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Philadelphia Social Security Disability Law Blog

The importance of disability benefits

Knowing what to do in circumstances of an unexpected disability is important for individuals in Pennsylvania facing an unexpected inability to work and mounting medical bills. There are different disability options, and one is Social Security disability. Social Security disability (SSD) is a program through the federal government that provides disability benefits to individuals who are unable to work because of a permanent disabling condition.

In addition to having a disabling medical condition that prevents them from working, applicants for disability must also have the necessary work history to qualify for Social Security disability benefits. Workers earn work credits while working and paying into the Social Security system. Disabled individuals must also suffer from a medical condition that prevents them from gainful employment and is expected to last for 12 months or longer or result in death.

'Compassionate allowances' for Social Security disability

Because the Social Security disability application process can be lengthy and sometimes complex, it is helpful for disabled individuals in Pennsylvania to be familiar with the compassionate allowances program and what it entails. The compassionate allowances program allows applicants who suffer from medical conditions on the list of compassionate allowances to have their application for benefits expedited.

The compassionate allowances list includes medical conditions that are considered so severe that it is ensured they will qualify for benefits. The Social Security Administration maintains a list of medical conditions on the compassionate allowances list that currently numbers 165 qualifying medical conditions. Medical conditions on the list include various forms of cancer, heart disease, brain injury, neurological disorders, immune system disorders and others. The expedited process can save months or years in processing times.

Steps following a denied claim for disability benefits

When a claim for Social Security disability (SSD) benefits has been denied, it can be a serious concern for disabled individuals in Philadelphia who may badly need the benefits provided by Social Security disability insurance. SSD benefits can help disabled individuals with their daily needs, as life may be a struggle while they are facing a disability and an inability to work. It is important for disabled individuals to be aware that if their claim for SSD benefits has been denied, appeals options are available.

Following a denied claim for Social Security disability benefits, several levels of appeal are possible. The majority of initial claims for Social Security disability benefits are denied, so it is important not to become discouraged. Generally, the disabled applicant has 60 days from the claim denial to file an appeal, so it is essential to be familiar with the timelines and adhere to them.

Helpful guidance through the Social Security disability

The process of applying for Social Security disability benefits can be a challenging process. Because most applications are initially denied, and because of the availability of options for appeals, trained guidance can be useful throughout the application and appeals processes, if necessary. The definition of disability to qualify for Social Security disability is a strict one and requires that the disabled individual suffers from an impairment that prevents them from doing substantial work and that the impairment is expected to last a year or longer or result in death.

Though eligibility for SSD benefits does depend on work history, it does not depend on financial resources, however, Supplemental Security Income is an option for those of limited income and resources to consider. To qualify for Social Security disability benefits, the applicant must first submit an application, including medical records. If the application is denied, there are 4 levels of appeal for the disabled individual to consider.

Social Security disability wait hits record length

It may be more important than ever to understand how to fill out an application for Social Security disability benefits and to understand eligibility requirements and appeals options. Individuals who have applied for benefits, requested the first level of appeal and are now seeking a hearing before an administrative law judge are waiting a record amount of time for a hearing which is the second level of appeal in the application process.

The average wait time for a hearing is now 596 days which has increased from 353 days in 2012. Overall, the backlog of cases waiting for a hearing is about 1.1 million currently which is up from 700,000 in 2010. At times, once an application for disability benefits has been approved, retroactive benefits may be available. The monthly benefit depends on the disabled individual's earnings but the average is $1,170. To be eligible to receive Social Security disability benefits, the disabled individual must have sufficient work history, which varies according to the circumstances, and suffer from a physical or mental medical condition that prevents them from engaging in substantial gainful activity and is expected to last a year or longer or result in death.

Electronic medical records coming to more disability claims

Part of the application process for Social Security disability benefits is providing medical records. When applying for Social Security disability benefits, it is important to understand the requirements for eligibility and know what is required as part of the application process. The Social Security Administration recently partnered with a major medical care provider in a neighboring state for the electronic transfer of medical records, with the patient's consent, for purposes of Social Security disability applications.

The health care system the Social Security Administration most recently partnered with is one of the largest in the United States and serves greater than 2.8 million outpatient patients annually. The Social Security Administration has entered into several similar partnerships over the past several years and plans to continue expanding the program with high volume healthcare providers.

Benefits are crucial for disabled workers

Social Security disability benefits are an option for disabled individuals with the necessary work history to qualify for benefits to consider. Typically, the work history requirement to qualify for benefits is 10 years for a disabled individual 31 years or older. It is important to understand that the Social Security disability application process includes the initial application, as well as several levels of appeals if the application has been denied which many are.

Factors that are considered when evaluating a claim for Social Security disability benefits include the age of applicant; the education of the applicant; the applicant's work experience; and the applicant's ability to read, write and communicate in English. In addition, the applicant's physical or mental medical condition causing the disability will also be considered when determining eligibility for benefits and if the claim for benefits will be approved.

What are my options if my SSD benefits are stopped?

Pennsylvanians who suffer from an injury, illness or condition and are approved for Social Security disability benefits must understand that there are periodic reviews by the Social Security Administration to make certain that the benefits should continue. If the SSA determines that the person no longer has a qualifying disability, the benefits will stop. However, like when there is a denial of benefits at the initial application, a claimant can appeal to continue receiving benefits.

With an appeal, the SSA will examine the entire decision and if it is found that a mistake was made, it will be changed. There are 60 days for a claimant to request an appeal of the decision to stop payments. This will start after the letter is received saying that the benefits are stopping. There is a presumption on the part of the SSA that the letter will be received five days after its date. If the time frame is missed, the claimant must show that the letter took longer to arrive. There must be a good reason for having been late in filing the appeal.

What disability evidence do I need for my benefits claim?

If you are disabled and unable to work, you will need money to support yourself until you are back on your feet again. For some Philadelphia residents, these benefits may last for the rest of their lives. Unfortunately, though, the application process is not always easy. Even people with seemingly obvious disabilities have had their claims denied. If you want to file a claim for benefits with the Social Security Administration, then you will need to provide adequate evidence to prove your condition and how it renders you unable to work.

The evidence you provide must establish that you have a long-term disability and that your condition is severe enough to warrant disability benefits. The SSA will consider both medical and non-medical evidence that shows your ability to complete the tasks required of you at work.

What are compassionate allowances?

No matter how old you are, you can suffer an injury or illness that impacts your future and keeps you from doing your job. Many people in this position depend on Social Security Disability benefits to support themselves if they are unable to work. We often hear stories about how claims for SSD benefits take a long time to process and often get denied. Fortunately, there is one way to speed up the process for applicants with severe medical conditions.

Compassionate Allowances (CAL) are intended to make it easier for people with serious conditions that obviously qualify for SSD to get their benefits sooner. Through this designation, the Social Security Administration quickly identifies people with certain conditions and awards their benefits quickly.

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Pennsylvania Bar Association Philadelphia Bar Co-Chair SSD Committee Philadelphia Bar Co-Chair SSD Committee