Social Security Disability

The Social Security Administration administers numerous benefit programs. The two primary programs are Disability Insurance Benefits (DIB), which provides benefits for disabled individuals based upon their earnings record, and Supplemental Security Income (SSI), which pays benefits to disabled individuals based upon financial need. Other programs include Disabled Widow's Benefits (DWB), which provides benefits based upon the earnings record of a deceased spouse (or ex-spouse) for widows and widowers who are over 50 and disabled, and Childhood Disability Benefits (CDB), which provides benefits based upon the earnings record of a deceased or retired parent for individuals who can show they were disabled before age 22.

The process begins when an individual (claimant) applies for benefits for one or more programs. The Social Security Administration then makes an initial determination on the claim, a process that can take several months. The next stage of review is reconsideration, which again can take several months. Some cases are approved at these two levels, but many meritorious claims are denied. If the claim is again denied, the claimant may request a hearing before an administrative law judge (ALJ). It can be 18 to 24 months or sometimes longer from the time an application is filed to the time the hearing is actually held.

After the hearing, the ALJ evaluates the evidence in the case and issues a written decision. In evaluating the case, the ALJ must follow a five-step sequence:

1. Is the claimant working? If the claimant is engaging in "substantial gainful activity," which is often determined by average monthly income from work, the ALJ will find the claimant not entitled to benefits.

Exception: If the claimant was unable to work for 12 or more consecutive months due to his or her impairments but has returned to work by the time of the hearing, the claimant may be eligible for a "closed period" of benefits - that is, a lump-sum payment of benefits for the period the claimant could not work.

2. Does the claimant have a severe impairment? A severe impairment has more than a minimal effect on the claimant's ability to do basic work activities such as see, hear, speak, lift, carry, sit, stand, walk, concentrate, maintain a pace, or interact with others. If a claimant has a severe impairment, the ALJ goes to step 3 of the process, if not, the ALJ will find the claimant not entitled to benefits.

3. Do the claimant's impairments meet or equal a Listing? Social Security has set standards, called the Listing of Impairments, by which it rates certain impairments. If the claimant's impairments meet or equal a Listing, the ALJ will find the claimant disabled, if not, the ALJ will go to step 4 of the process.

4. Can the claimant return to his or her past relevant work (PRW)? PRW is generally work done in the past 15 years. The ALJ determines whether the claimant can return to any PRW given the limitations imposed by his or her impairments. It is up to the ALJ to determine what limitations are supported by the record in each claimant's case. If the ALJ find the claimant can return to PRW, the ALJ will deny the case; if the ALJ finds the claimant can't return to PRW, the ALJ will go to step 5 of the process.

5. Is there any other work available in the economy that the claimant can still do? To find a claimant not disabled, the ALJ must find that there are jobs the claimant can do. If there are no jobs the claimant can do, he or she is disabled. Even if there are possible jobs the claimant can do, some claimants can, based upon their age (generally 50 and above), "grid out," that is, be found disabled based upon SSA criteria known as "the grids." If the claimant does not grid out and the ALJ finds there are other jobs the claimant can do, the ALJ will find that claimant not disabled.

At Schneider Law Offices, we know the law, and we know how to prepare cases for hearing. Our staff and attorneys solidify cases by obtaining medical records as well as statements from doctors and witnesses. Because our firm has tried thousands of Social Security cases, we also know how to present the case to the ALJ.

Most cases taken to hearing are won there. Cases that are denied after a hearing can be appealed to the Social Security Appeals Council. If lost at the Appeals Council, they can be appealed to the United States District Court, United States Court of Appeals and even to the United States Supreme Court. Schneider Law Offices does many such appeals and many of those clients ultimately receive benefits.

All Social Security fees are contingent, regulated by the Social Security Administration and subject to approval by the Social Security Administration. Generally fees are limited to 25% of past due benefits with a $5300 cap. If you don't get benefits there is no fee.

DISCLAIMER: The above is intended as general information, not legal advice, and use of this information does not establish an attorney-client relationship. If you have questions about your specific situation, please call Schneider Law Offices at 503-255-9092 or 1-800-630-4SSD.