Disability And Injury FAQs
Injuries and illnesses that keep from work can cause considerable personal and financial strain. At these times, individuals and families rely on insurance policies to keep them secure. When those benefits are denied, it’s natural to have many concerns and questions. Browse our FAQs to find information and insight from our experienced disability and injury attorneys.
How to Apply For Social Security DisabilityShow Answer Hide Answer
One of the top reasons applicants are denied Social Security disability benefits is because the claimant failed to complete his or her application!
How Does That Even Happen?
People frequently ask me, “How can a person fail to complete the application?” If I had to venture a guess, I would say that some claimants fail to complete the application because of all the work that is required to file a claim.
Perhaps it would be easier to explain this by detailing what information is required to file a disability claim with the Social Security Administration.
How to Apply for Social Security Disability
There are three ways that you can apply for disability benefits: on the internet (online), in person, or on the telephone.
When you file a claim either in your local field office or by telephone, a Social Security representative will interview you and complete the application for disability benefits and the Adult Disability Report.
Even if you choose an application interview in person or on the telephone, you can greatly reduce your interview time as much as 50% by starting the process online. You can complete both the application for benefits and the Adult Disability Report online by going to SocialSecurity.gov.
You still need to keep your scheduled appointment with your local field office so a Social Security representative can review your information.
How to Apply Online
You can apply for disability via the internet by visiting SocialSecurity.gov.
There are four (4) steps to apply online
- Review the Adult Disability Checklist.
- Fill out the Disability Benefit Application.
- Fill out the Adult Disability Report.
- Fill out the Authorization to Disclose Information Form and mail or take it to your Social Security Office.
How to Apply On the Phone
The first thing you should do is call Social Security’s toll-free number, 1-800-772-1213, to set up an appointment for someone to take your claim over the telephone. If you are deaf or hard of hearing, you may call Social Security’s toll-free TTY number, 1-800-325-0778.
The disability claims interview typically lasts from one to three hours, depending on how well prepared you are for the interview. If you schedule an appointment, Social Security will send you a Disability Starter Kit to help you prepare for your disability claims interview. The Disability Starter Kit also is available online at Socialsecurity.gov. For your information and convenience I will list much of the information you will need to gather below.
How to Apply In Person
Again, you should call Social Security’s toll-free number, 1-800-772-1213, to make an appointment to file a disability claim at your local Social Security office. In the greater Pensacola area, you may call the Pensacola office directly at 1-877-505-4550.
What Completes The Application?
To apply for disability benefits, you must complete (1) a Social Security Benefit Application, (2) an Adult Disability Report, and (3) an Authorization to Disclose Medical Records.
The Authorization is a one-page medical release that gives Social Security permission to request your medical records from your doctors. The Social Security Benefit Application is your claim for benefits. It does not take very long to make a claim. The real time-consuming part of a disability application is the Adult Disability Report, which collects detailed information about your personal history, work history, medical history and current disability.
If you cannot complete the Adult Disability Report online, you can still complete Social Security’s (1) Medical and Job Worksheet (“Worksheet”) and (2) Checklist – Adult Disability Interview (“Checklist”), and have them ready for your appointment. I made a shortcut web address for the Worksheet and Checklist, which you can access at SSA.gov.
Use the following Checklist to prepare for your application, whether it be online, in-person, or on the telephone:
- Medical records already in your possession. (You do not need to go out and gather all of your medical records. You only need to gather what you already have. Social Security will help you obtain the rest of your medical records.).
- Workers’ compensation information, including the settlement agreement, payout ledger (distribution), date of injury, claim number, and proof of other disability awarded payment amounts.
- Names and dates of birth of your minor children (under 19 years old) and your spouse.
- Dates of marriages and divorces.
- Checking or savings account number,including the bank’s 9-digit routing number, if you want Direct Deposit for your benefit checks.
- Name, address, and phone number of a person Social Security can contact if it is unable to get in touch with you.
- If a medical release Form SSA-827 (Authorization to Disclose Information to the Social Security Administration) was mailed to you by Social Security, complete (sign and date with witness signature) and return it as directed.
- As stated above, if you are unable to file for benefits online, complete the “Medical and Job Worksheet – Adult” and take it to your interview.
Take the Checklist items and information to your appointment or have them with you if your appointment is by telephone.
You should keep your appointment even if you do not have all of the information. Social Security will help you obtain any missing information.
You should also complete the Medical and Job Worksheet to prepare for your in-person or telephone appointment, or when filing online. This Worksheet is not an application for Social Security disability benefits. It is meant to help you fill out the application for benefits.
The Worksheet requires you to list the following information:
- Medical Conditions: You should list all of the physical or mental conditions (including emotional or learning problems) that limit your ability to work. If you have cancer or any other condition that is measured in stages, you should include the stage and type.
- If you are not working, list the date you stopped working.
- Your height without shoes in feet and inches.
- Weight without shoes in pounds.
- Medical Sources: You should list any doctors, hospitals, clinics, therapists, or emergency rooms you have visited because of your conditions. For each medical provider, you should list the name of the provider, address, phone number (with area code), the date you were first seen (or admission date), and the date you were last seen (or discharge date).
- Medicines: You should list any medicines you take, why you take them (for which medical condition), and the prescribing doctor’s name.
- Medical Tests: List any medical tests you have had, or are going to have in the future. For each test, you should also provide the type of test, the name of the doctor who ordered the test, and the date(s) of the test.
- Job History: List the jobs (up to the most recent 5) that you had in the 15 years before you stopped working. For each job, you should list the job title, type of business, dates worked, number of days worked per week, hours worked per day, and rate of pay.
Armed with the above documents and information, you are well-prepared to file your claim form for disability. It is strongly recommended that you have someone such as an attorney experienced in handling disability claims go through your application with you.
Mr. Ortiz is a Board Certified Social Security Disability Advocate Attorney and offers free case evaluations. Call today at 850-898-9904 for your free consultation.
Proof of Number Holder Name ChangeShow Answer Hide Answer
You checked the status of your Social Security disability application. It says, “We requested that you send the following documents to the office that is processing your application:
Proof of Number Holder Name Change.” What in the world does that mean?
For women, it may mean that Social Security wants to verify your previous names, such as maiden name, prior married names, etc.
For men, it is much less common to have name changes. So why would a man receive such a message. Well, it may mean that your records show a misspelled name, nickname or alias.
Just be sure to respond to Social Security with any requested information to be sure your application moves forward.
Do I Have To Pay Income Tax on Social Security Disability Benefits?Show Answer Hide Answer
The answer is, “It depends.” You must pay federal income taxes on your Social Security disability benefits if either of the two following situations applies to you.
- You file an individual federal tax return and your total income is greater than $25,000. Or,
- You file a joint return and the income of you and your spouse is greater than $32,000.
You should also refer to the Internal Revenue Service (IRS) Notice 703 on the back of your Social Security Benefit Statement, Form 1099, to determine if any of your benefits are taxable. A copy of Notice 703 may be found by clicking this link: Notice 703.
Further note that the above only references federal income tax. Social Security does not have the authority to withhold state or local taxes from your disability benefits. However, many states and local authorities do not tax Social Security benefits. You should consult with your tax advisor and your state or local taxing authority for additional information.
Disability for Diabetes (Type I or II) | Diabetic NeuropathyShow Answer Hide Answer
Diabetes occurs when the body does not produce enough insulin to process glucose, which results in excessive amounts of glucose in the blood and urine, excessive thirst, and weight loss. In some cases, there is a progressive destruction of small blood vessels which leads to such complications as diabetic neuropathy, infections and gangrene of the limbs, or blindness.
Diabetes can often be controlled with medication and a proper diet. However, as a person ages, sometimes diabetes cannot be controlled. This is a problem as uncontrolled diabetes can cause damage to internal organs and other problems.
Symptoms and Complications of Adult Diabetes
Symptoms of both Type I Diabetes and Type II Diabetes include:
- frequent urination,
- unusual thirst and hunger, and
- extreme fatigue.
Individuals with type 2 diabetes also can experience numbness and tingling in the hands and feet, frequent infections, and cuts that are slow to heal.
Complications from diabetes may include:
- retinopathy (eye and vision problems)
- nephropathy (kidney disease)
- neuropathy (nerve damage) in feet or hands that disrupts your ability to stand, walk, or use your hands
- hypertension (high blood pressure)
- heart disease
- gastroparesis (a type of nerve damage that interferes with digestion)
- peripheral arterial disease (reduced blood flow to your limbs)
- cellulitis (skin infections), and
Qualifying for Disability Benefits with Diabetes
If you have uncontrolled diabetes and you have been unable to work for at least 12 months, or you expect that you will not be able to work for at least 12 months, then you may be eligible for Social Security disability (aka SSDI or SSD) benefits or Supplemental Security Income (SSI) benefits. To qualify for disability benefits, you must be able to demonstrate that the damage caused by your diabetes severely limits what you can do.
One of the biggest reasons disability claims are denied is because the patient is “non-compliant” with the doctor’s orders. If your diabetes is uncontrolled because you failed to follow your doctor’s prescribed treatment, your claim for disability will likely be denied. For more information, see our article on failing to comply with treatment orders.
Meeting a Disability Listing for Diabetic Complications
The Social Security Administration (SSA) has a Listing of Impairments (the “Blue Book”) that tells you how severe an illness must be to qualify for disability benefits. Diabetes is no longer included as a separate Listing, so a diabetes diagnosis will not automatically qualify you for disability benefits. However, if you have complications arising from your diabetes that fall under a Listing, you may be approved for benefits.
If your complications meet the requirements of a Listing of Impairments, you will automatically be approved for disability benefits before Social Security goes any further in the five step sequential evaluation process.
The following are some listings that may apply to patients with complications from diabetes (both hyperglycemia and hypoglycemia):
- Diabetic retinopathy (Listing 2.00). If you have blurred vision, poor visual acuity (between 20/100 and 20/200 in your better eye), or poor peripheral vision from surgery to correct your central vision, you may qualify for disability benefits under this listing. More about disability for vision loss.
- Diabetic nephropathy (Listing 6.06). If your kidneys are no longer filtering properly and you require daily dialysis or there is evidence of too much protein or creatine in your plasma, you may qualify for Social Security disability benefits. More about disability for kidney disease.
- Diabetic peripheral neuropathies (Listing 11.14). Many patients with diabetes have some form of neuropathy or nerve damage in their hands, feet, arms, or legs. To qualify for benefits under this Listing, you must demonstrate that your neuropathy causes a significant impairment of your ability to walk, stand, or use your hands in a skilled way. More on disability for peripheral neuropathy.
- Cardiovascular problems. Diabetes can lead to coronary artery disease (listing 4.04), chronic heart failure (listing 4.02), peripheral vascular disease (listing 4.12), and an irregular heartbeat (listing 4.05). More about disability for heart problems.
- Poorly healing skin and bacterial infections (Listing 8.04). If you have ulcerating skin lesions that last for three months or longer despite treatment and such lesions make it difficult for you to walk or use your hands, you may qualify for disability benefits under the listing for chronic skin infections.
- Amputation of an extremity (Listing 1.05). If you’ve had a foot amputated due to nerve damage and poor circulation caused by diabetes, you may qualify for benefits if you have other limitations as well. More about disability for amputation.
- Diabetic ketoacidosis (DKA), DKA is an acute, potentially life-threatening complication of Diabetes Mellitis (DM) and usually requires hospital treatment to correct the acute complications of dehydration, electrolyte imbalance and insulin deficiency. If you have serious complications resulting from your treatment, SSA will evaluate your condition under the affected body system. For example, the SSA evaluates cardiac arrhythmias under the Cardiovascular System (Listing 4.00), intestinal necrosis under the Digestive System (Listing 5.00) and cerebral edema and seizures under Neurological (Listing 11.00). Recurrent episodes of DKA may result from mood or eating disorders, which SSA evaluates under Mental Disorders (Listing 12.00).
Should I Request Reconsideration Using a Lawyer If My Disability Claim is Denied?Show Answer Hide Answer
Requesting Reconsideration Using a Lawyer if a Disability Claim is Denied
If you have filed for Social Security Disability Insurance (SSDI or SSD) or Supplemental Security Income (SSI) benefits, and your application for disability has been denied, you have the right to file an appeal of the denial. The first stage of appeal in Florida is the Request for Reconsideration. You can either file a reconsideration appeal on your own or find an attorney to represnt you and file the appeal.
You Are Likely to be Denied Again After Your Request for Reconsideration
If your initial application is denied, then it is very likely that your reconsideration appeal will be denied as well. A lawyer may be able to help you turn things aground if you left out important information in your application; however, there is no guarantee.
If your reconsideration request is denied, you will have to file a second appeal ton continue with your claim. The second appeal is decided by an administrative law judge (ALJ) at a disability hearing. Before your hearing you should have legal counsel.
Numerous studies have shown that ALJs are significantly more likely to approve disability benefits to those who are represented than to those who represent themselves. Statistically, less than 40% of unrepresented individuals who apply for SSI or SSDI and have their case heard before a administrative law judge (ALJ) will end up winning disability benefits. About 70% of individuals who are represented by an attorney will end up winning disability benefits.
Be Aware of the Deadline
Anyone can file their own appeal online or at their local Social Security District office. However, many of those who choose to file reconsideration appeals on their own have a tendency to procrastinate, sometimes to the point of missing the appeal deadline. Always remember that Social Security only allows 60 days from the date of denial (plus 5 additional “grace” days to allow for mailing time) for an appeal to be filed at the Social Security office.
A surprising number of disability claimants who fully intended to file an appeal miss this deadline. Most of these make the mistake of thinking that the deadline only means that their request for reconsideration has to be postmarked within 60 days from when they received their notice of denial. But tt actually has to be in the Social Security office, not just postmarked, within 65 days of the date stamped on the denial letter. This is one reason why it is a good idea to get a lawyer before you file an appeal. A good disability lawyer will file all appeal paperwork for you on time.
If You Want Help, Seek it Early On In the Process
If you do decide to hire a disability attorney for your reconsideration appeal (or for a disability hearing), do not put this task off until it is too late for the lawyer to be of any real help to you. In order to act on your behalf in proceedings before the Social Security Administration, your lawyer must have certain forms signed, such as an Appointment of Representative, an attorney fee agreement, and permission to get your medical records (Form SSA-827, which is a medical records release form). If you wait too long to hire an attorney, you may not allow enough time to complete the forms, and you may end up having to request an appeal on your own so that you do not miss the 60-day deadline.
Time Limits For An AppealShow Answer Hide Answer
Generally, you have 60 days after you receive the notice of our decision to ask for any type of appeal.
- In counting the 60 days, the Appeals Council presumes that you received the Administrative Law Judge’s unfavorable Notice of Decision five days after Social Security mailed it unless you can show that you received it later.
- If you do not appeal on time, the Appeals Council may dismiss your appeal. This means that you may not be eligible for the next step in the appeal process and that you may also lose your right to any further review.
- You must have a good reason if you wait more than 60 days to request an appeal. If you file an appeal after the deadline, you must explain the reason you are late and request that Social Security extend the time limit. The people in the Social Security office can explain further and help you file a written request to extend the time limit. The Appeals Council will consider your request and decide whether to extend the time limit.
What Are The Steps In The Social Security Disability Application and Appeal Process?Show Answer Hide Answer
The first step in the disability process is to actually apply for Social Security disability benefits. You can file an application for Social Security disability (SSDI) benefits by phone, by mail, online or in person at your local Social Security Administration District Office. Your lawyer can help you file your application.
A claim for Supplemental Security Income (SSI), on the other hand, must be done in person at the local Social Security office or by phone appointment with an SSA Representative.
Your disability claim will then be processed by a representative from your local Social Security field office, and by and your state agencies. The Social Security representative will verify your age, marital status, employment and whether you have enough work credits to qualify for SSDI benefits by having paid Social Security taxes into the system. Your file is then sent to Disability Determination Services (DDS) to determine whether your medical condition is disabling. The DDS is responsible for gathering the required medical records from your doctors. DDS may also make arrangements for you to be seen by consultative examining doctors (that are paid by the Social Security Administration) to determine the severity of your impairments.
Once DDS determines they it has enough medical evidence, it will issue the first decision as to whether you are disabled under the Social Security disability regulations. If you meet the medical requirements for disability the DDS will return your file to the local Social Security field office to calculate the amount of your disability benefits, and you will then begin receiving those benefits. If the DDS finds you are not disabled, then the file is still sent back to the Social Security field office where they will wait to see if you appeal the decision.
To appeal the decision in the state of Florida you must go through the process of reconsideration. You must file a Request For Reconsideration, which is basically a repeat of the initial claim process. [Note: In other states, such as Alabama, if you appeal your initial denial you will skip the Reconsideration stage and go straight to the hearing stage before an Administrative Law Judge.]
If you are denied on reconsideration, then you proceed to the hearing stage. Your case is now in another office called the Office of Disability Adjudication and Review, or ODAR for short. The ODAR that covers Pensacola, Florida is in Mobile, Alabama. The average wait time for a hearing is extremely long, with national averages ranging from 12-18 months (and sometimes longer). As of March 2013, the Mobile ODAR had a wait time of 13 months. And that is not calculated from the initial application. That wait begins at the time the Request for Hearing is filed. If you win at the hearing stage (and your case is not reviewed by the Appeals Council), it will be sent to the local field office for payment.
If the Administrative Law Judge issues a “Notice of Decision – Unfavorable” and you lose at the hearing stage, you can appeal the decision to the Appeals Council.
The Appeals Council will do one of three things: deny your appeal, remand the case for another hearing, or find you disabled. If you continue to lose at the Appeals Council your only recourse is to file a civil action (lawsuit) in United States Federal Court.
Abbreviations in Social Security Disability ClaimsShow Answer Hide Answer
This list indentifies many of the common abbreviations used in Social Security Disability claims.
How Do I Report Fraud?Show Answer Hide Answer
Unfortunately, fraud is a reality in any entitlement program, including Social Security disability.
How to Report Fraud in Social Security Disability and SSI Claims
The Social Security Administration’s Office of the Inspector General (“OIG”) is responsible for investigating fraud in Social Security programs. Among its many responsibilities, the OIG detects and prevents fraud, waste and abuse in Social Security disability insurance and Supplemental Security Income (“SSI”) claims.
You, as a responsible US citizen, can use this online form to report allegations of fraud, waste, and abuse in SSA disability programs. The OIG has the jurisdiction and authority to investigate allegations of work and the concealment of assets. The OIG also investigates misuse and misappropriation of assets by representative payees.
How Do I Appeal The Denial Of Social Security Benefits?Show Answer Hide Answer
There are many ways you can appeal:
- First, you can contact Social Security by calling 1-800-772-1213 and tell the representative that you want to file an appeal. They will send you the proper appeal paperwork. However, it is still up to you to file the appeal paperwork with Social Security within the sixty day time limit.
- Second, you can file an appeal online at: https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp. Click on the button that says, “Start a New Appeal” and you are on your way.
- Third, you can go down to your local Social Security office and file the appeal in person.
- Fourth, you can call an attorney like me to assist you, and guide you through the appeal process. I would be happy to answer any questions you have about the appeal process. Call us at (850) 898-9904, or fill out the contact form.