Medical expenses from hospital stays, long-term rehabilitation, and devices to adapt to living at home add up quickly. If you can’t work due to your injury, it may seem impossible to make ends meet.
There is an option. You may be eligible for Social Security disability (SSD) benefits. However, the Associated Press has reported that people are flooding the Social Security Administration with applications for SSD benefits. Applications are up nearly 50 percent from a decade ago. As a result, the government currently denies over three-quarters of claims, even for people who are entitled to SSD benefits.
Learning about the system can help increase your likelihood of receiving SSD benefits.
Am I Eligible for SSD Benefits?
SSD benefits are designed to provide financial help for people with physical disabilities and severe mental health conditions that prevent them from working full-time – including those with spinal cord injuries.
Unfortunately, the Social Security Administration doesn’t accept claims from every person with a spinal cord injury. To qualify, the spinal cord injury must be severe enough that it impacts your ability to work.
You may be eligible for SSD benefits if your condition:
- Prevents you from working;
- Prohibits you from working in any capacity – not just the job you held previously;
- Has lasted – or is expected to last – for at least one year;
- Is life-threatening.
You also must have paid into the Social Security system within the past five years. If you haven’t worked long enough or recently enough to qualify for SSD benefits, you may be eligible for Social Security Income (SSI) benefits instead. The application process is the same for both.
Applying for SSD Benefits – Getting Started
If you want to apply for SSD benefits, or if you have questions, contact the Social Security Administration at 1-800-722-1213. You can visit www.ssa.gov to file online or make an appointment at a local Social Security District Office as well.
The claim evaluation process can take 120 days or more. The Social Security Administration will review your medical records thoroughly. They will look for proof of diagnosis, treatments, prescription medications, and other details about your medical history to determine the severity of your spinal cord injury. You should see your physician regularly and follow your prescribed treatment plan. Failing to do so will likely make you ineligible to receive SSD benefits. The Social Security Administration also will evaluate your claim based on your age, education, and work history.
If you’re approved, you will receive SSD benefits after your sixth full month of disability. SSD payments are retroactive from the date you’re evaluated as disabled. The money you receive is based on your average top earnings over the past 15 years of work history. Note however, that your SSD medical benefits will not kick in until the 29th month from the date you’re considered disabled.
Appealing a Denied Claim
If the Social Security Administration denies your claim, don’t give up. Remember, they deny the majority of claims. But, you must act quickly. You have only 60 days to appeal. You can reapply after that time period, but the process starts all over again.
If you appeal the decision, you’ll go to a hearing, which can take 12-18 months. The judge may take several months to issue a decision. If that doesn’t work, you can move on to the Appeals Council. Last, you can pursue a case in Federal Court. You must have an attorney at the federal level.
SSD and SSI are considered lifelong benefits, but the Social Security Administration could terminate your benefits if they believe you’ve earned too much money or if your condition has improved. If that happens, you can appeal the decision within 60 days (10 days to continue receiving checks while the appeal is pending). However, if you don’t win the appeal and you continued receiving checks while the appeal was pending, you will have to pay back the money you received during that time period.
Learning to Navigate the System
Applying for SSD benefits can be a long and difficult road for people living with spinal cord injuries and their families. There are plenty of opportunities to make mistakes.
To improve your chances of getting approved for SSD benefits, learn everything you can about the Social Security disability system. Know what the Social Security Administration will look for when they evaluate your claim. Be sure to see your doctor regularly and follow your prescribed treatment plan.
Finally, be ready to file an appeal within 60 days if your claim is denied. Knowing how to navigate the system can make all the difference.
By Dennis Liotta, Esq.
Attorney Dennis Liotta, a partner at the law firm of Edgar Snyder & Associates, has over 20 years of experience and has helped people with physical and mental disabilities get the Social Security disability benefits they deserve. For a comprehensive overview of SSD, with answers to commonly asked questions, download a free guide at: http://www.edgarsnyder.com/ssd-guide.