Questions and Answers

Typical questions that you might have for your situation

How do I know if I’m eligible for Social Security disability benefits?

You might be eligible for social security disability benefits if you are unable to work because of a physical condition, mental condition, or combination of both.  Your condition(s) must be expected to last 12 months or end in death and must prevent you from being able to engage in “substantial gainful activity.”  Substantial gainful activity means that you are working and earning $1,260.00 or more per month or are capable of working and earning at least $1,260.00 per month.  Social Security will look at medical evidence to determine whether or not they believe you are capable of performing substantial gainful activity.

The Social Security Administration offers disability benefits under two separate programs.  The first is commonly referred to as Title II benefits, or Social Security Disability Insurance (SSDI) benefits.  You are considered “insured,” and therefore eligible for SSDI benefits depending on how much you have worked and paid into the Social Security system via your FICA taxes.  The taxes you have paid into the Social Security system also help determine the amount of your monthly benefit.

The second type of disability benefits is Title XVI, or Supplemental Security Income (SSI) benefits.  SSI benefits are strictly need-based.  Disability is proven the same way, but because this is the welfare-side of the social security disability program, your monthly benefit is need-based and currently capped at $771.00 for an individual. 

Can I get disability benefits even though I’m still working?

You might still be able to receive social security disability benefits, even though you have continued working.  If you are working and earning less than substantial gainful activity ($1,260.00 per month for the year 2020), and can prove that your medical conditions prevent you from performing substantial gainful activity, you could still be eligible for benefits.

I think I’m eligible – how does social security decide if I’m disabled?

Social Security uses a 5-step process to decide if you are disabled.  First they must look at whether or not you are currently engaged in substantial gainful activity.  If you are working and earning over $1,260.00 per month you are not eligible for benefits and will be denied.  At the second step social security looks at whether you have a medically determinable impairment that is “severe.”  To determine this, Social Security will gather medical records from your doctors and ask you questions about how your condition(s) impact your daily life.  For this reason, you must be receiving fairly consistent medical treatment in order to be found disabled.  Third, Social Security looks at their own internal rules and regulations to determine whether or not you have a special condition that automatically qualifies you for benefits – these are called “listings.”  It is very rare and extremely difficult to be found eligible for disability benefits under a “listing.”  The most critical questions come at the fourth and fifth steps of the process.  At the fourth step, Social Security will analyze all jobs you have performed in the past 15 years and determine whether you are able to perform any of those jobs despite your medical conditions.  If Social Security decides that you can, your claim will be denied.  If Social Security decides you cannot do your past work, they will then move on to the fifth step, at which point they determine whether there are other jobs you could do.  When determining whether you can do any other type of work, Social Security considers age, educational background, and prior work experience. 

Since I stopped working I lost my health insurance.  I cannot afford to see the doctor.  What do I do?

Social Security cannot approve your claim for disability benefits without evidence that you suffer from a severe medical impairment or combination of impairments.  Many of my clients are facing this same dilemma – health insurance is costly and often even the best policies leave you with overwhelming medical debt.  Many physicians require payment up front or will not continue to treat you as your debt to them grows.  Because your claim depends on the medical evidence, you have to get some kind of treatment.  Look for low-cost or sliding scale health clinics in your area.  There are a number of these resources available in Tennessee. 

Does it really take two years to get disability benefits and do I really need an attorney?

Unfortunately, obtaining social security disability benefits can be a lengthy process.  If you have applied for disability benefits and received a denial letter from the Social Security Administration, do not give up!  You have 60 days to appeal this denial and a qualified representative can help you with this process.  As an experienced Social Security disability attorney, I know the Social Security statutes and regulations and I know what kind of evidence Social Security is looking for.  If you have received a denial letter or are facing a hearing in front of an administrative law judge, you definitely need an advocate on your side.  An experienced attorney can help make sure that none of your medical records are missing from your file, gather critical opinion evidence from your physicians, and make a persuasive argument to an administrative law judge on your behalf. 

I am not working – how could I possibly afford to hire an attorney to help me with my case?

All Social Security disability cases are handled on a contingency-fee basis.  This means that I don’t get paid unless I successfully help you obtain your disability benefits, and my fee is only a small percentage of any backpay you receive when your case is approved. 

I have long-term disability benefits through work.  Can I receive these benefits and Social Security disability benefits at the same time?

Yes!  Private short-term and long-term disability policies are always useful tools to have in your back pocket.  If you suffer from an unexpected injury, illness, or surgery, short-term disability benefits can be there to help you pay your bills until you can get back to work.  If you are unable to return to work, long-term disability benefits can be approved and paid at the same time that you are applying for Social Security disability and working your way through that process.  Most long-term disability policies will require you to apply for Social Security disability benefits.  If approved for Social Security disability, your long-term insurance carrier will want to offset your monthly benefit by the amount you are receiving in Social Security benefits.

I’ve been denied my long-term disability benefits from my insurance carrier.  What now?

If you have received a denial letter for either short-term or long-term disability benefits, I can help.  Don’t wait – come in for a free consultation.  Appealing a denial of short-term or long-term disability benefits can be even more complex than appealing Social Security disability benefits.  Most private insurance policies are governed by a federal law known as “ERISA” (Employee Retirement Income Security Act).  You need an advocate experienced in this complex area of the law to gather the necessary medical evidence and argue on your behalf.  Your window for appealing or even pursuing a cause of action in court can close relatively quickly, cutting off your opportunity to get valuable medical evidence in front of the insurance company.  Many people give up and do not appeal these denials – your private disability insurance benefits are benefits you have paid for!  Don’t be discouraged by the big insurer – let me fight the company for you!

Do I have to pay an attorney up front to represent me for my private disability benefits?

Just like Social Security disability cases, I represent clients against private insurance companies on a contingency-fee basis.  I don’t get paid unless you get paid! 

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