If you have had the misfortune of suffering a catastrophic traumatic injury or illness and are unable to work, you may be eligible for Social Security Disability (SSD) benefits.
Until quite recently, if you wanted to apply for SSD benefits you needed to apply directly for those benefits on your own.
Now if you so desire, you can have an attorney represent you in the initial process from day one and through an appeal process should you be denied benefits at the first level.
The first level is the initial application. If you are not successful, you can then appeal by having a hearing before an Administrative Law Judge. This is the second level. If unsuccessful at the second level, you may proceed to the third level by appealing to the Appeals Council.
The Kwak Law Firm can represent you at all three levels and has done so for hundreds of clients. Our team can be instrumental in obtaining and submitting all of your medical records to the Social Security Administration (SSA) for their review.
In some instances, these complete medical records are enough for you to receive a favorable decision at the first level without appealing the decision to an Administrative Law Judge.
An attorney can also help you in determining if you are eligible for benefits.
Your eligibility depends upon:
Your INSURED STATUS. This means you needed to pay into the social security system through your payroll deductions. These payments are then calculated in "quarters of coverage" (QC), the quarters of a calendar year in which you made payment to the system. You can only earn 4 QC per year regardless of the number of employers you may have had during that given year.
This Insured Status falls into three categories:
FULLY INSURED, where you need to have at least one QC for each calendar year after the age of 21 and the earliest of the following:
1. The year before you reach age 62;
2. The year before you die; or
3. The year before you become disabled.
PERMANENTLY INSURED. This is when you are fully insured at the time you stopped working under covered employment.
DISABILITY INSURED. You have this insured status if you:
1. Have earned at least 20 QC during the last 10 years, and
2. Are Fully Insured.*
*There are exceptions for those under the age of 31 and in certain other cases.
Your Insured Status can be reviewed and verified by obtaining your annual Earning Statement from the SSA. In the past, these statements were mailed to you annually in the month of your birth date. With recent changes, the SSA has stopped mailing these statements unless a request form is submitted. Additionally, your statement is now available online by simply creating a login on the social security website and requesting your statement.
The link to create an account is as follows:
The Supplement Security Income (SSI) Program makes monthly payments to individuals who do not have insured status with low income who are:
1. Age 65;
2. Blind; or
The Social Security Administration manages this program, but it is funded through the US Treasury rather than the SSA.
These benefits can also be paid to blind or disabled children.
SSI is a "needs" based program based upon your income and your resources.
Income is money you receive such as wages, Social Security benefits and pensions. Income also included such things as food and shelter. The amount of income you can receive each month and still qualify also depends on where you live.
Resources that the SSA consider in determining your qualification for benefits include real estate, bank accounts, cash, stocks and bonds.
You may be able to qualify if your resources are worth no more than $2,000. A couple may qualify if their resources are no more than $3,000.
SSA will not consider everything you own in making their determination. SSA will not consider:
This is only a quick overview of the SSI Program, more information can be obtained at:
As a standard, the Kwak Law Firm will submit your application for all social security benefits, SSD and SSI, with your initial application to ensure that the SSA consider you for all programs that you may be qualified.
The truth is that SSD can be awarded to people unable to work for a litany of conditions including but not limited to diabetes, mental illness or mental conditions, cancer, chronic back pain, fibromyalgia to name a few.
It is also true that SSD benefits are not easy to obtain. The process is setup to discourage applicants from pursuing a claim. You should have frank discussion with each of your treating physicians about any/all of your medical impairments.
If you and your doctor(s) are certain:
That you are unable to work;
That your medical conditions have kept you or is expected to keep you out of work for at least a 12 month period; and
You lacked the capacity to perform work during that same time period.
You may wish to apply for SSD benefits.
1. MEDICARE ELIGIBILITY. Should you qualify for SSD benefits, along with receiving your monthly benefits check, you will also be eligible for Medicare. There is a 24-month waiting period for Medicare to become effective but it does eliminate the necessity of also applying and going through the Medicare process. If you are currently on your spouse's healthcare or have your own private healthcare, you can reject the Medicare benefits.
2. EARNING STATEMENT FREEZES. Another advantage is receiving SSD benefits will keep you social security retirement from depleting. The longer you remain out of work, the more zeroes you will accumulate in your Earning Statement. This can result in a lower retirement amount once you reach that golden age.
3. DEPENDENT BENEFITS. Should you have children, under the age of 18, or under the age of 19 and in high school or disabled, they may also qualify for benefits automatically if your application is approved. Children are entitled to roughly half of what the parent is eligible to receive. This dependent amount is then divided among the qualifying dependents. In short, if your dependent benefit would be for example, an additional $800.00 per month, you would only receive $800.00 if you have one dependent or 3 dependents.
If you have received an unfavorable decision, it is best to have an attorney represent you and handle the appeal process for you.
IT IS VERY IMPORTANT TO FILE YOUR APPEAL AS SOON AS POSSIBLE FOR IT MUST BE FILED WITHIN SIXTY (60) DAYS FROM THE DATE OF YOUR UNFAVORABLE DECISION.
This appeal process includes filing a "Request For Hearing Before An Administrative Law Judge".
This hearing will be held at your local SSA office or you can opt to have a teleconference hearing before a Judge from another part of the country, meaning that the teleconference Judge could be in Wisconsin or California for example. The advantage to teleconferencing is that it expedites the process but the disadvantage is the Judge is not able to see you "live" to observe your physical well being and/or impairments.
These hearings provide you with the opportunity to tell the Judge exactly why you cannot work and how your medical condition(s), both physical and/or mental, affect your daily living. The Judge will observe your demeanor and determine whether he finds your statements about your condition to be credible.
Additionally, a vocational expert could be asked to appear at your hearing. This person would review your past relevant work history, an offer an opinion as to whether you may return to any of the work you performed in the past, and if not, whether there are any positions you would have the physical and/or mental capacity to perform.
There are no up-front costs to retain the Kwak Law Firm for services provided during the initial or appeal processes.
We will be paid, when and only when, you receive a favorable decision and the SSA issues your payment of past due benefits.
You receive past due benefits based upon the date of your disability as stated on your initial application for benefits. This is the date you stopped working.
Under the Social Security guideline, an attorney who represents you is entitled to twenty five percent (25%) of your past due benefits or a maximum amount of $6,000 in attorney fees.
You can receive both workers' compensation and SSD benefits at the same time. However, there are certain offset rules which vary from state to state.
In the Commonwealth of Pennsylvania it is possible that your SSD benefits can be reduced if you are currently receiving workers' compensation benefits. This is called an offset. Between your workers' compensation and your SSD benefits you cannot receive over 80% of your average current earnings.
It is crucial that the SSA is aware that your are receiving workers' compensation benefits, or more importantly that you have settled your workers' compensation claim for a one time lump sum amount, so that your SSD benefits can be recalculated in a timely manner and you are not overpaid.
Once the SSA realizes there was an overpayment, rest assure the SSA will be requesting that you repay the excess amount back to them. This could be a sizable amount which if not repaid, can reduce your SSD monthly benefits substantially until the amount is repaid. This reduction can definitely affect your income for that period and put an additional hardship on your finances which would not have happened if you were upfront about your workers' compensation benefits and/or settlement.
SOMETIMES A CLAIMANT WILL RECEIVE A LETTER OR NOTICE FROM THE SSA STATING THAT THEY HAVE BEEN OVER PAID. THERE ARE TWO (2) REMEDIES WHEN THIS HAPPENS.
1. REQUEST FOR RECONSIDERATION. This appeal can be filed with the SSA if you believe that the SSA erred in their calculations and you believe that there really was no overpayment. This is often very difficult to prove for it is often difficult to determine how the SSA arrived at their overpayment calculations.
The reconsideration appeal is subject to a deadline which is normally 60 days.
If your reconsideration appeal is denied, you will have certain appeal rights and can have an opportunity to have a hearing before an Administrative Law Judge.
2. REQUEST FOR WAIVER OF OVERPAYMENT OR CHANGE IN REPAYMENT RATE. By filing this request, you are not disputing that there was an overpayment, but instead you are claiming that:
2.1. You are not at fault for the overpayment; and
2.2. You cannot afford to pay the SSA back.
The SSA may forgive the overpayment if it is determined that you have met both criteria above.
If it is determined that you are capable of the repayment, the SSA often will arrange a repayment plan for you.
There is no clear cut answer to this question. Much depends on your unique filing situation including your marital status, dependents, and whether you have any other sources of income. It is best to contact a qualified tax professional to determine what your options are.
It is important to note, that the SSA will send you a 1099 form reporting the full amount of your SSD benefits. The key word here is full amount.
If you are currently receiving both workers' compensation and SSD benefits, this 1099 form will should the amount of benefits you were entitled to not the lesser offset amount as discussed above. So though your workers' compensation benefits are not taxable in the Commonwealth of Pennsylvania, you will be responsible to report and possibly pay tax on the full amount of your awarded SSD. Again, it is best to discuss these issues with a qualified tax professional.
The Kwak Law Firm has a staff of highly qualified paralegals to assist in helping you obtain your qualified benefits.
We are a very progressive office, and most of our paralegals work from home, though rests assure, each of our staff has years of experience.
In today's day and age, it is not necessary for qualified employees to travel to the office to sit at their assigned desk or office.
All of our paralegals are available to our clients via direct dial numbers and/or email.
Additionally, though your case is a team effort, you will be assigned one f our qualified paralegals as your personal contact regarding your case.
As you can see from this quick overview, the social security system is complicated and it can be a long process until you are awarded the benefits that you feel you deserve.
Having a qualified, experienced attorney in your corner can alleviate the stress and uncertainty about the process.