Here’s What You Must Know About Social Security Disability Insurance Law

If your medical condition prevents you from taking a job or find employment, you might be eligible to get disability benefits under the Social Security Disability Insurance Law. To qualify for Social Security Disability Insurance (SSDI), the Social Security Administration has set up a few norms.

– The person cannot work as before

– The person has a condition, usually physical disability, which prevents him in engaging in profitable activities to earn a living.

– The disability is expected to last at least for a year or has been the same for more than a year.

– The person has a disability that can eventually result in death

– The person cannot take up or adjust to a job, because the medical condition makes it hard to do so.

It might be confusing for people to understand if they qualify for SSDI benefits, which is why many choose to get in touch with a lawyer. As for the amount paid, it largely depends on the average of past earnings of the person. As for 2017, the monthly disability payment on an average was $1171, with maximum benefit reaching about $2,687.

When to seek legal help?

Thanks to the formalities involved, one can be denied SSDI benefits, and such cases are not uncommon. In fact, legal experts and lawyers can solve the issue for you. The first step is to understand if you are actually eligible to get the benefits under Social Security Disability Insurance Law. Your lawyer will explain everything in detail, following which the follow steps are to be taken.

– Completing the application. The paperwork involved in Social Security Disability Insurance Law application can be complicated at best. Many people are not sure of how to go ahead, which is why they seek legal expertise on the matter. The lawyer’s team can ensure that the trail of papers is completed as per requirements.

– Assistance with the reconsideration. Applications are often rejected, as mentioned earlier, and if that has occurred, do not panic or lose hope. Talk to your lawyer, who can file a request for reconsideration. Do not delay with the step, because the reconsideration request must be filed within 60 days after the first application is rejected.

– The third step is about Administrative Law Judge Hearing, which is required when the request for reconsideration is denied, as well. Another application will be moved by your lawyer before an Administrative Law Judge.

If your lawyer is competent, you can win the case in your favor in no time. It is important that you choose the right attorney for Social Security Disability Insurance Law application and follow-up procedures, if required. Take your time to evaluate the legal services available, and don’t shy away from asking relevant questions. Keep in mind that your lawyer can save considerable time and money, and their payments are usually linked with the services they provide. Ask for references and meet your legal team in person before taking the final call on moving an application.

How to Claim Veterans Disability Benefits

A veteran who has experienced an injury or disease that was caused or made worse by their military service can receive disability benefits. The amount of time that has elapsed since their active duty does not matter. Anyone who is eligible to receive veterans disability benefits should apply to claim them as soon as possible.

Methods of Application

– The federal government provides an online application for veterans disability benefits. Visit the Department of Veterans Affairs website to initiate the application process.

– Applicants can also submit their paperwork by mail. Visit the Veteran Affairs website to download the correct form, and then mail it to your closest Veterans Affairs (VA) office; they are located throughout the country.

– If you are within the United States, you may call the VA office at 800-827-1000 to submit an application by phone. Veterans located outside of the United States should call 412-395-6272.

Additional Assistance

It’s also possible to receive help filling out and submitting paperwork. A disability lawyer can help you complete your claim, or you can visit a VA organization or service office to receive help from their representatives.

Completing the Paperwork

The application requires information about medical conditions that necessitate the compensation. When completing these forms, include specific information about diagnosed conditions, injuries, and illnesses. If possible, add specific details, such as the date on which you first began experiencing symptoms and the specific medical diagnoses you received from your physicians. Submit copies of your medical records that verify and substantiate your claim for disability, if possible. You have up to one year to submit the necessary documentation. If you don’t have all your records, the federal government can request your records on your behalf.

The Process

When you receive confirmation of your disability or illness, apply for compensation immediately. Early application preserves this date as the effective date for benefits, which can affect the amount of benefits you receive. Do not allow a lack of medical documentation about your disability to stop you from completing the process; you can submit verification paperwork later, if necessary.

Time Line

The approval process for veterans disability benefits can vary. You may receive a decision within a few months, but it can take up to three or more years of processing to reach a decision. Some applicants may be able to fast-track the approval by submitting complete medical records with the initial application. This can effectively streamline the review time and enable the government to more quickly return a decision.

Special Status

Some people are eligible for special fast-track status. Former POWs, as well as those who have suffered sexual trauma in connection with the military or have post-traumatic stress disorder, receive priority processing on their claims. In addition, Vietnam veterans who were exposed to Agent Orange and are submitting a claim will receive special priority processing. Those who are homeless or who have emergency financial needs can also receive priority service.

If you are unsure of how to proceed with an application for veterans disability benefits, ask for professional assistance so that you can submit your claim in a timely manner.

Avoiding a "Self Reported" Disability Claim Nightmare

1,200,100 Social Security Disability applications were filed in 1999 (48 percent or 579,000 were declined). In 2009, ten years later, 2,816,200 Social Security Disability applications were filed (and 65 percent or 1,830,530 were declined). The number of disability applications more than doubled while denials more than tripled. In one year, more than $23 TRILLION dollars of annualized benefits were lost.

In 2011, TRILLIONS of dollars in Insurer, Social Security and Veterans Administration disability claims will continue to be denied unnecessarily.

Disabled Americans diagnosed with serious medical and psychological illnesses are just beginning to process the enormity of the physical, emotional and financial challenges they will be facing. This is the worst imaginable time to be filing a disability claim.

Insufficient preparation and inadequate presentation of a long-term disability (LTD) claim form increases the likelihood that your application will be denied substantially, especially when it’s a claim for chronic fatigue or another “self-reported” (fibromyalgia, carpel tunnel) disability.

Review your LTD policy. Does it offer total disability benefits only or does it provide partial or residual (long-term partial disability) benefits so that you don’t have to be totally disabled to collect benefits? Hopefully it’s the latter. What’s the policy’s definition of partial disability? Does it state your inability to perform one or more of the material daily duties of your occupation and/or is there reference to performing the duties of your occupation in a reduced capacity?

For “self reported” disability claimants, we’d like to share some “tips” to improve your chances of collecting disability benefits.

TIP # 1: It’s been our experience, over a three-decade career specializing in the disability insurance business, that an improperly completed LTD claim form increases the chances of the claim being denied, even when the complete information is submitted to the insurer after the initial claim has been submitted. Remember you are applying for benefits to replace your lost wages. You’ll need to prepare your application for benefits with the same (or better) attention to details as when you applied for your job..

TIP #2: You will need to have a focused conversation with your physician about the specific ways in which you will need his or her cooperation as you navigate the LTD claim process. As noted: You absolutely, positively must have the complete cooperation of your physician as well as his or her agreement with you as to the extent of your disability. Complete documentation of your “self reported” disability, supported by irrefutable evidence from your treating physician(s) (who are recognized experts and authorities in the treatment of your specific condition is absolutely essential in the initial filing of your claim).

TIP #3: Is your treating physician a specialist (an expert) in the treatment of your specific condition? Very few are. If he or she is not, take heed. Due to the specialized nature of a diagnosis, your insurer will expect your physician to have expertise in the treatment of your specific condition. A disability insurer looks for expertise in the treatment of any illness, especially “self reported” disabilities. This, however, does not mean you have to change doctors. Your primary care physician (PCP) has possibly already referred you to a specialist for diagnosis and initial treatment. In such a case, your PCP would probably follow your course of treatment, with an occasional update with your specialist.

TIP #4: What has been your doctor’s experience in helping other patients with “self reported” disabilities obtain disability benefits? Has he or she had significant success or great difficulty? Your physician needs to be your ally in the claims process, especially until you’ve begun receiving benefits.

TIP #5: What type of testing has been utilized to confirm a diagnosis? When “self reported” disabilities first began to be recognized as unique and difficult-to-diagnose illnesses, considerable controversy surrounded the various methods of diagnosis. Leading researchers and clinicians, the Centers for Disease Control and Prevention, and the National Center for Infectious Diseases developed various guidelines for evaluating your condition. (For more, we urge you to do a web search and read “Social Security SSR 99-2P: Your Guide to CFS Claims Success).

Summary

In reviewing a multitude of long-term disability claims that were denied by insurers there’s one predominate theme: the claimants’ personal physician and/or other subsequent medical documentation does not support or validate the extent of the disability. The claimants were expecting a certain outcome (for their claim to be paid) while the medical information attached to their claim form did not validate the extent of the disability. In essence, claimant and physician just have not communicated properly. The Bottom Line… do it right the first time.

Copyright 2016

Allan Checkoway, RHU

Under 65 Disabled Medicare

Many questions come up with it comes to Medicare, let alone when you are under 65 and disabled. The steps of the things you need to do or the things you know are not quite as clear as you would like it to be. If you do not register everything within a window that the government provides, you could be penalized. The penalty will be costing you more money than you had expected. Someone who qualifies for SS Disability income has a waiting period of two years before eligible for Medicare A and B. This could be a long time to wait if you need insurance.

If you were gainfully employed, you would be offered coverage through your job. If you had to take a leave of absence as a result of the qualifying disability, you would be provided COBRA to extend the coverage you had from your previous employer. The COBRA option could let you pay for the health insurance for up to 18 months, and in some cases you can get 24 or 36 months, depending on the situation. That will buy you some time to transition to Medicare Disability.

If you fall short of the premiums due to cash flow for COBRA, there might be a chance you could qualify for Medicaid. Medicaid is a health program available through the state. They do have their own set of requirements to qualify. Refer to your state guidelines to apply. Then your health care will be a nominal cost to you, paid by the state.

Once you have met your two-year waiting period for disability to be eligible for Medicare coverage, you have a window to do other things to stay compliant. The government requires to have a Part D coverage; D is for Drugs. Original Medicare does not supply this except for inpatient medication. They give you a window of about three to four months to purchase a Part D. Typically it’s the month of the start of Part B (supplied by Original Medicare), and then 90 days after that month. If you do not sign up for a Part D, or equivalent, during this time frame, you will be penalized when you finally do sign up for it. Medicare requires this to allow more people to pay in to control the cost for everyone.

If your state requires insurers to offer Medicare Supplemental insurance for the under 65 disabled, then you are allowed to apply with no underwriting involved during the same time frame. You will notice that the premium are much higher for those under 65 years of age than if you were 65 and older. Part of it is that you are on Medicare early because you have a disability, it means you are more likely to have more claims. Either way, you have an opportunity to apply for a plan that has to underwrite and take advantage of the lower rates without being screened for the health condition. However, in some states, like Indiana, does not require the insurance companies to participate in the under 65 disability market.

If you remain working and can maintain the insurance through the workplace, becoming eligible for Medicare A and B does not change anything. You can keep that coverage if you choose to. You will have to provide proof of qualifying coverage either then, or when you apply to gain Part D or qualifying coverages in the future if you ever did lose that health care coverage. Retain any supporting documents as necessary.

Some programs combine both Medicare Supplements and Part D in a program called part C, or Medicare Advantage. There are pluses and minuses to these. You need to do your homework before jumping into the program. Many can be restrictive and possibly more out-of-pocket for the year. However, it can be a good fit and save you money.

Transitioning to Medicare A and B and all the other items that attached to it can be confusing, but can become clear in the end. Taking the right steps and getting the right help can make all the difference in the world and save you money and time.