Social Security Disability Benefits and How to Obtain Them

The challenges caused by a disability and its long-lasting effects on a person’s life and those of their loved ones can be significant. Whether disabled from birth, from a disease, on the job or from an accident, there is help for Pennsylvanians through Social Security disability benefits.

Two of the programs that provide government assistance to qualifying U.S. residents or non-citizens are called Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Processed by the Bureau of Disability Determination, the two programs pay benefits based on specific requirements – both medical and technical. The programs are not mutually exclusive, so some people may qualify for both SSDI and SSI.

While both Social Security Disability Insurance and Supplemental Security Income provide assistance to people with disabilities, the programs differ in a number of ways.

Determine if you are eligible for Social Security benefits by contacting Pennsylvania Social Security attorney Gary Black at the Canton office of Lepley, Engelman, Yaw and Wilk, Attorneys-at-Law, LLC.

Social Security Disability Insurance (SSDI) Explained

Social Security Disability Insurance (SSDI) provides income to qualified individuals who can no longer work due to disability, as well as certain family members. According to the Social Security Administration, “… [that] means that you worked long enough – and recently enough – and paid Social Security taxes on your earnings.”

In other words, the Social Security Administration considers workers to be eligible for applying for SSDI if they have contributed to the Federal Insurance Contributions Act (FICA) through taxes for a certain period of time and somewhat recently. SSDI benefits for qualified individuals are available regardless of current income or assets.

Eligibility for SSDI requires an accumulation of work credits. Work credits are earned according to income and the amount of taxes that are withheld from your paycheck. Funding for SSDI comes from the Federal Insurance Contributions Act (FICA) and Social Security taxes, so benefits are only available to individuals who have contributed to these funds through taxes paid on work income.

SSDI monthly payments are generally much larger than SSI payments and are determined by an individual’s Social Security income record or contributions. SSDI recipients may sometimes receive benefits for family members as well.

Supplemental Security Income (SSI) Defined

The Supplemental Security Income Program (SSI) was created to meet the basic needs of disabled adults and children who have limited income and resources. This program covers low-income people who do not qualify for SSDI.

Applicants must prove through medical and non-medical criteria that they are not working, are unable to work, are US citizens or meet requirements for non-citizens, and they meet certain financial and residency requirements. There is no work history requirement for SSI, but there are very strict financial requirements for eligibility. Applicant’s financial need is based on work history, income and assets. Funding for SSI comes from general taxes.

Determine if you are eligible for Social Security benefits by contacting Pennsylvania Social Security attorney Gary Black at the Canton office of Lepley, Engelman, Yaw and Wilk, Attorneys-at-Law, LLC.

What Does Social Security Consider a Disability?

The Social Security Administration has a very strict definition of disability by law. They say to qualify for either the SSDI or SSI program, an adult must have a medical condition that renders them unable to do any substantial work for at least one year or the medical condition must be expected to result in death.

For children, the applicant must prove the child has a physical or mental condition(s) that very significantly limit activities and the condition must have lasted or be projected to last at least one year or result in death.

The Challenge of Obtaining Social Security Disability Benefits

Obtaining Social Security disability benefits can be quite challenging. More than 145,000 Pennsylvania disability claims are processed each year, but two-thirds of initials claims are denied.

The application process can be challenging due to the amount of information required and because seemingly minor technical or medical eligibility issues can easily cause the claim to be denied.

The help of a qualified Pennsylvania Social Security disability attorney can be very beneficial from the very beginning of the application process. Pennsylvania Social Security disability attorneys understand SSDI and SSI procedures and Pennsylvania’s disability insurance laws from years of experience. This insight can help applicants navigate the complex application and, if needed the appeals process, avoiding pitfalls and achieving greater success.

The Social Security Disability Benefit Process

Applying

The first step to obtain Social Security benefits through SSDI or SSI is to complete an application for disability benefits. It is advisable to file your application for disability benefits in the state where you currently reside. Applications may be completed online or with the assistance of a Pennsylvania Social Security disability lawyer who understands the application process.

One benefit of working with a Social Security disability lawyer in Pennsylvania is that they can assist you with obtaining the information needed to complete your application. A significant amount of information is required to complete your application and it must be provided correctly to prevent a denial. A Social Security disability attorney can also work with you to determine the date your disability began and what conditions are disabling – both physical and mental.

Appealing if the Claim is Denied

When a claim is denied, the applicant will be notified by Disability Determination Services (DDS) by letter, which will include the rationale behind the denial and notification of the right to appeal the decision.

If the Social Security disability benefit claim application is denied, the individual can appeal the decision. Individuals who pursue appeals have a greater chance of obtaining Social Security disability benefits.

There are four levels of sequential appeal:

  • Reconsideration
  • Hearing
  • Appeals Council Review
  • Federal Court Case

An appeal must be made quickly due to the strict deadlines involved in each stage of the appeals process. Generally, individuals only have 60 days after the Social Security Administration’s decision to request an appeal. Late appeals may result in a dismissed claim.

If you have not worked with a lawyer at this point, contacting a qualified, Pennsylvania Social Security disability attorney quickly could make a significant difference in the success of your application. An experienced Social Security disability lawyer will help you meet the strict deadlines and guide your appeal through the rigorous procedural rules and complex procedures.

When an appeal is made, the claim is moved to the Reconsideration phase. The SSA will review the claim again and issue a determination to either approve or deny the claim.

If the claim is rejected again, another appeal may be made to obtain a hearing, where the applicant – and his or her attorney – presents the case to an Administrative Law Judge (ALJ). This is one of the last opportunities to present evidence in support of your claim. Having a qualified Social Security disability attorney advocating for your claim is exceptionally important during this stage. The average hearing wait time in Pennsylvania ranges from 14 to 20 months.

A Request for Review from the Social Security Appeals Council can be pursued if the Administrative Law Judge rules against the case. If rejected again, the final option is to file a lawsuit in Federal District Court.

Determine if you are eligible for Social Security benefits by contacting Pennsylvania Social Security attorney Gary Black at the Canton office of Lepley, Engelman, Yaw and Wilk, Attorneys-at-Law, LLC.

The Value of a Social Security Disability Benefit Attorney

To significantly increase the likelihood of your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability claim approval, seek the help of an experienced Pennsylvania Social Security disability benefit attorney. The disability benefit claim application and appeals process are complicated, difficult to navigate, and time-intensive to do on your own.

Pennsylvania Social Security disability attorneys, like Gary Black of Lepley, Engelman, Yaw and Wilk, LLC, have experience with claims, understand the SSDI and SSI process, and can provide invaluable guidance through every step. Meeting with a Social Security disability benefits lawyer will help you identify what benefits you may be eligible for and the options you have available.

Worried about the cost? The Social Security Administration has placed limits on attorney fees and most Social Security disability benefit lawyers only get paid if the client wins benefits.

Gary Black, of Lepley, Engelman, Yaw and Wilk, LLC, has extensive experience in obtaining benefits for clients. His insight into the insurance industry and years of work with bureaucratic state government systems have well prepared him to assist you with your Social Security disability benefit claim. Contact us today!

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