Info on disability benefits, why some people get disability and others do not, etc

[dixiegrrrrl]

I have seen LOTS of threads of late about disability, about people who know people who cannot get on it,
about people who imply others are faking their disability for the money, etc.

So here is some info ( my credentials are 20 plus years in the Mental Health field, and personal experience)

If you find this helpful, please kick.
Questions and comments will be appreciated.


There are different kinds of "disability " programs. They each have their own rules and requirements.
You cannot tell which program anyone is on by looking at them, AND a lot of people do not have visible disabilities.

1.Workman's Comp disability.
Who is qualified:
usually earned by work on one's job. Age is not an issue for eligibility, as far as I know.

Covers a wide range of disabilities, visible and non-visible, the length of coverage and of the disability may vary,
the amount paid may vary, the restrictions on a persons daily activities may vary.
How you qualify:
rules and measurements can vary from place to place, depending on the job, union, etc.
What I don't know:
if there is a lump sum payment from time from application or disability to time of acceptance into the program.


2. Soc. Sec. Disability:.( SSDI)..Is a FEDERAL program.
Who is qualified:
Anyone who has sufficient numbers of work credits, counted in quarterly hours.
*or*
a child under age 18 whose parent had enough work history.
( I think I am right on child rules, someone might know the latest on this)

Covers a wide range of disabilities, visible and non-visible, the length of coverage and of the disability may vary,
the amount paid may vary, the restrictions on a persons daily activities may vary.
How you qualify:
Soc. Sec. has very detailed measurements of "disability" and requires one or more Doctor exams, which may include testing. They pay for this. It can take 6 months or more fro 1st application to last Dr. Visit, it can take more than one application attempt.
To "get on" Soc. Sec. disability is often a matter of how the Dr. views your disability and even which state you apply in, but the requirements are supposed to uniform NATIONWIDE, since it is a 100% Federal funding program by the Soc. Sec, administration.

There is a lump sum paid to the successful applicant, from the date the Soc. Sec. Admin decides you were entitled to disability to the date they officially start the payments. It can be considerable.
Amount you can get a month:
Usually determined by the amount of the disability ( permanent and total or partial disability)
and based on what your regular Soc. Sec. check would be at age 65.
( or whenever the "full retirement age" is determined to be at the time you are eligible for it, it can change in the future).
At age of full retirement you are moved from Soc. Sec. disability to your regular Soc. Sec. retirement status, and get a regular Soc. Sec. check.

Soc. Sec. from time to time reserves the right to re-evaluate your disability status. They can and do decide you are no longer disabled. It often appears to be caprious.

3. Supplemental Security Income (SSI) is a Federal program administered by the Social Security Administration (SSA),
the state puts in part of the money

Who is qualified:
The SSI program provides cash assistance to individuals who
do not qualify for the 2 program above because they have insufficient work history
AND
are either age 65 or older, or blind or disabled, including children.
You must have limited income and resources.
(SSI is a "needs-based" program, sometimes called a "welfare" program.)

which means you must be stone cold broke, essentially.
I mean really broke.
Covers a wide range of disabilities, visible and non-visible, the length of coverage and of the disability may vary,
the amount paid may vary, the restrictions on a persons daily activities may vary.
There was no lump sum when I was working with SSI clients.

EACH state has a different monthly amount, and it is LOW. The pot of money for SSI is determined at the beginning of every fiscal year, the number of people who are lucky enough to qualify depends on that pot of money, people can and do get kicked off the program often. Some people have to re-apply every year.
Age varies, your children under age 18 can qualify for SSI.
Sometimes many children in a family can qualify ( based on my past experience, it may have changed by now).
SSI recipients are eligible for State Medicaid services.

The BIG question:
Why didn't my friend/neighbor/family member get disability????

2 reasons may apply:

They were not eligible for the program to which they applied
( they applied to wrong program even tho they had a disability, or
they were not determined to be disabled when they applied,
even if it appears to others they have a disability)

or

the system has put up road blocks to applications.

Sad but true, the program that gives out the benefits also has a vested interest in not paying out all the benefits.
That is why for Soc. Sec. disability you often hear that people had to get an attorney to get it, or had to apply more than one time.

Here is one cause of roadblocks that even DEM governors have put up: closing down the Soc. Sec. application offices
even tho it does not cost the state a dime, the salaries of the Soc. Sec. workers are paid by Federal dollars.

Sound unbelievable?
Read and weep:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=439x839129

[Lasher]

1. Thank you very much, Dixie.

I've been injured and can't work anymore. I have enough credits to qualify for Social Security, so it looks like I should apply for SS Disability, right?

Lasher

[dixiegrrrrl]

4. Assuming you are not covered by any other program/insurance/etc.

I forgot to mention that Soc. Sec. requires you to apply for any insurance you might have, first.

Won't hurt to call your local Soc. Sec. office and ask them about applying, assuming you still have a local office in your state.
Also you can go to Soc. Sec. site and call one of the 800 numbers ( assuming the government is not shut down.)

[dflprincess]

13. But once you're receiving long term disability payments from an insurance company

that company will expect you to apply for Social Security disability. If all insurance companies work the way my brother's did, you'll have the advantage of either the private company or a 3rd party they work with helping you with your SS disability claim.

My brother (who has advanced lung cancer) was on short term disability for 3 months, then was switched to the long term program - but was only on that maybe 2 or 3 months before he was moved to Social Security. I was amazed how quickly that happened.

[dixiegrrrrl]

14. Interesting. Thanks for the info.

Very sorry about your brother. ;(

[pinto]

8. They'll want you to check out workers' comp as a first choice, if you were injured on the job.

If not, SSDI is a primary possibility.

[SheilaT]

11. Not necessarily.

That yearly statement you get from the Social Security Administration tells you if you have enough recent credits to qualify for Disability.

I worked long enough many years ago that I will collect social security. But because I was out of the workforce for a very long time (about 25 years), I do not have enough recent credits to get disability.

Do not assume anything. The rules are many and strict. Just qualifying for Social Security tells you nothing about whether or not you qualify for disability.

[pinto]

2. I receive SSDI. Some comments on access to that program.

The medical review board works on the info they actually get to review.

I encourage applicants to include *every* professional record related to their claim. From the primary MD, to specialists, to mental health providers and social service providers as relevant. And sign a release of information permission, with accurate contact info, for each one. The reviewers need all the information to make a decision within the guidelines they're given from Soc Sec.

And in the personal declaration, I encourage people to run a typical day through their head and note each and every impact their medical/psychiatric/functional condition effects ability to work. Some may be minor in another situation, yet a part of a larger picture in one's life if there's a bigger impairment.

Review, if I remember correctly, is every 5 years for permanent disability determinations.

[CC]

3. Another delay for SSD or SSI is that

there is a major shortage of judge advocates and other employees. The GOP freezes and downsizing has affect SSA a lot. On the judge advocates it is hard to find qualified people at the pay rate offered. (How many lawyers do you know that would work on a Federal employees salary?)

During the Bush admin. there were directives from the political appointed top to deny as many people as possible. There were many long time SSA employees that hated what the Bush Admin tried to do to SSA. Many retired if able and others left for the private sector. Many of those that left to go to the private sector earn 3 to 4 times as much salary than they got working for the government.

Also how a doctor (yours and/or theirs since you are allowed to use a doctor of your choice) fills out the paper work matters, A LOT. It can be the difference between acceptance and denial. Should you be denied you should get a lawyer that is skilled in SS disability cases. It can and does make a difference when going through the appeal process. If you are found eligible during the appeal process they will pay you back pay to the date of application if not over 2 years. As for drug testing recipients, many recipients are drug addicted, some recovering some not. There is a lot of science about the brain damage that can occur and though the right would love to boot you off for drugs it is considered a disease.

When you do get SSD or SSI you have a 2 years waiting period before you can get Medicare if you qualify. It can be backdated to application too but many do not realize you have a wait. (I don't know what the reasoning is there, makes no sense to me.) Many on SSI will qualify for Medicaid as you can never have more that $500.00 at any time. (Watch bank accounts carefully.) I have seen people able to save money on SSI, don't know how but it can really screw thing up if it hit that 500 limit.


I do not work for SSA, I was just raised by a SSA employee and get hit with so many questions from people I've learn to read their site well. It is all online to find for anyone that needs the info.

http://www.ssa.gov/

[dixiegrrrrl]

5. Thank you for the added info.

The Medicare info is good to have in mind also.

:hi:

[eShirl]

6. (#2) Isn't there a maximum time span covered for the lump sum back payment?

I seem to remember (from 15 years ago) it being one year

[dixiegrrrrl]

7. I looked this up, this is what I found:

Social Security rules provide for back pay up to 12 months prior to your date of application, beginning at your onset date. The agency also imposes a five-month waiting period before benefits are payable.

Looking back at what Mr. d got for his lump sum, it seems it was an amount equal to 16 months after last day of work.
( he luckily got approved fairly quickly)

Oh, I like this explanation a bit better, it is more clear:

"For Social Security disability, back benefits are due back to the date of the onset of your disability,
and up to 12 months before the date of your application. Social Security imposes a five-month waiting period after your onset for actual disability payments, so the effective start date is up to seven months before the application."

http://www.ehow.com/info_8154603_lump-disability-payment-social-security.html

[pinto]

9. One issue I think some people have that can complicate things is seeing Soc Sec as the "enemy".

They're not, in my experience. It's a byzantine labyrinth in many ways. Yet developing a working relationship with an individual representative in it all really helps.

The disability program was established to offer support for those unable to work. Keeping that in mind is a plus in the process. :hi:

[RobinA]

12. Absolutely

They generally are not the enemy. Another thing people run into is you have to play by SS's rules EXACTLY or they won't play. Follow directions to the letter. Also, KNOW the rules. They are supposed to tell you when you interview every possible way you can qualify, but some workers do not. Others will bend over backwards. If you haven't heard from them when you think you should have, call them and ask for a status report. There are all kinds of screw-ups that end up getting an applicant rejected that can be avoided by keeping up with the process.

[Shagbark Hickory]

10. Don't you mean "got"? Got disability, not get disability. Days are numbered.