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Mike Wells: Have a Social Security disability claim? Get ready to wait.
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Mike Wells: Have a Social Security disability claim? Get ready to wait.

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When citizens do not have the physical and mental ability to engage in gainful employment, despite their strong will to do so, how will they support themselves?

The Social Security system is an insurance system created not only to help people after retirement, but also to help them throughout life. The benefits are meant to take the place of wages.

There are two different disability programs that may provide benefits: 1. Social Security Disability Insurance Benefits and 2. Supplemental Security Income.

Disability Insurance Benefits (DIB) are for disabled workers and certain dependents who have worked enough (generally five out of the past 10 years) to obtain the number of credits required to be eligible for benefits. In addition to the length of time, you must also have earned a certain amount of money each year and have had FICA taxes withheld from your pay to receive credits.

Supplemental Security Income (SSI) is a public assistance program. SSI benefits are needs-based. Benefits are awarded to the disabled, people 65 and over, and visually impaired individuals who have income and resources below specific amounts.

Who qualifies for Social Security Disability Benefits? The Social Security Act defines disability as the inability to perform substantial gainful activity for at least 12 continuous months by reason of physical and/or mental impairment.

Factors considered are age, education, past relevant work experience, years worked and salary received.

There are a number of disabilities that may allow you to receive benefits. Some examples, and this is a non-exclusive list, are: breathing problems, chronic heart disease, obesity, mental disorders, blindness or deafness, rheumatoid arthritis, seizures, despite use of medication, cancer, immune system disorders, extreme psoriasis involving hands and feet, multiple sclerosis, HIV positive, and other severe medical conditions.

What is the process involved in applying for disability benefits?

Initial Application (1st level). This can be done over the phone by contacting the Social Security Administration (www.ssa.gov). It will take approximately three months to hear from the SSA. A significant number of claims are denied initially.

Reconsideration (2nd Level). This is an appeal of the initial denial, and it involves filing out a form provided by the SSA. This will take another few months. Many claims are also denied at this level.

Hearings (3rd Level). This is often the most important stage. Hearings are held by federal administrative law judges in Greensboro, Raleigh and Charlotte. Medical evidence, along with letters from doctors, is essential to a favorable result.

An administrative law judge will evaluate your case based upon the medical evidence you present and make the determination if you are “disabled” under the statute. It is a five-step process.

Compiling the medical evidence and vocational information, and marshaling all the other relevant facts, will greatly increase your chance of prevailing.

The whole process usually takes two to three years, but it can be longer if the initial two applications are denied.

When do you receive benefits and for how long? If you appeal within the appropriate period of time, you may be eligible for back benefits. If you cannot work in the future, you may be able to receive benefits for the remainder of your life.

If you consult with an attorney, the sooner you do so the better. If the attorney is an experienced Social Security attorney, he may suggest you handle the first two steps on your own. But if you have been denied benefits and you have to go to a hearing (3rd level), it probably makes sense to think seriously about employing an attorney. The attorney’s fee is set by the SSA.

Remember: An informed choice is a smart choice.

Mike Wells is a partner with Wells Law, PLLC in Winston-Salem. Contact him at mike@wellslaw.us or 336-283-8700.

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