Security Disability Attorney

Painesville-Mentor Ohio Social Security Disability Attorney, Patrice Denman.

 The Social Security Administration pays disability benefits under two programs.

 Social Security pays benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death. Federal law requires this very strict definition of disability. While some programs give money to people with partial disability or short-term disability, Social Security does not.

                               The Social Security Disability Insurance Benefits program (SSDI) authorized under Title II of the Social Security Act, provides benefits to disabled workers, dependents, and surviving spouses.

                               The Supplemental Security Income program (SSI), authorized under Title XVI of the Social Security Act, provides benefits to the disabled the aged whose income and resources fall below a certain level.

Requirements for Social Security Disability

Social Security will review your application to make sure you meet some basic requirements for disability benefits. They will check whether you worked enough years to qualify. Also, they will evaluate any current work activities. If you meet these requirements, they will send your application to the Ohio Disability Determination Services office.

This state agency completes the disability decision for SSA. Doctors and disability specialists in the state agency ask your doctors for information about your condition. They will consider all the facts in your case. They will use the medical evidence from your doctors and hospitals, clinics or institutions where you have been treated and all other information. They will ask your doctors:

• What your medical condition is;
• When your medical condition began;
• How your medical condition limits your activities;
• What the medical tests have shown; and
• What treatment you have received.

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They also will ask the doctors for information about your ability to do work-related activities, such as walking, sitting, lifting, carrying and remembering instructions. Your doctors are not asked to decide if you are disabled.

The state agency staff may need more medical information before they can decide if you are disabled. If more information is not available from your current medical sources, the state agency may ask you to go for a special examination. We prefer to ask your own doctor, but sometimes the exam may have to be done by someone else. Social Security will pay for the exam and for some of the related travel costs.

The individual applying for SSDI or SSI benefits is required to meet one standard of disability. Under both programs, a person is disabled if they are unable to “engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which:

                               can be expected to result in death, or

                               has lasted or can be expected to last for a continuous period of not less than 12 months”

To meet this definition, an SSDI or SSI applicant must have “physical or mental impairment[s] of such severity that they are not only unable to do their previous work but cannot, considering their age, education, and work experience, engage in any other type of substantial gainful work existing in the national economy.”

Disability is determined using a five-step sequential evaluation process conducted by the SSA. If, at any point, an applicant is found not to be disabled, the evaluation process terminates and the claim for disability insurance benefits is denied. Following are the five requirements in determining disability:

                               Substantial gainful activity. If the applicant is currently engaged in substantial gainful activity, there is no disability, regardless of medical condition, age, or work experience.

                               Severe impairment. If the applicant is not engaged in substantial gainful activity, the SSA determines whether the applicant has a severe impairment. An impairment is considered “severe” if it significantly limits a person’s physical or mental ability to do basic work activities. If there is a finding of severity, the evaluation proceeds to the third step.

                               Listing of impairments. If the applicant’s condition meets the requirements, or is the equivalent of a disability on the SSA’s Listing of Impairments, then the applicant is ruled disabled. If the applicant does not meet the requirements, the sequential evaluation process continues to the fourth step.

                               Past relevant work. A medical assessment is performed to determine whether the impairment prevents the applicant from performing his past relevant work. If the applicant is found to be able to perform past relevant work, the claim will be denied. If not, the evaluation process continues to the final step.

                               Other work. The SSA evaluates whether the applicant can perform other available work existing in significant numbers in the national economy. The evaluation considers the applicant’s residual functional capacity (what the applicant is able to do in a work setting despite the impairment), age, education, and past work experience. If an applicant cannot perform other work, they will be found disabled.

Disability Benefits

Once the disability evaluation requirements have been met and the disability has been proven, disability payments will begin after a five-month waiting period. Benefits are payable starting with the sixth month after the onset of the disability and continue through the second month after it ends. Benefits continue until the disability improves or the recipient returns to substantial work.

Termination/Reduction of Benefits

Disability benefits terminate when the disability recipient dies or reaches full retirement age. Benefits may be reduced to offset payments received from other government programs designed to replace lost earning capacity. Derivative benefits may be available to disabled spouses, widows or widowers, or children. In addition, the social security laws contain work incentive provisions allowing disability recipients to return to work for a trial work period, during which time they can test their ability to work without losing benefits.

Ongoing Evaluation

The SSA may conduct a continuing disability review on a periodic basis to determine whether the applicant is still eligible for disability benefits. The beneficiary is notified in writing of the impending review and its requirements. The beneficiary may be required to undergo a medical examination and may submit other relevant evidence for SSA consideration.

Appeals

Appealing unfavorable decisions by the SSA involves a three-step appeal procedure, after which a dissatisfied applicant or benefits recipient may sue in federal court. Each step concludes with written notification of the outcome and includes a 60-day period during which a claimant may file for further review. Following are the three steps of the appeal process:

1. Reconsideration. Is the first step in the appeals process.  A reconsideration is a  complete review by the SSA of its initial decision. A social security representative who was not involved in the original application or decision conducts the review. The representative will also consider any new evidence submitted by the claimant.
2. Hearing. An Administrative hearing is the second step of the appeals process.  Many times this is the first time an applicant has the opportunity to speak directly to a decision maker.   An administrative law judge conducts a hearing.
3. Appeals Council Review. The Appeals Council of the SSA does not review all hearing decisions. For decisions it does review, the Council will either render a decision or return it to the administrative law judge for further review.

A claimant who is dissatisfied with the final appeal decision may bring suit in federal court within 60 days of the decision.

 Please Contact us for a free evaluation of your case (440)-639-1020