Social Security Disability FAQs

What type of disability is required before I qualify?

You may be eligible for Social Security (SS) if you have mental and/or physical problems severe enough to keep you from working for a period of twelve (12) months or more at a regular paying job you are qualified to do. You must be unable to work at any reasonable job, not just the one you had before your disability. The inability to return to your present job, your age, education and work experience are all factors that SSA will consider.

What happens when I am denied?

Most claimants are denied several times before they receive a favorable decision on their claim. DO NOT GIVE UP. Your best opportunity to prove your disability occurs with a lawyer at an Administrative Law Judge (ALJ) hearing. You have paid SS taxes for years and should pursue your rights to get SS benefits aggressively.

What is an Administrative Law Judge Hearing?

SS hearings are held by a judge called an Administrative Law Judge (ALJ). The Western North Carolina area has been blessed with very competent and reasonable ALJs. The hearings are relatively informal and have no District Attorney or U.S. Attorney on the "other side" trying to trick or confuse you. Some ALJs will ask questions, some will let your lawyer ask all the questions. Your testimony to the ALJ should emphasize specific physical and/or mental problems and how these ailments prevent you from working.

The ALJ will hear all the evidence and make a decision based on your medical records and testimony heard at the hearing. Sometimes, the ALJ will request a Vocational Expert or Medical Advisor to testify. No jury or other panel will decide the case. Your lawyer should help you understand the issues, expected testimony and procedure.

When can I expect a hearing on my claim?

Due to the large number of appeals in Social Security cases, it is often many months before each level of an appeal is decided. You are generally given several months notice prior to a hearing before an ALJ and you will be expected to attend that hearing unless you have an extraordinary reason why you cannot attend. The exact number of months between appeals varies from time to time and there is little that can be done by you or your lawyer to speed up the process in light of the huge backlog of cases waiting for a hearing. Once a hearing is held, the ALJ should render a favorable or unfavorable decision within ninety (90) days of the hearing.

What is the difference between SS and SSI?

Both SS and SSI benefits have the same requirements for disability--the inability to work at a suitable job for a continuous period of twelve (12) months or more. SS benefits (also called Title II) are based on the amount of SS taxes you have paid in the system for the ten (10) year period before you became disabled. SS benefits are generally higher than SSI benefits. Dependants of SS recipients may also be entitled to benefits. You should report any dependants to SSA even if they do not live with you.

SSI benefits (also called Title XVI) are based on a financial need. You may be eligible for SSI benefits even if you have never worked or paid SS taxes in your life. Generally SSA will sort out whether you are entitled to SS or SSI when you apply. In some cases, you may be eligible to receive both SS and SSI benefits.

Why won't SS pay for my disability without an ALJ Hearing?

A very small number of applicants are awarded benefits in North Carolina before the ALJ hearing. Social Security decisions and opinions prior to the ALJ hearing are generally made by people who have never seen or talked to you. Many SS doctors will give opinions on your physical condition without the benefit of an actual exam. It is extremely important for you to maintain a good relationship with your treating doctor and to fully explain the reasons you are applying for Social Security. If you are persistent and have evidence of your medical disability, you will get the benefits you are entitled to.

Should I try to work if I have applied for Social Security?

Yes. While you cannot be eligible for Social Security benefits while you are working full time, the law does permit you to make "work attempts" for periods of time without any penalty to you. However, you should report any work attempts and should be very candid with your lawyer and the ALJ about all the times you worked or tried to work.

What witnesses or evidence will I need at the hearing?

Since most of the issues for hearing involve medical questions, medical reports from your treating doctors are critical. Doctors are not asked to attend SS hearings. ALJs will not decide the claim based on the number of witnesses. You should consult with your lawyer about the witnesses you need as well as the questions you will be asked.

What if I am getting Workers' Compensation benefits?

SS law requires that all other benefits you receive be accounted for. This accounting normally means that SS benefits are offset or reduced by the other benefits you receive. While Federal law requires you to report all payments you receive, the offset can often be lessened or eliminated with very careful planning and legal wording in your Workers' Compensation settlement. You should consult your lawyer for proper wording.

What if my disability is caused by alcohol or drugs?

Congress has passed legislation that severely limits the receipt of SS benefits if your substance abuse problems contribute to your disability. While the current law is very unfavorable to these types of claims, careful analysis by an experienced lawyer may help you to find other grounds that are legitimate reasons to qualify for SS benefits.

How much will a lawyer cost me?

The ALJ must approve any fee charged by a lawyer. Lawyers will take Social Security cases on a contingency or percentage (%) basis. The standard percentage is twenty-five percent (25%) of any past-due benefits you might be entitled to. If your claim is rejected by the ALJ, you will not owe any money for attorney fees. Although if you lose, you are still obligated to pay any "out of pocket" expenses such as costs to obtain medical reports, copies, long distance phone calls and other related calls. No fees will be charged on future benefit payments.

How do I select a lawyer?

Social Security law changes regularly with new Congressional legislation and Court decisions. You should select a lawyer who regularly practices in SS court. The lawyer should be experienced, knowledgeable and concerned about your claim.