Millions of disabled Americans depend on Social Security Disability Programs for financial support. To ensure that the disability determination is fair and unbiased, the SSA (Social Security Administration) reviews the medical records of the applicant to find the required medical evidence. Since the medical records are very important in determining disability, the service of medical review companies is much sought after. The social security system is rather complex and there are a number of misconception s and misunderstandings about the system. In this blog, we look at some of the most prevalent misconceptions about social security disability and the actual facts.
- I will be approved for disability if my doctor says I cannot work: The treating physician’s statement regarding the applicant’s inability to work is important and the SSA does give it due weight. However, they look at all evidence available to determine disability. In case the treating doctor’s opinion is not consistent with the rest of the evidence, the doctor’s opinion alone will not qualify the applicant for disability.
- I need to be disabled for a year before I can apply for disability: This is a misconception because a person who is disabled by an injury/illness that has lasted or is expected to last for 12 months or more, or to be terminal, may qualify for disability. That is why it is important to apply for SSDI benefits as soon as the doctor advises the patient that he/she may not recover from the injury/illness.
- I cannot receive SSDI benefits and workers’ compensation at the same time: This is not true. If you are disabled due to a work-related injury or illness, you should immediately apply for workers’ compensation. What is important to understand is that your SSDI benefits may be reduced if you are also receiving workers’ compensation. The SSA calculates your monthly disability benefits including what is due to your family members. That amount is added to your workers’ compensation/other public disability payments you receive. If that amount is more than 80% of your average current earnings, the excess amount will be reduced from your SSDI benefits. SSI (Supplemental Security Income) benefits, VA (Veterans Administration) benefits, and payments from private insurance/pensions will not count as “offsets.”
- If my medical condition is not in the SSA’s Blue Book, I won’t receive benefits: This is also not strictly true. The Blue Book lists the mental and physical impairments that the SSA considers severe enough to prevent a person from working normally and earning a living. However, even if your disability is not listed in the Blue Book, the SSA may review it and determine if your condition interferes with your ability to do the work you did before or prevents you from doing any other kind of work. If they find that your condition is equal in severity to a listed impairment, you may qualify for disability.
- Once I am granted SSDI benefits, I will be considered permanently disabled: Wrong! The SSA will periodically review your case and if they find that you no longer fit their strict definition of disability, they will stop the benefits. You are expected to promptly report any improvement in your condition. There are two ways in which your disability benefits could end. One is, if you return to work and your average earnings come to more than $1,260 per month, or $2,110 per month if you are blind. Second is, your medical condition improves to the point that you are no longer disabled.
- In case my claim is denied, I will soon have a disability hearing before a judge: This is not true, because a wait time is involved. If your claim is denied initially, you need to file two appeals before you can have an administrative hearing. The average wait time could be over a year from the time you request your hearing.
- I am in a very bad financial situation, so I will have my hearing sooner: Some cases are allowed an expedited hearing, though it is rare. To possibly have your hearing sooner, you have to prove that you are without food and don’t have the means to obtain it; you don’t have the necessary medical care or medicine and cannot obtain it; that you have become homeless and don’t have shelter. The SSA may also speed up claims in the following cases – you have a terminal illness, disease/health condition that qualify for compassionate allowance; a 100% permanent and total disability rating from the Department of Veterans Affairs, and so on.
- I have never worked and so I cannot apply for disability benefits: In such a case, you may be eligible for SSI or Supplemental Security Income benefits. However, if your spouse is working and earning an income, it may disqualify you for SSI eligibility. Children, whose parents’ financial resources are limited, may also be eligible for SSI benefits.
- I may be approved for disability even though I have an addiction problem: In most cases drug/alcohol addiction disqualifies an applicant for disability. However, if a person who uses alcohol or drugs can prove that he/she is disabled for reasons other than the use of the addictive substance, they may still be found disabled. Also, the long-term effects caused by drug/alcohol could continue even after the person has recovered from the addiction. In such cases also, there is a chance that he/she could qualify for disability.
- If I use my Ticket to go to work, the SSA will conduct a medical review and I will lose my benefits: This is not true. If you use your Ticket to go to work, and make “timely progress” following your individual work plan, the SSA will not conduct a review of your medical condition. However, if a medical CDR (Continuing Disability Review) has already been scheduled before you assigned your ticket, the SSA will go ahead with the medical CDR.
- If I go to work and my disability benefits stop, and then I have to stop working again because of my disability, I will have to go through the entire tedious application process again. So, it’s best not to try to go back to work: This is also a misconception. If your benefits stopped within the last five years because of your earnings and you meet some other requirements including that you still have the original medical condition or a similar on that prevents you from working, you may not need to reapply. This is a work incentive called Expedited Reinstatement and with this, you could receive up to six months of temporary cash benefits apart from your Medicare/Medicaid coverage. During this time, the SSA will conduct a medical review to find out if your disability benefits can be restored.
- My application was denied but I will get benefits after my hearing: Many disability claims are initially denied and later approved at the hearing stage. However, you do not automatically qualify at the hearing before an Administrative Law Judge or ALJ. This is a stage when you may require the assistance of a good attorney because you have to prepare your case for the hearing; you have to present it well before the ALJ; and you must ensure that all your records are up-to-date and provided to the ALJ.
- I must be close to my retirement age to qualify for disability: This is a misconception. The SSDI program is not a retirement program but is meant for those people who cannot work because of a debilitating disability, physical or mental. The benefit amount you receive, is however, based on your payments into social security. In other words, it is based on the social security taxes you pay when you are working and earning an income. So, older workers may receive higher payments compared to younger disabled workers.
- Social security will collect all my medical records, so I don’t have to worry: The SSA does need your medical records and have an obligation to develop your medical record well. When you file a claim, the adjudicator will send out a request for medical records to the doctors you have identified in your application form. However, doctors may not respond immediately to the request because they are often busy with too many requests to handle and other responsibilities. This could result in considerable delay in Social Security processing your claim. It is important therefore for the disability applicant to give the SSA the correct address from where to collect the medical records. Otherwise, a number of concerns including that of missing records could arise.
So, those are some of the most prevalent misconception s about social security disability that disability applicants need to be aware about. As a provider of medical review services for social security disability attorneys, we understand how detrimental it is for disability applicants to believe in such misconceptions. That is why it is best to seek professional counsel from a disability attorney when planning to apply for social security disability benefits.
Disclaimer: The content provided in this blog is for informative purposes only and has been sourced from reliable internet resources. For a professional opinion on this topic, contact a social security disability attorney.