Find Answers To Commonly Asked Questions About Social Security Disability

If you are preparing to file a claim or appeal for disability, you may be wondering what your chances of winning are. The most accurate answer will be complicated and specific to you. This FAQ will give you a general idea of how frequently disability cases are won at each level and what you can do to increase your odds of winning.

To be considered disabled, individuals must have a medical or psychological condition that makes working difficult or even impossible. The applicant’s impairment must have kept them from doing a substantial gainful activity (SGA) over a 12-month period. Keep in mind that having symptoms is not enough. The applicant must have medical or psychological evidence (medical records) to prove to the Social Security Administration that the symptoms actually exist.

It is possible to qualify for both SSI and SSDI, although it is unlikely. If you qualify for both forms of benefits, that is called concurrent benefits. Unfortunately, SSI stands for Supplemental Security Income and will only apply if your income is low enough to be supplemented. In other words, you would only get SSI if your SSDI benefits are too low. At that point, SSI would step in and supplement your benefits to bring them up to a combined total of $710 a month.

Yes. SSI benefits start accruing the first full month after you apply, so you lose money the longer you wait to apply for SSI. Since SSDI allows you to go back and get benefits for up to one year before the application date, there is less of a time limit. But you should still apply as soon as possible once you become disabled. Also, for SSDI, you must (usually) become disabled no later than five years after you stop working full-time.

To qualify for SSDI, the answer to each of the following questions must be no:

• Can you do the same job you did before?
• Can you adjust to working in another job?
• Are you earning more than $1180 per month (this is the 2018 amount; it rises slightly each year) from
  any work?
• Will your disability last less than 12 months?

If the answer to any of those questions is yes, you probably do not qualify for SSDI. But there are a few special circumstances.

The first step to knowing if you have enough work credits is to know what counts as a work credit. You earn work credits every year that you work. In a year, you can earn up to four work credits. Each year, the Social Security Administration sets the amount that you must earn for each credit. In 2018, the amount was $1320. Once you’ve made four times the amount for that year, you’ve received the maximum four credits for that year.

Only income that you pay Social Security taxes on qualifies. So how many work credits do you need to qualify for SSDI? It depends on your age.

• Under 24 years old, you need to have six credits in the last three years.
• Between 24 and 31 years old, you need to have two credits for every year since you turned 21.
• Between 31 and 42 years old, you need to have 20 credits in the last 10 years.
• Older than 42 years old, you need to have 20 credits in the last 10 years, plus one additional lifetime credit for every year you are older than 42.

If you are related to someone who qualifies for SSDI, you may also qualify. You usually qualify for SSDI if you are:

• A dependent child or stepchild of a disabled worker
• A spouse or ex-spouse caring for the child of a disabled worker
• A spouse of a disabled worker who is over 62 years old and doesn’t qualify for Social Security benefits on his or her own

The amount you receive from SSDI depends on the amount you paid into the system. The formula for figuring it out is complicated and changes every year. In essence, you receive most of the initial money you pay into the system, and the smaller the percentage, the more money you paid into the system. The maximum SSDI payment in 2018 was $2,788 and increases each year.

Family members can receive up to 50% of a disabled worker’s monthly disability amount. The total paid to all family members cannot be more than 150% of the amount the disabled worker receives.

Those who need legal help with Social Security Disability may be hesitant to get a lawyer. If you are looking to apply for Social Security Disability, you likely don’t have another source of income or have a very limited income source, and if you’re already receiving some Social Security, you are on a fixed income. Without a lawyer, the process of paperwork, appeals, and legal maneuvering can feel overwhelming. So what should you do? You should get the legal help you need. It is much more affordable than you may realize.

Absolutely nothing. Attorneys do not charge any fees upfront to work on your Social Security case. They do not charge to meet with you. They do not bill you hourly. There is no financial risk in speaking with a Social Security attorney since the service is free.

Absolutely nothing. If an attorney doesn’t charge you upfront, then they must bill you once you start receiving benefits, right? No. Whatever ongoing benefits you receive from the Social Security Administration are entirely yours. You will not have to live on a tightened income after your case just because you got an attorney.

You won’t have to pay. Some people might worry that if they lose their Social Security case, not only will they not have the money they need, they’ll have lawyers to pay with the money they don’t have. Don’t worry. If you don’t win your Social Security case, you pay your lawyers nothing.

If I don’t pay them upfront, if I don’t pay them from my benefits if I won’t get billed, and if I don’t pay when I lose, then how does my lawyer ever get paid? If you win your Social Security case, you’ll likely be paid in two ways. First, you’ll be paid an ongoing monthly benefit. Nothing from your monthly checks goes to your lawyer.

Second, most cases are also given a lump sum called “back pay.” This back pay is a reimbursement check for all the months that the Social Security Administration should have been sending you checks but wasn’t. Your attorney will charge 25% of this back pay. Typically when the Social Security Administration goes to disburse your back paycheck, it will actually send a check for 25% to your lawyer, and the remaining 75% will be sent to you so that you don’t even have to worry about it yourself.

The state of Texas requires that a Medicaid applicant have no more than $2,000 in countable resources. The key point here is whether or not your resource is countable. The Medicaid program allows you to exclude for application purposes many things, including the value of your homestead (up to $500,000), one automobile of unlimited value, your home furnishings, burial plots, up to $1,500 for burial expenses, and other enumerated items. If, after accounting for your exempt resources, you still have more than $2,000 in countable assets, you will not be able to qualify for Medicaid benefits until those funds are spent for your care, or you undergo some type of Medicaid planning with your attorney.

The Medicaid program has the ability to place a claim on a recipient’s probate estate under the Medicaid estate recovery program (MERP). This includes laying a claim for reimbursement from the recipient’s homestead property after he or she passes away. However, a vital limitation to this power is that Medicaid is limited only to the recipient’s probate estate. Therefore, if the home is transferred to the recipient’s heirs outside of probate, Medicaid will be prevented from laying a claim against it.

No. In fact, without proper planning for such a gift, that may be the worst thing you can do. Medicaid has instituted a five-year look-back period, which means any uncompensated transfer of property (a gift) occurring within five years and one month of your application date will be looked at and will create a penalty period. During the time of the penalty, Medicaid will not pay for vendor payments (payments to the nursing facility). Instead, you or your family will have to make those payments to the nursing home. The penalty’s length is determined by the amount of transferred property (gift amount).

A ladybird deed is a special type of real estate conveyance that reserves in the grantor a life estate along with some other very special powers. The life tenant/grantor keeps the right to take back the property or name subsequent grantees. For taxing and Medicaid purposes, this is an incomplete transfer. Therefore, Medicaid allows the life tenant to exclude the home’s value as his or her homestead. At the same time, however, the transfer/gift “vests” in the recipient (oftentimes the Medicaid recipient’s heirs) at the time of death, and the home does not become part of the recipient’s probate estate. This protects the home from the Medicaid estate recovery program.

In order to qualify for Texas Medicaid in 2018, a nursing home resident’s monthly income must be less than $2,250 (in addition to resource limits and other requirements). If a Medicaid applicant has income greater than the $2,250 cap, then a “Miller trust” or “qualified income trust” can be created to receive the income, to pay a small personal needs allowance to the nursing home resident, to pay a monthly allowance to a spouse, if any, and to pay the remaining funds to the nursing home as the resident’s cost of care.

Just because your doctor says you’re disabled doesn’t mean that the Social Security Administration will grant you disability. It is a good idea to get a lawyer to argue your case for benefits and present the facts in the most persuasive way possible.

Getting a notice that you owe the SSA money can be frightening, especially if you don’t have the money to pay them back. But don’t worry. If you receive an overpayment notice from the SSA, you have several ways to move forward.

If you receive a notification from the SSA that it is seeking money because of a past overpayment, you have three basic paths forward:

• Appeal the overpayment
• Pay the SSA the requested funds
• Request a waiver

The option to appeal is only available if the SSA did not, in fact, overpay you. So if the notification is correct, your only options are to pay or to request a waiver.

If you believe that an overpayment notice is incorrect, you have 10 days from the day you receive a notice to request an appeal without affecting future Social Security payments. Because of the time-sensitive nature of appeals, you should contact a Social Security attorney as soon as you consider requesting an appeal.

You can request a waiver from an SSA payment request even if the request is correct. Asking for a waiver is like asking the SSA to forgive the amount due. There are several ways you can obtain a waiver from an overpayment notice. You can show that you are without fault for the overpayment, you are unable to afford to repay, you passed on another moneymaking opportunity because of the amount you received from Social Security, or you purchased something more expensive than you otherwise would have (such as a car or home) because of the amount you received from Social Security.

When the SSA determines if you can repay, it looks at whether your current income is being spent on things like:

• Food
• Clothing
• Utilities
• Medical expenses
• Rent or mortgage

If, however, you still have the funds from the overpayment or receive a back-pay settlement, the SSA will likely determine that you have the ability to repay.

Imagine you have waited so long to win your Social Security Disability case and then are involved in a car accident. What kind of impact will a car wreck case have on your monthly Social Security benefits when the auto accident case is solved?