people struggle to sign a paper document without assistance. This rule is also odd in view of the fact that individuals can sign all kinds of documents online or via mobile apps. Disability advocates say that that the signature requirement represents an unfair barrier to their clients.

It’s now possible to sign for loans, leases and other important binding legal documents virtually. The wet signature requirement not only discriminates against people who have physical difficulty signing, but because paper documents need to be mailed and manually processed, it also increases the time it takes for paperwork to be processed.

There are plenty of other federal agencies that accept other forms of signatures. The IRS, VA, HUD and even Medicare allow people to sign documents electronically. To many observers, it’s very strange that the SSA makes a wet signature demand in this day and age.

Lawsuits Against the SSA

Lawsuits from organizations including the National Federation for the Blind have resulted in the temporary suspension of this restriction. However, many people say it’s clear that a permanent change needs to be made because it’s unfair for the SSA to erect barriers that keep legitimate claimants from receiving their benefits in a timely fashion.

Social Security Disability payments are the right of disabled Americans. If an individual has questions about denied claims or other barriers to access, they may want to reach out to an attorney.

The condition must prevent them from doing work they have done in the past for a year. For example, if an applicant has worked for most of 2020 and earns over $1,260 per month, they may not qualify. It must also be determined that the condition will last for more than one year.

The applicant must have been working in jobs that make Social Security disability payments regardless of their age. An applicant should also have earned enough credits within the last 10 years, which is commonly 40 credits. Most workers earn four credits per year. When the person reaches retirement age, it converts to standard Social Security.

The condition should restrict the applicant’s basic work mobility, such as standing and lifting for one year, and be on the Social Security Administration’s list of conditions. If the condition is not listed, it must be considered severe enough to inhibit working ability to qualify the applicant for payments. The Social Security Administration may also determine if the person could do other work.

There are special conditions that speed up the process, such as blindness, low vision or acute leukemia. In some cases, a qualified widow or widower, disabled minor child or disabled adult child between 18 and 22 can draw a deceased worker’s Social Security payments. If an applicant feels that they qualify and have been denied, a Social Security disability claims attorney may investigate the cause of denial.

Right now, individuals must go through a rigorous vetting process to see if they qualify to receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). The frequency with which a recipient is reassessed varies depending on how profound their disability is thought to be.

Right now disability benefits recipients have their files flagged with one of three different labels: “Medical Improvement Possible,” “Medical Improvement Expected” or “Medical Improvement Not Expected.” Recipients with the strongest potential for improvement are reevaluated the most often.

If this proposed bill were to go into effect, then a fourth category of “Medical Improvement Likely” would be added. The estimated 4.4 million current recipients that would fall into this category would be reassessed every two years. This means that many of these individuals would be vulnerable to losing their benefits.

One legal analyst points out that individuals classified as Step 5 recipients would be most affected if this piece of legislation were to get passed. The types of people that fall into this category are those individuals who suffer from herniated discs, schizophrenia, back pain or depression. Many of these people are between 50 and 65-years-old and have little job skills or education.

This latest proposal is one of the many different social program cuts that the Trump administration has proposed since coming into the office several years ago. The president recently proposed a plan that would do away with food stamps for more than half a million Americans. This would result in a $5.5 billion reduction in tax costs if this legislation were to pass.

Many individuals who are unable to work due to having debilitating illnesses or injuries rely on receiving their monthly payments from the SSA. Without them, they wouldn’t be able to survive. If you’re concerned about your ability to qualify for or continue receiving SSDI or SSI, then you may want to consult with a Social Security Disability attorney here in Goldsboro. Your lawyer can advise you of alternate options that may be available to you in North Carolina to help you make ends meet.

One common reason that the Social Security Administration (SSA) denies SSD or SSI payments is because an individual ceases to classified as disabled by them.

Individuals must meet very strict guidelines to be classified as having a disability by the SSA. They must have a disability that’s terminal or expected to last longer than 12 months. The condition that the applicant has must be listed on the SSA’s Listing of Impairments. It must also prevent them from performing the same work that they previously did and impact their ability to carry out regular work activities.

Recipients are re-evaluated at varying intervals from as little as every six months up to every few years depending on the severity of their condition and any prior prognosis reports. If the evaluating doctor determines that a recipient’s condition has improved and that they’re able to work, then they may lose their SSD or SSI benefits.

If you return to work while receiving SSD or SSI, then you may lose your benefits. If your disabling condition is improved and you’re considering learning new skills so that you can transition into a new field of work, then you may benefit from taking part in the SSA’s Ticket to Work (TTW) program.

The SSA may assist you in finding subsidized training opportunities where you can learn skills to transition into a new career that’s in a different field from the one that you previously worked in as part of the TTW program.

You should understand that once you start working, you’ll immediately put your eligibility to receive SSD or SSI benefits in peril. This is especially the case if you earn beyond a certain threshold.

A Social Security Disability attorney here in Goldsboro can review your case and advise you of your prospect of receiving benefits in North Carolina. They can let you know what may cause them to be withdrawn from you as well.

In the event you start working again, the SSA will likely reassess your eligibility according to its “trial work period” rules and regulations. If the job that you take pays less than $880, then it’s unlikely that the amount that you receive will decrease. If you earn between $880 and $1,220, then that amount may do down.

The SSA uses the trial work period program to give disability benefits recipients a way to test the waters to see if they may be able to work again. Under the program, the SSA will continue to pay your benefits provided that you continue reporting your income. They’ll keep doing this for up to 60 months. Once you have successfully earned $880 or more for at least nine months, your benefits can be reduced or withdrawn.

Once the trial period has concluded, the SSA will conduct a more thorough review of your file. If your monthly pay has exceeded $1,220, then the SSA may discontinue your disability payments. If your monthly earnings fall below that, then they may allow you to complete an extended eligibility period of 36 months. You may be able to continue receiving disability and work earnings simultaneously during this time.

You may qualify for expedited reinstatement of your benefits if you reapply for disability payments during the first five years after you stop receiving them.

If it’s been a while since you originally applied for disability benefits, then you may not fully remember just how difficult it is to qualify for them. The SSA has made it harder than ever for North Carolina residents to pursue SSD. They’ve done so to weed out fraudulent claims.

This is why it’s important that you have an experienced attorney here in Goldsboro to help you navigate through the governmental red tape. This may be the only way that you can secure or retain the benefits that you count on receiving.