Posted in Blog, Workers Compensation by on August 7th, 2017

By: Cara M. Kuzmiski | Law Clerk

Understanding-Social-Security-Disability” width=Have you been hurt and can’t return to work as a result of your injuries? Are you, or have you been involved in a workers compensation or personal injury case due to these injuries? If so, you may qualify for Social Security disability benefits. Applying for Social Security benefits can be a lengthy and confusing process, but knowing what to expect ahead of time can make the process easier, and hopefully less stressful.

Before you can apply for disability benefits, you must meet the requirements established by the Social Security Administration. First, you must have worked in a job covered by social security, and second, you must have a medical condition that meets the social security definition of “disability”.  The Social Security Administration defines “disability” as an inability to work. You will be considered disabled if you meet the following three criteria: 1) you cannot do work that you did before; 2) Social Security determines that you cannot adjust to other work because of your medical condition; and 3) your disability has lasted or is expected to last for at least one year or to result in death.

In order for the Social Security Administration to approve your application for benefits, it must determine you have met the threshold to be deemed disabled.  Social Security will use a five step process to make that determination. The first step is to find out if you are currently working. If so, Social Security will consider the amount of your monthly income. If you earn more than a set amount per month, you generally will not be considered disabled. If you are not currently employed, your application will be sent to the Disability Determination Services office which will make a decision regarding your medical condition. Second, Social Security will inquire as to the severity of your condition. They will require medical records and contact information from all treating physicians and facilities related to your injury. Third, your condition will be compared against the Social Security list of disabling conditions. If your condition is on the list, it is more likely than not that you will progress in the application process. If your condition is not listed, then a determination will have to be made to see if it is comparable to any of the disabling conditions listed. Next, Social Security will evaluate your case to see if you are capable of doing the work you did prior to your injuries. Finally, they will make a determination as to whether or not you are capable of doing any other type of work.

In addition to meeting the threshold standard of disability, you must also have worked long enough and recently enough under Social Security to qualify for disability benefits. Social Security uses a formula based on your age, when you were injured, and how long you worked prior to your injury to determine if you meet this additional requirement.

This application process can take anywhere from 3-5 months before a determination is made regarding your disability status. If you are approved for disability benefits, you will receive monthly cash benefits.  These benefits can continue until you are able to return to work on a regular basis. When a favorable determination is obtained, you are entitled to past-due benefits and they will be paid retroactively. Social Security also provides “work incentives” which provide continued benefits and healthcare coverage to help with the transition back to work. If your application for Social Security disability benefits is denied, you will be notified as to the reason for your denial and a time frame in which you have to appeal that decision.

You have a right to be represented throughout the entire process of filing for Social Security disability benefits. Fees for representation are strictly governed by the Social Security Administration and require a written agreement between you and your representative.  The Social Security Commissioner must approve the agreement at the time a favorable determination is made. Any fee for representation will be paid out of the past-due benefits, so you will not incur any up-front expenses.  Currently, fees for representation cannot exceed the lesser of 25% of the total amount of past-due benefits or $4000.

If you have questions regarding your eligibility or need help navigating this process please call the attorneys at Wynn & Wynn, P.C., at 1.800.852.5211 or request a free consultation.  We can help file your application, request all supporting documentation, and in the event of a denial, we can handle the appeals process and represent you at the hearing.

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