How does Social Security Administration (SSA) define disability?
Under the Social Security Act, “disability” means you are not able to work due to a documented physical or mental impairment that has lasted or is expected to last at least 12 months or result in death.back to top
Is it difficult to get Social Security disability benefits?
It can be. The SSA denies 65 percent of the people filing initial disability applications. It also can take a long time, on average one to two years. It is important to have competent representation during the process to ensure your claim has the best chance possible to be approved.
How many different types of Social Security disability benefits are there?
SSA offers two types of disability benefits. One is Social Security Disability Insurance (SSDI) and the other is Supplemental Security Income (SSI).back to top
What is Social Security Disability Insurance (SSDI)?
SSDI (Title 2) is a payroll tax-funded federal insurance program. Its purpose is to provide income to people unable to work because of a disability.
Who can get disability benefits under SSDI?
Under SSDI, three categories of individuals can qualify for benefits: 1) a disabled insured worker under full retirement age; 2) an individual disabled since childhood (before age 22) who is a dependent of a parent entitled to Social Security disability or retirement benefits, or who was a dependent of a deceased insured parent; and 3) a disabled widow or widower, age 50-60, if the deceased spouse was insured under Social Security.back to top
How do I qualify for SSDI?
You must be insured. That generally means you must have worked and paid into the program (payroll taxes) for five of the last 10 years. You must also have been disabled before reaching full-retirement age (65-67) and you must meet Social Security’s definition of disability.
Can I get additional benefits if I have children/dependents?
Children up to age 18 or who have not graduated from high school are entitled to benefits if a parent is deceased, retired or disabled. Generally, dependent children of a disabled parent will receive about 50 percent of the disabled parent’s monthly benefit. The 50 percent is divided equally among all eligible dependents.back to top
Can I receive disability benefits or payments and still get Medicare or Medicaid coverage?
Medicare helps pay hospital and doctor bills of disabled or retired people who have worked long enough under Social Security to be insured for Social Security benefits. It generally covers people who are 65 and over; people who are disabled and have been receiving benefits for at least 24 months or have amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease); and people who need long-term dialysis treatment for chronic kidney disease or require a kidney transplant. In most states, individuals who qualify for SSI disability payments also qualify for Medicaid. Medicaid is financed by federal and state matching funds, but eligibility rules may vary from state to state.
Can I work and still receive disability benefits?
SSA rules make it possible for people to test their ability to work without losing their rights to disability benefits and Medicare or Medicaid. These rules are called “work incentives,” and are different for SSDI and SSI, but both programs may provide continued cash benefits, continued help with medical bills, help with work expenses or vocational training.
Can I get unemployment benefits while waiting for SSDI benefits?
Receiving unemployment benefits does not necessarily preclude you from receiving SSDI benefits, but disability claim examiners consider unemployment benefits to be one indication that a claimant is capable of returning to work. Disability onset dates (the date the disabling condition began or the date your condition required you to seek SSDI) may have to be amended to the day after you receive your last unemployment check.back to top
Can I get Workers’ Compensation and/or State Disability as well as SSDI?
Yes, but you cannot get more than 80 percent of what you were earning while working from a combination of workers’ compensation, certain state pensions, and SSDI.
I am a veteran and I already receive VA disability benefits. Can I also receive SSDI?
There are two types of veterans’ disability benefits: service connected, where the disability is related to something that happened in the service, and non-service connected. There is no set rule preventing a VA disabled veteran from also applying for SSDI. Of course, SSA will re-evaluate that veteran’s disability, especially if it is not service-connected.
Do I have to be a U.S. citizen to get SSDI?
Non-citizens can apply for SSDI if they are in the United States legally. However, if you don’t have valid documents, particularly a social security card, your claim will be denied fairly quickly.back to top
What is Supplemental Security Income (SSI)?
SSI (Title 16) is a needs-based program, with benefits paid to claimants who are disabled, blind or age 65 or older, and with limited income and resources. Disabled children can also get SSI benefits. If a claimant’s income exceeds $721 per month ($1,064 for a couple) or the value of his/her resources is above $2,000 ($3,000 for a couple), a claimant is not eligible for SSI.
Who can get disability benefits under Supplemental Security Income (SSI)?
There are two categories of individuals with a financial need who can get SSI payments based on disability:1) a disabled adult age 18 or over; or 2) a disabled child under age 18.
How do I qualify for Supplemental Security Income (SSI)?
Under the SSI disability program, an applicant may be found “presumptively disabled or blind,” and receive cash payments for up to six months while the formal disability determination is made. The presumptive payment allows a needy individual to meet his or her basic living expenses during the time it takes to process the application. If SSA finally determines that an individual is not disabled, he or she is not required to refund the payments. There is no provision for a finding of presumptive disability or blindness under the SSI program.back to top
Can my children qualify for SSI?
For children applying for SSI, the process requires sequential review of the child’s current work activity (if any), the severity of his or her impairment(s), and an assessment of whether his or her impairment(s) results in marked and severe functional limitations. The five-month waiting period does not apply to children. Under SSI, disability payments may begin as early as the first full month after the individual applied or became eligible for SSI.
When should I apply for Social Security Disability Benefits?
Apply as soon as you and your doctors agree that your disability is going to last a full year. You are not eligible for SSDI if your condition does not last a full year, so many people have to wait for a while to see what happens with their medical conditions. Others, who have been struggling to work in spite of their disability and know the condition is not going away, should apply as soon as they stop working.
Are there retroactive SSDI benefits?
Yes. You can get retroactive benefits for up to one year before you applied, provided you were not working and you can prove you were disabled.back to top
How do I know when I became disabled?
Usually, your Alleged Onset Date (AOD) is the date upon which your physical or mental impairment(s) made it impossible for you to continue working.
Can the AOD be different from the date I last worked?
Sometimes it is different. Sometimes an injury may be unrelated to work, or it may have occurred at a different time. Then the AOD would be the date that you were hospitalized or injured, not the last date that you worked.
What is SGA and how does it affect my application for disability benefits?
SGA is work that brings in over a certain dollar amount per month. The current SGA limit, as of 2012, is $1,010 ($1,690 for blind applicants) before taxes. If you are making more than that amount per month, the SSA figures that you must not be disabled. In deciding whether you are doing SGA, SSA does not include income you obtain from non-work sources, such as interest, investments, or gifts.
Will my claim be denied due to SGA?
Individuals who work and earn gross monthly income exceeding the SGA threshold are not considered disabled and are ineligible to receive benefits, unless they were working under special circumstances. If, however, SSA determines that your work activity does not amount to SGA, you will have passed the first step of the SSA’s evaluation process and SSA will then look at your medical eligibility.back to top
What if I stop working?
If you stop working after you apply for benefits (because you find out SGA will disqualify you), you must be able to prove to SSA that your medical condition worsened to the point where you had to stop working. The SSA will then decide if your work activity was an “unsuccessful work attempt.” Generally, if you worked for a period of six months or less and had to stop or reduce the amount of work due to your impairment, your work will not be considered SGA.
What if I own my own business?
SSA offers two types of disability benefits. One is Social Security Disability Insurance (SSDI) and the other is Supplemental Security Income (SSI).
What are the Three Test factors?
The three factors SSA considers are: 1) if you provide significant services to your business and receive a substantial income from it; 2) if you perform work that is comparable to the work of persons without disability in your community engaged in the same or a similar business, and 3) if you perform work that is worth $1,010 per month in terms of its value to the business or what it saves you from having to pay an employee to do the same work.
Is that gross or net business income?
SSA deducts “unincurred business expenses” from your net earnings, which are expenses that you don’t pay for, or contributions made by others. After subtracting subsidies and impairment-related work expenses, the SSA will compare your earnings to the SGA amount.back to top
What about Substantial Gainful Activity (SGA) if I’ve already been approved for benefits?
If you have been approved for and are already receiving disability benefits, you can continue to make up to $1,010 per month without losing your benefits, as long as you still meet the SSA’s definition of disability. For SSDI, if your medical condition improves and you go back to work, SSA will allow you to make more than the SGA amount for a certain number of months (called a trial work period). For SSI, the SGA rule doesn’t apply to recipients who have been receiving benefits for a year or more, and part of their income isn’t counted toward the SSI income limit.
If I apply for SSDI benefits, how long will it take to get a decision?
Unfortunately, it’s not a quick process. Generally, it takes about three to four months for SSA to issue an initial decision. If that decision is unfavorable, reconsideration (your first appeal) can take another two to three months. Finally, an appeal of an unfavorable reconsideration decision is a hearing before an Administrative Law Judge (ALJ) in Social Security’s Office of Disability Adjudication and Review (ODAR). According to ODAR’s own figures, as of November 2012 it could take anywhere from eight to 15 months before your hearing date.
If I am successful, how much disability will I receive?
Every claim is different, and a disability award is based on a complicated formula, largely determined by the amount of your past earnings that have been subjected to FICA taxes. The Social Security Administration no longer sends an annual statement to U.S. citizens in the mail. However, you can obtain your social security statement (which includes a disability and retirement benefit estimate) online.back to top
When do SSDI benefits start?
Disability benefits for workers and widows usually cannot begin for five months after the established onset of the disability. Therefore, Social Security disability benefits will be paid for the sixth full month after the date the disability began.
Can SSA take away my SSDI benefits?
Yes. It does not happen often, but you can lose your disability benefits if your condition improves to the point that you no longer meet the SSA’s definition of “disabled.” SSA must show there has been medical improvement related to your ability to work before they can cease your SSDI benefits.back to top
What is a disability hearing?
The hearing is an opportunity to plead your case to a live person for the first time. The ALJ conducts the hearing, reviews the entirety of the record and takes testimony from the claimant. After reviewing the entirety of the claim, including testimony taken at the hearing, the ALJ renders a decision – either Fully Favorable, Partially Favorable or Unfavorable.
How long does a disability hearing last?
In our experience, an average hearing takes approximately 25 minutes from start to finish. For straightforward cases with strong medical support, the hearing is a formality and short in duration. For more complex cases with, for example, conflicting or inconsistent medical evidence, the hearing can last over an hour.back to top
Who attends the disability hearing?
There are generally four to six people present at a disability hearing: (1) yourself as the claimant; (2) your representative; (3) the Administrative Law Judge; (4) the hearing reporter; (5) a Vocational Expert (VE), if the ALJ elects to have one in attendance, and (6) a Medical Examiner (ME), if the ALJ elects to have one in attendance.
When will I receive the ALJ’s decision following the hearing?
A verbal indication of the intention to award benefits can be given by the ALJ at the conclusion of the hearing itself, although this is not common. On the other end of the spectrum, exceptionally busy or inefficient ALJs can take several months before rendering a decision. In a typical scenario, the ALJ’s decision will be written, reviewed and mailed in approximately 30 – 60 days following the hearing. If the decision is Favorable, benefits generally commence in approximately 30 days from the date of the receipt of the Favorable award letter.
How long is the wait for a disability hearing?
A request for hearing can only be filed after a claim has been denied at the initial and reconsideration levels. After the request for hearing is filed, it can take anywhere from eight to 15 months before your ALJ hearing date.back to top
Is there anything I can do to expedite my request for a hearing?
At the ALJ stage, however, a claimant can request an “on-the-record” decision. This asks the judge to expedite the hearing, usually because a claimant has recent and strong medical records that demonstrate an overwhelming evidence of disability.
What if I have no income while I am waiting for my hearing?
A claimant can also request an expedited ALJ hearing, based upon a “dire need” such as a present or impending lack of food, shelter, medical treatment and prescriptions. However, such “dire needs” requests are not often granted.
Are there specific medical conditions that are automatically approved?
Yes, SSA has a list of certain medical conditions, grouped according to specific body systems. This list is broken into two parts: Part A is the Listings of Impairments, Adult, and Part B is the Listing of Impairment, Child.
What if I have no physical problems but have severe depression and anxiety?
Section 12.00 of the Adult Listings concerns what SSA calls “mental disorders” such as depression, anxiety, substance abuse disorders, etc.back to top
Can people with terminal illnesses be approved for Social Security benefits?
Yes, disability claims with an indication of a terminal illness (TERI) are handled by SSA in an expeditious manner because of their sensitivity.
What other types of claims get faster handling by SSA?
Other types of claims that involve a high probability of allowance, but do not necessarily meet the TERI criteria include compassionate allowance claims, quick disability determination, presumptive disability and presumptive blindness, impairments that meet or equal listing level severity and a functional finding of a less than sedentary capacity.
What disorders of the musculoskeletal system are considered disabling?
Listing 1.00 includes impairments such as an inability to walk, or to move your arms, hands, legs or feet for any reason including pain. The listing also includes joint dislocations, back pain, disc problems, arthritis, amputations, fractures, soft tissue injuries and burns that need surgery.
What disorders of the special senses and speech are considered disabling?
Listing 2.00 includes disorders of the eye, optic nerve, optic tracts or the brain that may cause a loss of vision, either partially or fully, as well as hearing and/or speech disorders.back to top
What disorders of the respiratory system are considered disabling?
Listing 3.00 impairments include respiratory diseases (emphysema, chronic bronchitis or asthma), restrictive pulmonary disorders such as chronic obstructive pulmonary disease (COPD), which cause a primary loss of lung volume (pulmonary resection, thoracoplasty, chest cage deformity or obesity), and infiltrative interstital disorders (diffuse pulmonary fibrosis).
What disorders of the cardiovascular system are considered disabling?
Listing 4.00 impairments are chronic heart failure, ischemic heart disease, recurrent arrhythmias, symptomic congenital heart disease, heart transplants, aneurysm of the aorta or its major branches, chronic venous insufficiency and peripheral arterial disease.
What disorders of the digestive system are considered disabling?
Listing 5.00 impairments include gastrointestinal hemorrhage, hepatic (liver) dysfunction, inflammatory bowel disease, short bowel syndrome, weight loss due to any digestive disorder and liver transplants.back to top
What disorders of the genitourinary system are considered disabling?
Listing 6.00 impairments include chronic renal (kidney) disease requiring dialysis or kidney transplantation, massive swelling, elevated blood pressure, vascular congestion including fatigue, shortness of breath, hypertension, congestive heart failure and accumulation of fluid in the abdomen.
What disorders of the hematological system are considered disabling?
Listing 7.00 impairments include chronic anemia, sickle cell disease or one of its variants, chronic, severe anemia, chronic thrombocytopenia, spontaneous hemorrhaging, intracranial bleeding, hereditary telangiectasia (red skin spots caused by dilated blood vessels), hemophilia or a similar disorder with spontaneous hemorrhaging, polycythemia vera (a bone marrow disease that leads to an abnormal increase in the number of red blood cells), myeloproliferative syndrome (a bone marrow disease), chronic granulocytopenia (a decrease in white blood cells) and aplastic anemia (a condition in which the bone marrow does not produce enough blood cells) requiring bone marrow or stem cell transplantation.
What disorders of the skin are considered disabling?
Listing 8.00 impairments include ichthyosis (dry, scaly skin), bullous diseases (blistering caused by your body’s autoimmune system), chronic infections of the skin or mucous membranes, dermatitis, hidradenitis suppurativa (a skin disease affecting areas with sweat or sebaceous glands), genetic photosensitivity disorders and burns.
What disorders of the endocrine system are considered disabling?
Listing 9.00 impairments include disorders of the pituitary, thyroid, parathyroid and adrenal glands, and diabetes mellitus (Type 1 and Type 2).
What impairments of multiple body systems are considered disabling?
Listing 10.00 impairments include Down syndrome, a condition characterized by a complex of physical characteristics, delayed physical development, and mental retardation. Down syndrome exists in non-mosaic and mosaic forms.back to top
What impairments of the neurological system are considered disabling?
Listing 11.00 impairments include epilepsy, central nervous system vascular accidents, brain tumors, Parkinsonian syndrome, cerebral palsy, spinal cord or nerve root lesions due to any cause, multiple sclerosis, amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease), anterior poliomyelitis, myasthemia gravis, muscular dystrophy, peripheral neuropathies, subacute combined cord degeneration, Huntingon’s, chorea, Friedreich’s ataxia and spino-cerebella degeneration, cerebral trauma and syringomyelia.
What impairments of the mental health systems are considered disabling?
Listing 12.00 impairments include organic mental disorders, schizophrenic, paranoid and other psychotic disorders, affective disorders, mental retardation, anxiety-related disorders, somatoform disorders, personality disorders, substance addiction disorders and autistic disorder and other pervasive developmental disorders.
What impairments of the malignant neoplasty system are considered disabling?
Listing 13.00 impairments include soft tissue tumors of the head and neck, skin cancer, soft tissue sarcoma, lymphoma, leukemia, multiple myeloma, cancer of the salivary or thyroid glands, breast cancer, skeletal system sarcoma, cancer of the maxilla, orbit or temporal fossa (the jaw, mouth, nasal area and eye sockets), cancer of the nervous system, lungs, pleura or mediastinum, esophagus or stomach, the small or large intestines, liver or gallbladder, pancreas, kidneys, adrenal glands or ureters, urinary bladder carcinoma, cancers of the female genital tract, carcinoma or sarcoma of the prostate gland, testicles or penis and malignant neoplastic diseases treated by bone marrow or stem cell transplantation.
What impairments of the immune system are considered disabling?
Listing 14.00 impairments include systemic lupus erythematosus, systemic vasculitis, systemic sclerosis, polymyositis and dermatomyositis, connective tissue diseases, immune deficiency disorders, HIV, inflammatory arthritis and Sjögren’s syndrome.
What childhood growth-related impairments are considered disabling?
Listing 100.00 impairments include three scenarios in which a child’s growth rate is deficient due to a specific disease process, genetic predisposition or bone deficiencies related to age.
What disorders of a child’s musculoskeletal system are considered disabling?
Under Listing 101.00, disorders of the musculoskeletal system may result from hereditary, congenital, or acquired pathologic processes. Impairments may result from infectious, inflammatory, or degenerative processes, traumatic or developmental events, or neoplastic, vascular, or toxic/metabolic diseases. These include major dysfunctions of a joint, disorders of the spine, amputation due to any cause, fractures of the arms, legs or hips that do not join, and soft tissue injuries (e.g. burns).back to top
What disorders of a child’s special senses and speech are considered disabling?
Listing 102.00 disorders include a loss of visual acuity, a contraction of vision or a loss of visual efficiency in a child’s better eye, a hearing loss not treated with a cochlear implant, or a hearing loss treated with a cochlear implant, up to age five or for at least one year after the implant, whichever is later, and a word recognition score of 60 percent or less determined using the HINT or the HINT-C tests.
What disorders of a child’s respiratory system are considered disabling?
Listing 103.00 disorders include chronic pulmonary insufficiency, cystic fibrosis and a lung transplant.
What disorders of a child’s cardiovascular system are considered disabling?
Listing 104.00 disorders include chronic heart failure, recurring arrhythmia, congenital heart disease, a heart transplant or rheumatic heart disease.
What disorders of a child’s digestive system are considered disabling?
Listing 105.00 disorders include gastrointestinal hemorrhaging from any cause that requires a blood transfusion, chronic liver disease, inflammatory bowel disease, short bowel syndrome, malnutrition, a liver transplant and, for children under age three, the need for supplemental daily feeding via a gastrostomy.
What disorders of a child’s genitourinary system are considered disabling?
Listing 106.00 disorders include any impairment of the renal (kidney) function, nephrotic syndrome (damage to the kidneys) and congenital genitourinary impairments resulting in infection, hospitalization or surgery.
What disorders of a child’s hematological system are considered disabling?
Listing 107.00 disorders include hemolytic anemia, sickle cell disease, chronic idiopathic thrombocytopenic purpura (low blood platelet counts) and inherited coagulation disorder.
What disorders of a child’s skin are considered disabling?
Listing 108.00 disorders include ichthyosis (dry, scaly skin), bullous diseases (blistering caused by your body’s autoimmune system), chronic infections of the skin or mucous membranes, dermatitis, hidradenitis suppurativa (a skin disease affecting areas with sweat or sebaceous glands), genetic photosensitivity disorders and burns.
What disorders of a child’s endocrine system are considered disabling?
Listing 109.00 disorders include diabetes in a child less than six who requires daily insulin.back to top
What disorders of a child’s multiple body system are considered disabling?
Listing 110.00 disorders include non-mosaic Down syndrome and a catastrophic congenital abnormality or disease.
What disorders of a child’s neurological system are considered disabling?
Listing 111.00 disorders include major motor seizure disorder, non-convulsive epilepsy, brain tumors, motor dysfunction due to any neurological disorder, cerebral palsy, Meningomyelocele and related disorders (spina bifida) and any communication impairment associated with a documented neurological disorder.
What childhood mental disorders are considered disabling?
Listing 112.00 disorders include organic mental disorders; schizophrenic, delusional (paranoia), schizo-affective and other psychotic disorders; mood disorders; mental retardation; anxiety disorders; somatoform, eating and tic disorders; personality disorders; psychoactive substance dependence disorders; autism and other pervasive developmental disorders; attention deficit hyperactivity disorder (ADHD); and developmental or emotional disorders of newborn and younger infants (to age one).
What childhood cancers are considered disabling?
Listing 113.00 disorders include malignant solid tumors, non-Hodgkins lymphoma, leukemia, cancer of the thyroid gland, retinoblastoma (cancer in the retina), brain tumors and neuroblastoma, a cancer that originates in the nerve tissue of the adrenal gland, or the abdomen, chest, neck, or pelvis.
What impairments of a child’s immune system are considered disabling?
Listing 14.00 impairments include systemic lupus erythematosus, systemic vasculitis, systemic sclerosis, polymyositis and dermatomyositis, undifferentiated and mixed connective tissue diseases, immune deficiency disorders excluding HIV infection, human immunodeficiency virus (HIV) infection and inflammatory arthritis and Sjögren’s syndrome.back to top
What type of Medical Evidence do I need to prove my disability?
You have to show that you have a medical impairment and that it is severe enough to last at least 12 months or result in death. Once you file a claim, you will sign a consent form, permitting SSA to obtain your medical reports from sources that have treated or evaluated you.
Who are acceptable medical sources?
Licensed physicians (medical or osteopathic doctors); licensed or certified psychologists including school psychologists (only for purposes of establishing mental retardation, learning disabilities and borderline intellectual functioning); licensed optometrists; licensed podiatrists only for purposes of establishing impairments of the foot or ankle; qualified speech-language pathologists only for purposes of establishing speech or language impairments.
What medical sources are most reliable?
SSA regulations place special emphasis on evidence from treating sources because they are likely to be the medical professionals most able to provide a detailed, ongoing picture of a claimant’s impairment(s).
What about doctors in hospitals, clinics, etc.?
SSA also requests copies of medical evidence from hospitals, clinics, or other health facilities where a claimant has been treated. All medical reports received are considered during the disability determination process.
What information should medical reports include?
All medical records should contain a claimant’s medical history, clinical findings (such as the results of physical or mental status examinations), laboratory findings (such as blood pressure, x-rays), a diagnosis of a claimant’s impairment(s), treatment(s) prescribed with response and prognosis, and a statement about how a claimant’s impairment(s) affect his or her Activities of Daily Living (ADLs).back to top
How detailed should Activities of Daily Living (ADL) statements be?
For adults age 18 or over, the ADL statements should describe the claimant’s ability to perform work-related activities, such as sitting, standing, walking, lifting, carrying, handling objects, hearing, speaking, and traveling.
What if I don’t have a physical impairment?
In adult cases involving mental impairments or mental functional limitations, the ADL statement should describe the claimant’s capacity to understand, to concentrate, to carry out and remember instructions, and to respond appropriately to supervision, coworkers, and work pressures in a work setting.
What if the claimant is my child?
If a claimant is a child under age 18, the ADL statement should describe his or her functional limitations compared to children his or her age who do not have medical impairments.
How specific does a child’s Activities of Daily Living (ADL) statement have to be?
The statement should describe how a child’s impairment(s) affect his or her ability to acquire and use information, attend and complete tasks, interact and relate with others, move about and manipulate objects, care for himself or herself, and the child’s general physical and mental well-being.back to top
What other evidence does SSA look at for disability claims?
Information from other sources may also help show the extent to which an individual’s impairment(s) affects his or her ability to function in a work setting; or in the case of a child, the ability to function compared to that of children the same age who do not have impairments.
What are these other sources?
Other sources include public and private agencies, non-medical sources such as schools, parents and caregivers, social workers and employers, and other practitioners such as naturopaths, chiropractors, and audiologists.
Will SSA accept just my doctor’s opinions and evaluations?
Not usually. In most cases, SSA will ask claimant to attend a Consultative Examination (CE), paid for by SSA.back to top
What is a Consultative Examination (CE)?
SSA will often contact a treating source physician for additional information or clarification. If the treating source is not available, or is unwilling, to conduct another examination for SSA, then SSA will arrange for a CE, using a doctor or doctors from its list of approved contract doctors, who will conduct the examination.
Are these doctors employed by SSA?
No. They are usually doctors in private practice who have agreed, usually for a set fee, to conduct these examinations on behalf of SSA.
Aren’t these doctors biased in favor of SSA?
In theory, no. In reality, however, these doctors perform a number of consultative examinations, for a set fee, based upon how useful and timely their reports are generated and used by SSA.
How detailed can these consultative examinations be?
Another reality is that a consultative examination is often cursory, at least from a claimant’s viewpoint, and rarely provides a long-time look at a claimant’s medical history, symptoms, diagnosis, treatment history and ultimate prognosis.
Don’t these consultative examinations have to follow certain guidelines?
Yes. A complete CE report will involve all the elements of a standard examination in the applicable medical specialty and should include the following elements: the claimant’s major or chief complaint(s); a detailed description, within the area of specialty of the examination, of the history of the major complaint(s); a description and disposition of pertinent “positive” and “negative” detailed findings; and any relevant findings reported or found during the examination.back to top
Isn’t that what my treating doctor usually provides?
Yes, it is. SSA, however, often seems to place greater weight on the opinions of a doctor conducting the CE, perhaps because SSA feels that this doctor is more independent and neutral, during an examination, and is the most recent doctor to examine a claimant before a disability decision.
Do these doctors do mental as well as physical CEs?
Yes, and a claimant, especially on alleging both a mental disorder as well as a physical impairment, will be instructed to report for both a physical and a psychological CE. The “psych CEs” are usually performed by licensed psychiatrists or psychologists.
Do children also go to CEs?
If a claimant is a child under age 18, he or she may be directed to report for a physical or a psychological CE.
What does a report from a child’s CE consist of?
Generally, the same as an adult’s report. Just like a medical report issued by a child’s treating source physician, a child’s CE report should describe how a child’s impairment(s) affect his or her ability to acquire and use information, attend and complete tasks, interact and relate with others, move about and manipulate objects, care for himself or herself, and the child’s general physical and mental well-being.
Are the CE reports of a child considered confidential?
Unfortunately, they are not confidential.
What other evidence other than medical and ADL reports does SSA consider?
SSA investigates all evidence that may relate to a claimant’s allegations. This includes information regarding a claimant’s daily activities; the location, duration, frequency, and intensity of the pain or other symptom; precipitating and aggravating factors; the type, dosage, effectiveness, and side effects of any medication; treatments, other than medications, for the relief of pain or other symptoms; any measures the claimant uses or has used to relieve pain or other symptoms; and other factors concerning the claimant’s functional limitations due to pain or other symptoms.
What role does age play in being awarded SSDI benefits?
The older you are, the more SSA believes you cannot be trained for new work, or are less able to adjust to a new work environment. In effect, it’s always easier to win a claim for SSDI benefits if you are older than if you are younger.
What about the work I used to do?
SSA will consider the type of work you used to do, and whether it could be considered sedentary (sitting all day), light work, heavy work, etc. It will also consider your ability to perform that work, or similar work that exists in today’s economy, when they decide if your impairment(s) will prevent you from going back to work.
Are some SSDI cases more easily won than others?
Yes. If you are legally blind, you are automatically disabled. If you have ALS (Lou Gehrig’s Disease), your claim will usually be expedited through the system. On the other hand, psychiatric cases are generally harder to win than others because many psychiatric patients fight the process or don’t see their doctors regularly. It is also hard to win a pain case where someone alleges a great deal of pain and there is no objective evidence of a medical impairment. For that reason, people who have fibromyalgia, or claimants alleging chronic fatigue disorders, have a difficult time succeeding without expert representation.back to top
Do I need a disability representative or disability advocate working for me?
You can apply on your own. A disability advocate, however, dramatically improves – and speeds – your chances of receiving disability benefits. The vast majority of claimants whose claims reach the Administrative Law Judge (ALJ) level of appeal rely on the experience of their representatives.
Why should I choose Quikaid to help me get SSDI?
Quikaid’s representatives have more than fifty years of accumulated experience processing disability benefits. Some of our representatives have worked as disability claims examiners for the Social Security’s Department of Disability Determination and can apply their special insight to the handling of your claim.
What is Quikaid’s success rate?
Our overall award rate is about 95 percent for those who start and complete the process with us.
What exactly will Quikaid do for me?
We will represent you at all levels of the SSDI process, from application through appeals, until a favorable award is received. We simplify a very complicated process and do all of the paperwork, collect medical records, prepare you for hearings and speak to the SSA on your behalf. We actively check the status of your claim on a regular basis. We’re here when you need us, and we keep you informed.
What are Quikaid’s fees?
The SSA governs the fees of representatives. Our typical fee is 25 percent of the retroactive (back) award, not to exceed $6,000. We do not charge a fee unless we are successful in obtaining your benefits. Also, we do not charge any added fees for travel, collecting medical records, etc.
Will Quikaid charge me any extra costs to review my case?
No. We never charge a fee unless you are awarded your benefits. Contact us now for a free consultation.
Will Quikaid help me if I need a hearing?
Your Quikaid representative will thoroughly prepare you for the hearing and will represent you at the hearing. 5 of 10 of Quikaid’s awards are obtained without the need to see a judge (or visit an SSA office), which allows you to stay at home.back to top
How can I contact Quikaid?
Our office is located at 695 Central Avenue, Saint Petersburg, FL 33701. You can call us toll free at (800) 434-4364, or locally at (727) 498-8956. You can also email us at [email protected] We represent claimants throughout the United States.
That’s a lot of information. What else can I do to find answers to my questions?
You can look at the SSA’s POMS (Program Operations Manual System) section dealing with SSDI by going online to SSA’s secure website, or you can contact Quikaid at (800) 434-4364.