Social Security Disability FAQ
WHEN CAN A PERSON APPLY FOR SOCIAL SECURITY DISABILITY BENEFITS?
A person who has been disabled at least five (5) months, expects to be disabled for a continuous period of not less than 12 months, and is less than full Social Security age, may apply for Social Security Disability Benefits if they are in a fully insured status. The determination as to whether you are fully insured is calculated by the Social Security Administration based on the Claimant having sufficient calendar quarters in which the Claimant has worked within a period of time prior to the onset of the disability.
HOW IS DISABILITY DEFINED?
Disability is defined as the inability to engage in any substantial gainful activity for reason of any one (1) or combination of medically determinable physical or mental impairments which can be expected to result in death or has lasted, or can be expected to last, for a continuous period of not less than twelve (12) months.
WHAT IS THE DIFFERENCE BETWEEN SSD AND SSI?
SSD is the short-hand reference for Social Security Disability, which is also known as Title II of the Social Security Act. SSI is the short-hand reference for Supplemental Security Income, also known as Title XVI of the Social Security Act. The definition for disability for both SSD and SSI are the same. SSI is a Federal Program established to care for those disabled individuals who have not contributed adequately to the Social Security System to qualify for SSD. The payments to a recipient of SSI are substantially less than those received by an individual under SSD. A person who receives SSD is not limited to the amount of assets that they may have, nor are they limited in the amount of passive income (income derived from sources other than their labor). Under SSI there are specific limitations as to both income and resources of each person prior to qualifying.
HOW DOES A PERSON APPLY FOR SOCIAL SECURITY DISABILITY OR SUPPLEMENTAL SECURITY INCOME BENEFITS?
Application can be made either at your local Social Security Office or online. Social Security now prefers people to apply online. It is not necessary to have an attorney for the initial application process, although many applicants find it valuable to have an attorney involved in organizing their claim and preparing the application. A list of the area offices is found at the end of this page.
IF REJECTED, HOW DOES A CLAIMANT APPEAL?
A person who is denied benefits has sixty (60) days from the date of denial to appeal the denial to an Administrative Law Judge (ALJ). Claimant should consult with an attorney immediately after receiving a denial.
If denied benefits by the ALJ, an applicant can file an appeal with the Social Security Appeals Counsel and ultimately with the United States District Court.
HOW DOES AN ATTORNEY GET PAID FOR REPRESENTING A CLAIMANT IN SSD AND SSI CASES?
An attorney is required to enter into a Fee Agreement with a Claimant, which would authorize the payment of 25% of all past due benefits payable up to a maximum of $6,000 in any one case. This amount of money is taken out of the Claimant's first check only.
IF A DOCTOR SAYS THE CLAIMANT IS TOTALLY DISABLED, DOES THAT MEAN THAT THE CLAIMANT WILL AUTOMATICALLY RECEIVE BENEFITS UNDER THE SOCIAL SECURITY ACT?
No. A doctor can only diagnosis and define the condition of the Claimant. The doctor can very specifically list limitations that the Claimant may have. It is up to the Social Security Administration and the Courts to determine whether the specific limitations meet the criteria of the Social Security Act.
One way that the Social Security Representative and Administrative Law Judges (ALJ) have to determine whether the person meets the criteria of the Social Security Act is referred to as "Listing of Impairments." The Listings break the body into fourteen systems. Each Listing sets forth specific symptoms and/or laboratory findings of severity that must be met for a person to be found disabled. Many physicians are unaware of the requirements of the Listings and therefore may omit a necessary objective finding from their report. Part of the attorney's role is to educate medical professionals on the requirements of the Listings.
ONCE THE LISTING REQUIREMENTS ARE MET, DOES THE CLAIMANT RECEIVE BENEFITS?
Not automatically. First the Claimant must show that he or she cannot perform any past relevant work. If past relevant work is not possible, then the question still remains as to whether the Claimant has the vocational capacity to adjust to work different from that which the Claimant performed in the past.
WHAT DOES A CLAIMANT BRING TO AN ATTORNEY AT AN INITIAL CONFERENCE?
For the initial visit, the Claimant should bring copies of all documents previously filed with the Social Security Administration, and all notices received. The claimant should also complete the Social Security Disability Worksheet found on this website. This will help the claimant organize a complete work history, list the treating physicians and medications. While most people are prepared to discuss their primary illness, the claimant should be prepared to discuss every injury or illness that he/she has that imposes any physical or mental limitation on them.
ARE DISABILITY BENEFITS SUBJECT TO INCOME TAX?
The answer is “no” and “yes.” Private disability policies that you may have through your employment or you have purchased personally are not subject to Federal income tax due to the fact that they are purchased with after-tax dollars.
Social Security Disability is subject to Federal income tax. Many of us grew up thinking otherwise. Effective with the tax year 1984, all Social Security benefits became subject to Federal income tax, although it only impacts individuals who have substantial income in addition to the Social Security Benefits.
If a person files Federal income tax as an individual with total income, including Social Security, between $35,000 and $43,000, that individual may pay income tax on up to 50% of the Social Security benefits received. For any individual filing with combined income above $35,000, up to 85% of the Social Security benefits may be taxable.
For a married couple filing jointly with a combined income between $32,000 and $44,000, income tax may be paid on up to 50% of the Social Security benefits. Above $44,000, the percentage of Social Security Benefits subject to tax increases to 85%.
For additional reference, go to https://www.ssa.gov/planners/taxes.html.
Pennsylvania does not tax Social Security disability or retirement income benefits. A minority of states do impose some taxes on Social Security payments.
Social Security offices serving the Tri-County area
39 W. Ridge Pike, Royersford, PA 19468
330 W. Market Street, West Chester, PA 19382
201 Penn Street, Wyomissing, PA 19610
1700 Markley Street, Norristown, PA 19401
1251 S. Cedar Crest Blvd., Allentown, PA 18103