Applying for Social Security Disability

How do I apply for Social Security? Back to Top

It is easy and free to apply for Social Security. All you have to do is call Social Security, toll-free, at 800-772-1213. You can also apply in person at your local Social Security office. When you apply, I recommend that you tell the person who answers the phone that you want to apply for both Disability and SSI. When the Social Security employee asks you when you became disabled, you should give the earliest possible date that you think you became unable to work (we can always amend your "onset date"). You can use our new client questionnaire to organize the information you will need to give Social Security.

How much will I get if I am approved? Back to Top

Disability benefits are calculated based on how much you earned when you were working and how much you paid into the system. I have seen Disability checks as low as $100 per month and as high as $1,800 per month. The typical Disability check I see is about $1,100 per month, but yours may be higher or lower.

SSI benefits are set by law and change every year. If you have no offsets, your SSI check will be around $515 per month.

As you can see, Social Security benefit payments are not large, especially in comparison to what you can earn if you are able to work.

What are "back benefit checks" or "lump sum payments"? Back to Top

You may know friends or relatives who have received large, lump sum payments from Social Security. These lump sum payments represent past due benefits. People receive past due benefits because it takes so long for claims to work their way through the system. For example, in the Atlanta area, it can take two to three years from the time a person applies until he is approved and receives his check. It takes this long because Social Security Administration employees are overworked and because thousands upon thousands of people apply every day and each claim must be evaluated.

Why would I want to hire an attorney and how much will it cost? Back to Top

An experienced lawyer can be very helpful to you in many ways. First, as your lawyer I can make sure that you have applied for all disability programs for which you are eligible. For example, I have seen claimants whose Disability applications were not processed by Social Security, or whose applications were lost. In several cases, I have been able to argue that the mere evidence of a communication with Social Security is enough to prove that an application was filed, thereby preserving my client's rights.

As your lawyer, I can determine if you are eligible to "reopen" old applications. In some cases, a prior application, even one filed three or four years earlier, can be reopened, thereby making you eligible for years of back benefits. If you ever filed an old application, or even if you simply called Social Security to inquire about benefits, you could lose thousands of dollars if you fail to look into reopening an old application.

As your lawyer, I can evaluate your case and suggest a strategy to win your case. After handling hundreds of cases, I have a fairly good perspective as to what cases are winnable and what cases are not, and what it takes to win a case. While my opinion is not a determination of how your case will end up, I can offer you the benefit of my experience. More importantly, if you decide to hire me, I will make sure that your case file is up-to-date with all medical records. In addition, I will work with your doctors to "translate" your medical problems into work limitations so that Social Security can evaluate your claim properly.

If you choose to hire me, I handle most cases on a "contingency" basis, meaning that I am paid only if I win. My fee is typically 25% of any past due benefits I can collect for you. My attorney-client contract is available on this web site for you to review.

How do I get started with your law firm? Back to top

If you would like me to evaluate your claim, I can offer you the best information if you download my Georgia Social Security new client questionnaire, fill it out as best you can, and fax the completed form to me at 770-234-5434. If you would prefer to call, my office number is 770-393-4985. If you will ask for my paralegal Joy Carter or secretary Pat Punter, either one can gather the information I will need so that our conversation can be useful for both of us. You can also e-mail me to let me know about your case.

Winning Your Social Security disability case

How is my case decided - will I have to appear before a Judge? Back to Top

The Social Security decision-making process is unwieldy and time-consuming. When you first file (your initial application), your case is opened by an office called the Disability Adjudication Section (the D.A.S.) which is part of the State, not Federal, government. The D.A.S. adjudicator will interview you and request medical records from your physicians. After about 3 months, the adjudicator will issue a decision.

It has been my experience that D.A.S. adjudicators are often overworked and unable to spend the time necessary to develop your case file. In addition, by law, adjudicators have specific guidelines that they must follow when evaluating your case. For this reason, many deserving cases are denied at the initial stage because records were simply not returned by doctors or because a medical record does not contain language discussing work activity limitations. Although Social Security is working to change the D.A.S. position, most claimants never have the opportunity to speak with the adjudicator deciding their case, and most adjudicators are too busy to spend as much time as they might want to analyze each case.

The D.A.S. adjudicator's decision denying your case is mailed to you in a letter that briefly explains why you were denied. This letter also advises you that you have 60 days to appeal, although the appeal forms are not mailed to you. If you follow-up with Social Security, you (usually) will be provided with an appeal form called a Request for Reconsideration and a 6 page Reconsideration Disability report. As you might imagine, many claimants fail to appeal, and those that do often find the lengthy paperwork difficult to complete.

If you complete your Reconsideration paperwork, it is sent back to the D.A.S. where another adjudicator reviews your file. It has been my experienced - and this is backed up by Social Security statistics - that very few cases are reversed at Reconsideration. The Reconsideration process takes about three to four months.

If your case is denied at Reconsideration, the Adjudicator's decision denying your case will be mailed to you with a brief explanation and a notice that you can appeal by requesting a hearing within 60 days. Again, no hearing request paperwork is enclosed, although it will be sent to you if you ask.

If you request a hearing, you will receive an acknowledgment and a letter advising you that you can expect to wait about a year. During this year, your file will be transferred from the D.A.S. to the Social Security hearing office called the Office of Hearings and Appeals (the O.H.A.). After about a year, you may receive a notice from the Judge to whom your case is assigned advising you that your file is being worked up. Thereafter, you will receive a hearing notice setting the time and place for your hearing.

I get involved in cases at all levels of this process, although most of my clients hire me after receiving their initial denial. Many clients feel more comfortable having my firm complete and submit the appeal paperwork within the 60 day deadline. In addition, as noted above, I make sure that your medical record, including recent treatment, is sent to the Adjudicator or the Judge at the correct address prior to the hearing. Most importantly, I identify a strategy to win your case and obtain forms, letters or other documents from physicians and others to prove your case.

Obviously, not all cases need to be heard by a Judge. It has been my experience, however, that many seriously ill claimants will not be approved at the initial or reconsideration adjudication level.

What are typical cases you see? Back to Top

Our firm handles many different kinds of disability cases. You can download our client intake forms by clicking on the link. Feel free to mail or fax us your intake form for a free telephone case evaluation. Here are a few typical case areas and how we approach them:

1. Mental Health cases - Mental illness and mental health problems can strike people of any age or background. I have found that Judges accept as disabling cases involving long term, severe depression, schizophrenia, bipolar syndrome and other mental illnesses. A key to winning this type of case is to show extended treatment, even if the counseling is with a County Health Department. Psychiatric hospitalizations and suicide attempts are seen as strong evidence of a significant problem. In mental health cases, Social Security usually refers the claimant to an independent psychologist for a consultative evaluation. Psychologists, like judges, see ongoing treatment as evidence of a long-standing problem.

2. Back pain cases - It has been my experience that judges expect to see objective evidence of back pain, specifically MRI evidence of significant disc herniation. X-ray evidence is usually not very helpful, and chiropractic treatment is given very little weight. In addition to objective evidence, I have found that judges like to see evidence that a claimant has tried to work through his pain - evidence of unsuccessful work attempts can include employment records or statements from ex-co-workers or supervisors.

3. Diabetes - Diabetes is a very common disease and many people are afflicted. As such, I have found that in order to win a case based on diabetes, we must show severe complications, such as vision problems, organ damage (i.e. kidney or liver), and/or peripheral neuropathy (numbness and burning in hands and feet). I usually look for clients who have suffered with diabetes for many years and who have been unable to control their blood sugar despite compliance with regular medical care.

4. Arthritis - Like diabetes, arthritis is very common in the population. The most common form of arthritis is osteoarthritis, which is commonly associated with getting older. In order to win an osteoarthritis case, I look for older clients with significant deformity in their hands, feet, knees or spine and regular medical treatment. Other forms of arthritis, such as rheumatoid arthritis, often strike younger people, and are often more severe. Rheumatoid arthritis cases are usually strong cases.

5. HIV/A.I.D.S. - The Social Security regulations provide that HIV cases should be granted when lab reports show very low T-cell levels. My experience has been that most judges view HIV cases somewhat liberally and will grant benefits even if the lab reports do not demonstrate full-blown A.I.D.S. Many HIV cases also involve depression, which can provide another theory for recovery. Again, regular treatment and a supportive treating physician is very helpful.

6. Intestinal, stomach, liver and kidney diseases - It has been my experience that internal organ diseases often produce very significant work activity limitations. For example, a person with irritable bowel syndrome might be able to function at work for a time, but would not be able to maintain employment because of frequent absences or excessive unscheduled breaks at work. A record of regular medical treatment and written support from a treating physician are necessary.

How does age and education factor in to a Social Security evaluation? Back to Top

Social Security recognizes that the older a person is, the harder it will be for that person to adjust to changes in the working world. Similarly, a claimant's limited education or intellectual ability is a vocational factor. For Social Security purposes, a claimant who is less than 50 years old is considered a "younger individual" and is not entitled to any specific consideration due to age. At age 50 and again at age 55, special rules making it easier to qualify are put into place for claimants with physical impairments who have limited schooling.

If you are 50 or older, I can advise you if these special rules, called the "grids," apply to you. Under the grids, if you are 50 years or older, your impairment is a physical problem and you have a limited formal education or no significant work skills, you can be found disabled even if there are some “sit-down” or “light” jobs you can still do. The idea behind the grids is that people over 50 with limited work skills and education will have a more difficult time re-entering the work force. Please ask if you want to know whether the grids apply to you.

Do I Have to Meet a Social Security “listing” in order to win? Back to top

There are basically two ways to win a Social Security case. If your medical condition meets a Social Security listing, you win automatically. The “listings” are medical definitions published by Social Security. Most major diseases are described in one or more listing categories. Not only does a listing describe a specific medical condition, but the evidence Social Security wants is also included. You can read examples of two common listings:

herniated disk listing

anxiety disorder listing

My experience has been that many people who meet a listing are approved early on in the process since the medical descriptions in the listings are very conservative. In other words, if a Social Security adjudicator, who may or may not have a lot of medical training, can recognize that your condition meets a listing, you are likely to be very sick. It has been my experience that in order to win a case on the listings, you will need extensive medical records and, ideally, a statement or questionnaire on the listing completed by a treating physician. At Ginsberg Law Offices, P.C., we have prepared questionnaires on most of the listings, thereby enabling your doctor to answer questions about the listings by checking off boxes or completing short answer questions.

It has also been my experience that most approved cases are not “listing level” cases. Thus, the second way to win a Social Security case is by proving that your “functional capacity” for work has been so diminished by your medical or mental health condition that you would not be a reliable employee. Most cases I see are won on the “functional capacity” basis.

If I don’t meet a Social Security "listing" can I still win? Back to Top

As noted above, most Social Security cases are decided based on the work activity limitations resulting from one or more medical problems. I use the listings as a framework to identify what is wrong with you medically, but the big picture has to do with identifying specific work limitations that leave you unable to perform work. Unfortunately, if you do not meet a listing, you can expect to wait months or even years before your case is scheduled for a hearing. I am hopeful that these long SSI and SSDI hearing delays are temporary and that SSA is successful in implementing is new disability decision making process. The new, streamlined process will be introduced in August, 2006 and should reach Georgia by mid-2007.

What if I lose at the hearing? Is my case over? Back to Top

If the Judge concludes that you are not disabled (an unfavorable decision), or if the Judge finds you disabled, but at a later date than you contend (a partially favorable decision), you can appeal the decision to the Appeals Council. As before, your appeal must be filed within 60 days. Usually, the Appeals Council will only consider legal challenges to the Judge's decision; therefore, it is wise to have a lawyer prepare your Appeals Council brief. At Ginsberg Law Offices, we sometimes accept Appeals Council cases from clients who had another lawyer appear with them at the hearing, but we are very selective. If you want my firm (or any other firm) to evaluate your Appeals Council case, do not wait - the earlier we see the case, the better.

Every judge has his or her own technique for hearing cases. Click to learn more about Atlanta Social Security disability local rules and customs.

How will my workers' compensation case affect my Social Security case? Back to Top

Your worker's compensation case may have a very significant impact upon your Social Security case. In terms of your benefits, your worker's compensation payments may totally offset your Social Security payments - in this case, it may not be possible for my office to handle your case on a contingency since there may be no back benefits. In other cases, your worker's compensation settlement can be structured as a lifetime pay out, thereby reducing or eliminating your worker's compensation offset.

If you have a worker's compensation claim, it is crucial that you advise us about it so we can properly advise you about Social Security. If you are not represented by an attorney in your worker's compensation case, we offer our clients the benefit of our expertise and experience in both worker's compensation and Social Security Disability.

What if I have a Long Term Disability policy and am receiving LTD benefits? Back to Top

It has been my experience that most LTD carriers require claimants to apply for Social Security since Social Security benefits can reduce the amount of money that the LTD carrier must pay over the course of a claimant's lifetime. In addition, the Medicaid and Medicare benefits that accrue to Social Security beneficiaries can reduce the health insurance costs to a LTD carrier. Our office has established ongoing relationships with most of the LTD carriers who issue coverage in the Atlanta area. In most (but not all) situations, LTD carriers can assist our office in obtaining Social Security benefits and the end result to you will be the same or more monthly cash benefit. If you are covered by an LTD policy, please let us know. 

Medicare and Medicaid

Will I get Medicare or Medicaid if I win my Social Security case? Back to Top

As a general rule, you will be entitled to Medicaid as of your date of entitlement for SSI. You will become eligible for Medicare 24 months (2 years) after your date of entitlement for Disability.

Summary Back to Top

Social Security Disability and SSI are programs that provide monthly payments to individuals who cannot work. If you have a serious medical problem, ongoing medical treatment and/or a supportive doctor, and you cannot perform at a job, we would be pleased to speak with you about Social Security Disability. Please feel free to email Jonathan Ginsberg, or fax us a completed intake form for a free case review. There is never a charge for phone calls and we are happy to answer your questions. Call Jonathan Ginsberg at 770-393-896 3.

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