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“They sent somebody to visit me in the hospital and get my side of the story (totally free). I was assigned Mr. Crawford and told that we had a case. Fast forward about 9 months later and I received literally 14x what the insurance company had offered me. This is after the lawyer and medical fees as well. So basically this was totally free and I barely had to do anything I am so glad I called Marks and Harrison and I will be recommending them to all of my family and friends.”— Robert Smith
The process that goes into obtaining Social Security Disability (SSD) benefits can be complex and difficult to understand. It is no wonder that many people develop misconceptions about how it works.
At Marks & Harrison, our lawyers want to separate fact from fiction. Here, we debunk seven common Social Security Disability myths that we have encountered over the years.
Myth No. 1. You don’t need a lawyer to help with your SSD benefits claim.
Technically, you are not required to hire a lawyer to file your claim for SSD benefits. However, if you do not work with an attorney, it could be costly. You will miss out on the many important benefits that a lawyer can provide. These benefits include:
- Gathering and analyzing medical evidence that establishes the nature and extent of your disability and assisting you in completing Pain Questionnaries and Function Reports, which can help to get your claim approved at the initial application stage.
- If your application is denied, helping you to work through all stages of an appeal, including representing you at a hearing before an administrative law judge (ALJ). (If your appeal reaches the point where you need to file a lawsuit in the nearest U.S. District Court, you must a lawyer.)
- Effectively preparing your case for a hearing by using insights the lawyer has gained from previous hearings before ALJs at the local Office of Disability Adjudication and Review (ODAR)
- Seeking ways to speed up a decision in your case such as writing a dire need letter in the event of extreme financial hardship or requesting an “on-the-record review” that can eliminate the need for a hearing.
- Establishing a protective filing date and presenting evidence of your onset of disability date in order to maximize your backpay and retroactive benefits.
In contrast to a non-attorney disability “advocate” or “claims representative,” a lawyer brings legal education and training to your case. Your lawyer must also adhere to the professional and ethical standards set by the Virginia State Bar. Those are important differences.
Some people worry about paying for a lawyer. It may help to know that a lawyer from Marks & Harrison lawyers are only if you obtain benefits. Your lawyer’s fees are paid directly from the back pay benefits awarded to you. Those fees are capped at 25 percent of your backpay and can never be higher than $6,000.
Myth No. 2. You have to be disabled for at least one year in order to be eligible for SSD benefits.
Not true. To be considered “disabled” by the Social Security Administration (SSA), you must be unable to work due to a medically determinable physical or mental impairment that has lasted or “is expected to last for a continuous period of 12 months” or result in death.
So, if you have suffered from a medical condition for only six months, but your condition is expected to last for at least 12 consecutive months (or to result in death), you could still be eligible for SSD benefits.
Myth No. 3. If my application is denied, that means I do not have a case.
False. In reality, the majority of applications for Social Security Disability benefits are initially denied. SSA statistics from the 15-year period between1999 and 2013 show that 62.4 percent of applications were denied at the “initial adjudicative level.”
Many claims are denied because the disability examiner does not believe that the claimant’s condition meets the SSA’s definition of a “disability.”
However, if your application is denied, you still have several opportunities to appeal the decision. Many claimants are successful on appeal – especially with a lawyer’s help.
Virginia Disability Determination Services (DDS) will make the initial decision on a claimant’s medical eligibility. If DDS denies your claim, you can request that your claim be reconsidered by DDS.
If your claim is denied again, you can request a hearing before an ALJ at your nearest ODAR. You can continue to appeal by filing notice with the Appeals Council and, if necessary, by filing a lawsuit in the nearest U.S. District Court.
Consider the following SSA statistics, which show the rate of claims that were allowed at the hearing stage in Virginia’s five ODAR offices between September 2015 and March 2016:
As you can see, during that six-month period, ALJs in Virginia allowed a claim in nearly half of their decisions. This shows that it is far from “impossible” to get your claim approved after it is initially denied. Indeed, it may be highly possible. You should never stop trying.
Myth No. 4. Your medical condition must be listed in the “Blue Book” to be eligible for SSD benefits.
This is not true. If your mental or physical condition neither matches nor is equal in severity to a condition found in the SSA’s Listing of Impairments, or “Blue Book,” DDS will conduct what is called a “residual functional capacity” assessment.
First, DDS will consider whether you can return to your previous work. In other words, can you still handle the physical and mental tasks that you did before the onset of your medical condition?
If not, DDS will consider whether you can do any other type of work. DDS will look at your age, education, training, work history and transferrable skills in order to make this determination. If you cannot do any other work, then you may be deemed to be disabled and entitled to benefits through a “medical vocational allowance.”
A lawyer can play an important role in establishing your eligibility for a medical vocational allowance by gathering and presenting your medical records, work records, a statement from your doctor and other important evidence.
Myth No. 5. You cannot receive SSD benefits and workers’ compensation benefits at the same time.
False. If your disability arose from a work-related injury or illness, you may be able to receive both SSD benefits and Virginia workers’ compensation benefits. However, if you collect both benefits, your SSD benefits would be subject to an “offset.”
First, the SSA will determine your “average current earnings.” This is the average monthly pay that you received during the year in which you had your highest earnings during the five years before your disability arose.
Next, the SSA will determine your “total public disability benefit.” This amount includes what you receive in workers’ compensation benefits, SSD benefits and many other types of disability benefits. (Veterans Administration benefits are not included).
If your total public disability benefit amount exceeds 80 percent of your average current earnings, then your SSD benefits will be “offset” by that amount. For instance, if your total public disability benefit amount is $500 above your average current earnings, your monthly SSD benefits payment would be reduced by $500. This offset will also be applied to any SSD benefits that your family members receive.
Myth No. 6 After you start receiving SSD benefits, you can never go back to work.
Not true. In fact, the SSA offers several incentives to return to work if you are able to do so and want to work again. This is called the “Ticket to Work” program.
The program includes:
- Free employment support services such as career counseling, vocational rehabilitation and job placement and training
- Protection from continuing disability reviews while you are working, which allows you to continue to receive SSD benefits while giving work a try
- If your benefits stop because you end up earning an amount each month that goes beyond the SSA’s substantial gainful activity threshold, but you then need to stop working because of your condition, you can seek a reinstatement of your benefits without filing a new application (and receive benefits for up to six months while the SSA reviews your case).
Get Help Today from Our Virginia SSD Benefits Lawyers
At Marks & Harrison, we know how confusing and overwhelming it can be to face the process of applying for SSD benefits. We are here to help you.
We can carefully guide your claim through the application process, fight for you on appeal and work aggressively to pursue the benefits you are due. Our skill, experience and resources can truly make a difference in your case.
Don’t wait to get assistance. Call us today or reach us through our online form to receive a free, immediate and confidential consultation. We serve clients in Richmond and from eight other offices located throughout Virginia.