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Providing Social Security Disability (SSD) and Supplemental Security Income (SSI) Representation

Frequently Asked Questions About Disability Insurance

  1. What are the disability requirements for an adult?
  2. How much can I earn and still receive Disability benefits?
  3. What kind of disability benefits does Social Security pay?
  4. If I go back to work, will I automatically lose my disability benefits?
  5. How does a child qualify for disability benefits?
  6. I applied for disability benefits 3 months ago and still haven't received an answer. When should I expect to be notified of the decision?
  7. How do I apply for disability benefits?
  8. Why is there a five-month waiting period for Social Security disability benefits?
  9. I currently receive Social Security disability benefits. My disabilities have worsened and I have other health problems. Can my monthly benefit amount be increased?
  10. How do workers' compensation payments affect my disability benefits?
  11. What Payments May Affect Your Disability Benefits?
  12. What is the earliest age that I can receive Disability benefits?
  13. How many credits are required to be eligible for disability?
  14. I had an accident at work last year and am now receiving Social Security disability benefits for myself, my wife, and our daughter. Before my accident, I helped support another daughter by a woman to whom I had never been married. Is the second child entitled to some benefits as well?
  15. I understand that to get Social Security disability benefits, your disability must be expected to last at least a year. Does this mean that you must wait a year after being disabled before you can get benefits?
  16. I had a serious back injury four years ago and received disability benefits for about 18 months until I could return to work. Unfortunately, my back problems have recurred and I don't know how much longer I will be able to continue working. When I initially applied for benefits, I waited several months before I received my first check. If I reapply for benefits, will my wait be as long as it was the first time?
  17. What is a disability trial work period?
  18. If my disability benefits end because of my work, will I have to file a new application if I can't work anymore?

What are the disability requirements for an adult?

The definition of disability under Social Security law is a strict one. To be eligible for benefits, a person must be unable to do any kind of substantial gainful work because of a physical or mental impairment (or a combination of impairments), which is expected either:

  • to last at least 12 months, or
  • to result in death.

If, because of a medical condition, a person cannot do the work that they performed in the past, then age, education, and past work experience must be considered in determining whether the person can do other work. If the evidence shows that the person can do other work, even if it involves different skills or pays less than their previous work, they cannot be considered disabled for Social Security purposes.

You should be familiar with the process Social Security uses to determine if you are disabled. It's a step-by-step process involving five questions. They are:

  • Are you working? If you are and your earnings average more than $780 a month, you generally cannot be considered disabled.
  • Is your condition severe? Your impairments must interfere with basic work-related activities for your claim to be considered.
  • Is your condition found in the list of disabling impairments? Social Security maintains a list of impairments for each of the major body systems that are so severe they automatically mean you are disabled. If your condition is not on the list, SSA will decide if it is of equal severity to an impairment on the list. If it is, your claim is approved. If it is not, then Social Security will go to the next step of the evaluation process.
  • Can you do the work you did previously? If your condition is severe, but not at the same or equal severity as an impairment on the list, then Social Security must determine if it interferes with your ability to do the work you did in the last 15 years. If it does not, your claim will be denied. If it does, your claim will be considered further.
  • Can you do any other type of work? If you cannot do the work you did in the last 15 years, Social Security then looks to see if you can do any other type of work. Social Security will consider your age, education, past work experience, and transferable skills, and review the job demands of occupations as determined by the Department of Labor. If you cannot do any other kind of work, your claim will be approved. If you can, your claim will be denied.

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How much can I earn and still receive Disability benefits?

Social Security evaluates the work activity of persons claiming or receiving disability benefits under Social Security Disability Insurance. Beginning January 1, 2002 a Social Security Disability beneficiary can earn $780 a month and remain eligible for benefits. The amount for 2001 was $740. The Social Security Administration uses the term "substantial gainful activity" (SGA) to determine if work is substantial enough to make a person ineligible for benefits. Under the new rule monthly SGA earnings limits will be automatically adjusted annually based on increases in the national average wage index. This amount applies to people with disabilities other than blindness.

There are other provisions and work exclusions that you should know about and we recommend that you contact Social Security or an attorney for further information.

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What kind of disability benefits does Social Security pay?

People who are disabled may be eligible for monthly benefits under one or more of the programs Social Security administers. Both the Social Security Disability Insurance Benefits (DIB) and the SSI program provide a monthly income for people with disabilities. However, the non-medical eligibility requirements for the two programs are different.

The Social Security Disability Insurance Benefits (DIB)program pays benefits to disabled workers and their families. To be eligible for DIB, you must be disabled and must have earned a minimum number of credits from work covered under Social Security. (The required number of credits varies depending on your age at the time you became disabled.)

The Supplemental Security Income (SSI)program provides monthly income to people who are age 65 or older, or are blind or disabled, and have limited income and financial resources. Effective January 2002, the SSI payment for an eligible individual is $545 per month and $817 per month for an eligible couple. If you are married, and only one person is eligible, a portion of your spouse's income may be counted. In addition, your financial resources (savings and assets you own) cannot exceed $2,000 ($3,000 if married). You can be eligible for SSI even if you have never worked in employment covered under Social Security. No SSI benefits are paid to family members, only to the disabled person.

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If I go back to work, will I automatically lose my disability benefits?

No, the new law has not changed Social Security’s work incentives rules. For more information about Social Security's work incentives you should contact Social Security or speak with an attorney.

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How does a child qualify for disability benefits?

Children who are disabled may be eligible for monthly benefits under one or more of the programs Social Security administers. Both the Social Security Disability insurance benefits (DIB) and the SSI program provide a monthly income for people with disabilities. However, the eligibility requirements for the two programs are different.

DIB pays benefits to disabled or retired workers and their families and to the families of deceased workers. Child's benefits generally may be paid to a dependent unmarried child under age 18, to a child age 18 or older who became disabled before age 22, and to a full-time elementary or secondary school student under age 19. If the parent is alive, he or she must be entitled to retirement or disability benefits. If deceased, the parent must have worked long enough under Social Security for survivor's benefits to be paid on the record.

A child age 18 or older may be entitled to DIB based on his or her disability when a parent who has worked long enough under the program is entitled or dies. The criteria used to evaluate the disability are the same as those used to evaluate disability in adults. The child must be unable to do any "substantial" work because of a medical condition that has lasted or is expected either to last at least 12 months or to result in death. Usually a job that pays $740 or more per month ($780 in 2002) is considered "substantial." The child's disability must have begun before age 22.

The SSI program provides monthly income to people who are age 65 or older, or are blind or disabled, and have limited income and financial resources. Children can qualify if they meet the definition of disability and if the household income of the parents and the child are within the allowed limits.

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I applied for disability benefits 3 months ago and still haven't received an answer. When should I expect to be notified of the decision?

In the year 2001 the average processing time for a Social Security Disability claim was 106 days. This is an average and the actual time it takes to process your claim may be more or less based on:

  • the State you live in;
  • the nature of your disability;
  • how quickly Social Security can obtain medical evidence from your doctor or other medical source; and
  • whether it is necessary to send you for a medical examination.

As further assurance of consistency, samples of the State agencies' determinations undergo an extensive quality assurance process performed by Federal reviewers. Unfortunately, this additional review may cause delays in some cases.

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How do I apply for disability benefits?

When To Apply
You should apply as soon as you become disabled. However, Social Security disability benefits will not begin until the sixth full month of disability. This waiting period begins with the first full month after the date Social Security decides your disability began.

How To Apply
You can apply for disability benefits online at http://www.ssa.gov/applyforbenefits, or you can apply by calling Social Security’s toll-free number, 714-515-5141. Representatives there can make an appointment for your application to be taken over the telephone or at any convenient Social Security office (http://www.ssa.gov/locator).

The Law Offices of Benjamin H. Berkley, APLC may be able to assist you with your application. Please call our office to speak with an attorney.

What You will Need
The claims process for disability benefits is generally longer than for other types of Social Security benefits, from 60 to 90 days. It takes longer to obtain medical information and to assess the nature of the disability in terms of your ability to work. However, you can help shorten the process by bringing certain documents with you when you apply and helping Social Security get any other medical evidence you need to show you are
disabled. These include:

  • your Social Security number
  • your birth certificate or other evidence of your date of birth
  • your military discharge papers, if you were in the military service
  • your spouse's birth certificate and Social Security number if he or she is applying for benefits
  • your childrens' birth certificates and Social Security numbers if they are applying for benefits
  • your checking or savings account information, so your benefits can be directly deposited
  • names, addresses, and phone numbers of doctors, hospitals, clinics, and institutions that treated you and dates of treatment
  • names of all medications you are taking
  • medical records from your doctors, therapists, hospitals, clinics, and caseworkers
  • laboratory and test results
  • a summary of where you worked in the past 15 years and the kind of work you did
  • a copy of your W-2 Form (Wage and Tax Statement), or if you are self-employed, your federal tax return for the past year
  • dates of prior marriages if your spouse is applying

The documents presented as evidence must be either originals or copies certified by the issuing agency. Social Security will not accept uncertified or notarized photocopies as evidence since it cannot verify their authenticity. Do not delay filing for benefits just because you do not have all of the information you need.

If you are applying for Supplemental Security Income benefits you also need the following:

  • information about the home where you live, such as your mortgage or your lease and landlord's name
  • payroll slips, bank books, insurance policies, car registration, burial fund records, and other information about your income and the things you own.

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Why is there a five-month waiting period for Social Security disability benefits?

Social Security assumes that working families have access to other resources to provide support during periods of short-term disabilities, including workers compensation, insurance, savings, and investments. Social Security is designed to provide a continuing income to you and your family when you are unable to do so. Benefits continue as long as you remain disabled.

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I currently receive Social Security disability benefits. My disabilities have worsened and I have other health problems. Can my monthly benefit amount be increased?

No. Your benefit is based on the amount of your lifetime earnings prior to your disability and not the degree of your disability.

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How do workers' compensation payments affect my disability benefits?

Ordinarily, disability payments from other sources do not affect your Social Security disability benefits. But, if the disability payment is workers' compensation or another public disability payment, your and your family's Social Security benefits may be reduced.

Your Social Security disability benefit will be reduced so that the combined amount of the Social Security benefit you and your family receive plus your workers' compensation payment and/or public disability payment does not exceed 80 percent of your average current earnings. (Note that the unreduced benefit amount is counted for income tax purposes.)

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What Payments May Affect Your Disability Benefits?

The kinds of payments that affect your Social Security disability benefits are a workers' compensation payment and/or another type of public disability payment.

A workers' compensation payment is one that is made to a worker because of a job-related injury or illness. It may be paid by federal or state workers' compensation agencies, employers, or insurance companies on behalf of employers.

Public disability payments that may affect your Social Security benefit are those paid under a federal, state, or local government law or plan that pays for conditions that are not job-related. They differ from workers' compensation because the disability that the worker has may not be job-related. Examples are civil service disability benefits, military disability benefits, state temporary disability benefits, and state or local government retirement benefits which are based on disability.

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What is the earliest age that I can receive Disability benefits?

There is no minimum age. However, to qualify for Social Security disability benefits, you must have worked long enough and recently enough under Social Security. You can earn up to a maximum of four work credits per year. The amount of earnings required for a credit increases each year as general wage levels rise.

The number of work credits you need for disability benefits depends on your age when you become disabled. Generally you need 20 credits earned in the last 10 years ending with the year you become disabled.

However, younger workers may qualify with fewer credits. The rules are as follows:

  • Before age 24 - You may qualify if you have six credits earned in the three-year period ending when your disability starts.
  • Age 24 to 31 - You may qualify if you have credit for having worked half the time between 21 and the time you become disabled. For example, if you become disabled at age 27, you would need credit for three years of work (12 credits) out of the past six years (between age 21 and age 27).
  • Age 31 or older - In general, you will need to have the number of work credits shown in the chart shown below. Unless you are blind, at least 20 of the credits must have been earned in the 10 years immediately before you became disabled.
Disabled At Age
Credits You Need:
31 through 42
44
46
48
50
52
54
56
58
60
62 or older
20
22
24
26
28
30
32
34
36
38
40

In addition to the earnings requirement, you must meet Social Security's strict definition of disability.

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How many credits are required to be eligible for disability?

To qualify for Social Security disability benefits, you must have worked long enough and recently enough under Social Security. You can earn up to a maximum of four work credits per year. The amount of earnings required for a credit increases each year as general wage levels rise.

Family members who qualify for benefits on your work record do not need work credits.

The number of work credits you need for disability benefits depends on your age when you become disabled. Generally you need 20 credits earned in the last 10 years ending with the year you become disabled.

However, younger workers may qualify with fewer credits. The rules are as follows:

  • Before age 24 - You may qualify if you have six credits earned in the three-year period ending when your disability starts.
  • Age 24 to 31 - You may qualify if you have credit for having worked half the time between 21 and the time you become disabled. For example, if you become disabled at age 27, you would need credit for three years of work (12 credits) out of the past six years (between age 21 and age 27).
  • Age 31 or older - In general, you will need to have the number of work credits shown in the chart listed above. Unless you are blind, at least 20 of the credits must have been earned in the 10 years immediately before you became disabled.

If you do not have enough work credits to be eligible for Disability benefits, you should file an application for SSI benefits. Please note you must meet certain requirements to be eligible for SSI benefits.

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I had an accident at work last year and am now receiving Social Security disability benefits for myself, my wife, and our daughter. Before my accident, I helped support another daughter by a woman to whom I had never been married. Is the second child entitled to some benefits as well?

Yes, even though you weren’t married to the second child's mother, Social Security pays benefits to all of your children, even if they were born out of wedlock. Each child is entitled to equal benefits.

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I understand that to get Social Security disability benefits, your disability must be expected to last at least a year. Does this mean that you must wait a year after being disabled before you can get benefits?

You do not have to wait a year after the onset of the disability before you can get benefits. You should file as soon as you can after becoming disabled and benefits begin after a 5-month waiting period. The waiting period begins with the month Social Security decides your disability began.

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I had a serious back injury four years ago and received disability benefits for about 18 months until I could return to work. Unfortunately, my back problems have recurred and I don't know how much longer I will be able to continue working. When I initially applied for benefits, I waited several months before I received my first check. If I reapply for benefits, will my wait be as long as it was the first time?"> had a serious back injury four years ago and received disability benefits for about 18 months until I could return to work. Unfortunately, my back problems have recurred and I don't know how much longer I will be able to continue working. When I initially applied for benefits, I waited several months before I received my first check. If I reapply for benefits, will my wait be as long as it was the first time?

Maybe not. It depends on what the new medical reports say and whether additional evidence is required. A worker who becomes disabled a second time within five years after benefits stop can have his or her checks start again, beginning with the first full month of disability if the new claim is approved.

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What is a disability trial work period?

The trial work period (TWP) allows disability beneficiaries to test their ability to work for at least nine months. During the TWP, Social Security beneficiaries may earn any amount and receive full Social Security Disability benefits. In 2000, earnings of $200 in a month count as a trial work month. Effective January 1, 2001 a new rule increases that amount to $530 per month and links annual changes to increases in the national average wage index. The amount is $560, effective January 2002.

After completion of nine trial work months, the substantial gainful activity (SGA) level is used to determine whether earnings are substantial or not. If earnings fall below the SGA level, full benefits generally continue. If earnings are higher than the SGA level, cash benefits are normally suspended while medical benefits continue. Beginning January 1, 2001 a Social Security Disability SGA level is $740 a month. This amount will be automatically adjusted annually based on increases in the national average wage index. The SGA level is $780, effective January 2002.

You should notify your local Social Security office if you go back to work while receiving disability payments.

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If my disability benefits end because of my work, will I have to file a new application if I can't work anymore?

If your benefits have ended because of work, you can request that Social Security start your benefits again without having to file a new application. There are some important conditions:

  • You have to be unable to work because of your medical condition.
  • The medical condition must be the same as or related to the condition you had when Social Security first decided that you should receive disability benefits.
  • You have to file your request to start your benefits again within 60 months of the date you were last entitled to benefits.
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Site Navigation Information Center Social Security Disability Office Locations

The Berkley Law Firm
1440 N. Harbor Boulevard
Fullerton, CA 92835

Phone: 714-515-5141
Toll Free: 866-470-6963
Fullerton Law Office

The Berkley Law Firm
23046 Avenida de la Carlotta
Suite 600
Laguna Hills, CA 92653
Phone: 714-515-5141
Toll Free: 866-470-6963
Laguna Hills

The Berkley Law Firm
Westin Emerald Towers
402 West Broadway
Suite 400
San Diego, California 92101
San Diego Law Office

Call: (714) 515-5141
Toll free: (866) 470-6963
Fax: (714) 871-9714

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