File for Disability Benefits with Quikaid

File For Benefits

There are two separate disability programs administered by the U.S. Social Security Administration: (1) Social Security Disability Insurance, also known as "SSDI", "SSD" or "Title II" benefits, and (2) Supplemental Security Income, also known as "SSI" or "Title XVI" benefits. While the two programs have much in common, they are distinct programs with specific requirements and very different benefits.

What is Social Security Disability Insurance?

Social Security Disability Insurance ("SSDI") is a payroll tax-funded insurance program of the United States government. It provides monthly income and Medicare insurance to people who can no longer work due to a medical disability. Every working American pays into SSDI through mandatory Social Security payroll taxes. If you have earned enough "work credits", you may be eligible to receive disability insurance benefits from the system you paid into. The average benefit for an SSDI recipient is approximately $1,000 per month, and can be over $2,000 per month for an individual and over $3,000 for a family, depending on the strength of your work history. Entitlement to benefits begins five months after the date you became disabled. This can result in substantial past-due, "lump sum" benefits that can exceed $30,000. Additionally, SSDI recipients become eligible for Medicare 24 months after their date of entitlement.

What is Supplemental Security Income?

Supplemental Security Income ("SSI") is another program administered by U.S. government, with benefits available to aged (65 or older), blind or disabled Americans. Like SSDI, the SSI program is administered by the Social Security Administration. However, unlike the SSDI program, which is an insurance program funded by the Social Security trust fund, SSI is funded by U.S. Treasury general fund. SSI is a need-based program which provides monthly benefits to Americans who have very limited assets, not to exceed $2,000 for an individual or $3,000 for a married couple. Disabled persons who have not earned enough "work credits" to qualify for SSDI may qualify for SSI. The average benefit is $674 per month and is generally awarded back to the date of the Initial Application for benefits. In most states, successful claimants also are awarded Medicaid benefits.

Both programs are simple in concept. However, getting disability benefits is rarely easy. Often those who should be awarded benefits are not, and those who should not be awarded benefits are. Life, as they say, is not always fair. However, understanding the process - and having a partner such as Quikaid on your side - can serve to increase the likelihood that your claim is ultimately approved.

Do I Qualify for Disability Benefits?

There are two sets of criteria that must be met for an individual is awarded benefits - medical and non-medical. The SSDI and SSI programs utilize the exact same criteria and process to determine if you are medically disabled. If you are determined to be medically disabled, you must also meet the non-medical criteria of the SSDI or SSI program. The non-medical criteria of the two programs are quite different. While SSDI's non-medical criteria focuses on work credits (have you "paid enough into the system by working"), SSI's non-medical criteria focuses on need ("do you have very limited assets and income, well below the poverty line")? When an individual meets both the medical and non-medical criteria of either program (or both programs), he or she is awarded benefits under that program.

The Five-Step Sequential Evaluation Process

The SSA utilizes the following five-step sequential evaluation process to determine if you qualify for SSD or SSI benefits:
1. You cannot be working full-time.
2. You must have one or more "severe" impairments that limit your ability to work.
3. If your impairment meets or equals a medical listing, you are disabled. A "listing" is framework used to evaluate each major bodily system, including mental and physical conditions. If your impairment does not satisfy a medical listing, the evaluation continues to Step 4.
4. You must no longer be able to perform the type of work you have done in the past, due to your impairment.
5. You must not have the ability to perform any other work based on your age, education and work experience, due to your impairment.

The Grueling Process of Determining Medical Eligibility

While the above evaluation seems straightforward, in practice it is not. There is a tremendous amount of information that needs to be gathered, synthesized and submitted to Social Security Administration and the state-level Disability Determination Service ("DDS"), to whom SSA assigns the task of determining the medical merit of the claim. While every case is unique, the fundamental steps within a disability case - whether SSD or SSI - are as follows:

STAGE ONE: Initial Application (2-4 months). At the Initial Application stage, the claimant (or his appointed representative, such as Quikaid) supplies the SSA with all information relevant to the claim. This information includes, but is not limited to, the following:
(a) Medical History: When and where have you received treatment for what conditions? What tests were ordered? What was prescribed by which doctor?
(b) Work History: When and where have you worked over the past 15 years? What was your title? What was your rate of pay? What activities did you perform at each job? How physically demanding was your job?
(c) Resources: What assets do you own or co-own? What are these assets worth? What other assistance do you receive?
(d) Personal: Where were you born? How old are you? What is your marital status? Do you have children? What is your citizenship status? What is your highest level of education completed?

After supplying this information on various complex forms, the Social Security Administration then sends your disability claim to a state-run agency called the Disability Determination Service, or "DDS". The DDS is tasked solely with determining whether you meet the medical definition of "disabled", as defined by the Social Security Administration. DDS does not concern itself with non-medical information, which is the domain of the Social Security Administration itself. DDS reviews all medical information provided, obtains medical records from treating sources, and can order the claimant to attend a consultative medical examination at SSA's expense and selection to further understand the nature of the claimant's medical condition. DDS can also end the claimant questionnaires to complete - such as Activities of Daily Living (what is your typical day like?), Supplemental Pain Questionnaire (how bad is your pain, what causes it, and what do you do to treat it?), or Third Party Questionnaire (to be completed by someone close to the claimant who understands their condition). After aggregating the entirety of this medical information, DDS doctors (both mental health and physical health) review the information and determine whether the medical definition has been met. DDS then sends the medical determination back to Social Security Administration - with either a favorable or unfavorable ruling. If DDS makes a favorable medical determination and SSA makes a favorable non-medical determination, benefits are awarded. However, the Social Security Administration routinely denies Initial Applications (only 20% of claimants are successful at this stage). If the ruling is unfavorable, the claimant has the right to appeal the denial and ask SSA to "reconsider" their case.

STAGE TWO: Reconsideration (1-2 additional months). Reconsideration of a claim must be requested in a timely manner, or the case is dismissed by SSA. Assuming a timely appeal of the Initial Application denial, the claimant enters the Reconsideration stage. At this stage, a different person at DDS reviews all information supplied at the Initial Application stage, as well as any new medical evidence supplied by the claimant or his representative since the time of the Initial Application (new doctor's appointments, diagnoses or test results, for example). As is the case with the Initial Application stage, at the Reconsideration stage, the DDS caseworker has the option to require the claimant to attend a consultative medical examination (at SSA's expense and selection), or complete one or more questionnaires related to the claimant's medical conditions. This information is designed to supplement the medical information supplied by the claimant to provide a complete picture of the claimant's medical condition. After aggregating the entirety of this medical information, DDS doctors (both mental health and physical health) review the information and determine whether the medical definition has been met. DDS then sends the medical determination back to Social Security Administration - with either a favorable or unfavorable ruling. If DDS makes a favorable medical determination and SSA makes a favorable non-medical determination, benefits are awarded. However, the Social Security Administration also routinely denies applicants at the Reconsideration stage (only 15% of claimants are successful at this stage). If the ruling is unfavorable, the claimant has the right to appeal the denial and request a Hearing before an Administrative Law Judge ("ALJ").

STAGE THREE: Hearing (6-15 additional months). If the Reconsideration is denied, Quikaid will automatically request a Hearing before an Administrative Law Judge. Depending on the strength of the case, Quikaid may elect to use an "On-The-Record" decision by which the judge may approve the award without an in-person Hearing. If a Judge requires a Hearing, Quikaid will brief you on the Hearing procedures and will appear with you before the Administrative Law Judge.

STAGE FOUR: Appeals Council (3-24 additional months). In the unlikely event that your hearing ends in a denial, Quikaid will review your case again in its entirety and may submit an appeal (along with any additional medical information and a written brief) to the Appeals Council. The Appeals Council reviews the hearing decision to determine if it was rendered in accordance with the law. About 6 percent of appeals of Hearing decisions result in a favorable overturn decision for Quikaid clients vs. the SSA system-wide average of 3 percent.

STAGE FIVE: Federal District Court. It is highly unlikely than your case will reach the federal court system. Currently, fewer than one percent of all claims ever reach this level. Typically, when they do, they are remanded back to the Appeals Council decision, so very rarely is a case decided at the Federal District Court level. In fact, this stage of the disability process may be removed entirely.

Quikaid's Keys to a Successful Disability Case

We work in partnership with you to deliver the benefits you need. We are your trusted partner in the entire process from initial consultation through receipt of your award - we are with you every step of the way. Here is what you can do to ensure we succeed together:

1. Medical records are the most important factor in a successful disability claim. So, continue to receive medical treatment, and let us know when you do, so we can obtain your important medical records. Receiving medical treatment for your disabling conditions will help your health - and your disability claim.
2. Stay in touch with Quikaid. We cannot win if we cannot reach you! Please tell us promptly if your contact information changes, and we will promptly notify SSA. Also, provide back-up contact information to ensure we can always reach you.
3. Let us know if you hear from the Social Security Administration. We will follow-up with them on your behalf to ensure every communication is beneficial to your claim.
4. Be patient! The entire process can last from 1 month to three years, depending on the complexity of your case. The average processing time is approximately one year. Rest assured, we will work aggressively on your behalf and we will do everything possible to win your case as quickly as possible.

Information You Need to Get Started

When you provide us the following information needed by the Social Security Administration, and we get started immediately on your behalf:

1. Your employment history, including organizations for whom you have worked over the past 15 years, with corresponding dates and earnings.
2. A description of your medical condition(s) for which you have received medical treatment and a list of physical and / or mental limitations imposed by your medical condition(s).
3. Names and contact information of doctors and hospitals from whom you have received treatment for your disabling conditions, as well as approximate dates of treatment, tests performed and medications prescribed.
4. If you have already applied for disability benefits through Social Security Administration, the details (dates, outcome, appeals, etc.).of the most recent application.
5. For SSI claims, a list of assets you own, financial assistance you receive, marital status, etc.

At Quikaid, we understand the Social Security disability process as well as anyone. Contact us now and let us help you get the process started today.