Social Security Disability (SSD) – Frequently Asked Questions

  • How does the Social Security Administration define “disability”?

    “Disability” is defined by the Social Security Administration as an  “… inability to engage in substantial gainful activity by reason of any medically determinable physical or mental impairment [or combination of impairments] which can be expected to last for a continuous period of not less than twelve [consecutive months] … taking into account the individual’s age, education and work history.” 42 U.S.C. sec 423 et al; 20 C.F.R. 404 (emphasis added).

  • If I can’t work because of my medical condition, does that mean I am eligible for disability?   

    Qualifying for Social Security Disability is as much a legal question as it is a medical one. Social Security laws require more than having your doctor tell you that you are disabled. Instead, we look at your medical condition, your physical and work restrictions, and the effects that these facts  have on your ability to work. This is a complicated evaluation which often requires an attorney’s assistance.

  • How much money will I receive on disability? 

    Disability payments under SSD are determined by your earnings record. Social Security uses your Primary Insurance Amount (PIA) which can be found on your Earnings Record with Social Security. SSDI payments are based upon lifetime earnings, not the severity of your disability. It is also important to note that SSDI benefits are reduced if you receive Workers Compensation payments. If you are entitled to benefits under SSDI, then the most that you could receive is $2,639 for 2016.

  • Will I get health insurance coverage under Social Security? 

    Pursuant to 42 U.S.C. sec. 426(b), you are entitled to be covered by Medicare within 24 months of being approved to receive disability benefits under SSDI. Please note that there is a 5 month waiting period from the onset of the disability to entitlement. However, under SSI, you should be able to get Medicaid coverage which is administered by the State.

  • How do I apply for Social Security Disability? 

    The fastest way to apply for SSDI disability is to apply online at However, if that is not feasible, then you may contact Social Security at their toll free number 1-800-772-1213 and apply over the telephone. Of course, you can go to any Social Security office near you to apply.

  • When do I need to get an attorney to help with my Social Security Disability claim?

    Applying for Social Security benefits involves more than completing an application, and it is helpful to have someone who will work for you from the beginning.  The Law Office of J.J. Talbott accepts claims at the initial application stage and would be happy to evaluate your case, answer your questions, and file your application with Social Security. Although you can complete your application without an attorney’s assistance, consulting an attorney early in the process, before you apply or shortly after, can be extremely beneficial. An experienced Social Security Disability attorney can help put your claim on the best footing from the outset. Let our team of attorneys fight for your Social Security benefits today!

  • How long does it take Social Security to make a decision on my claim? 

    A significant part of the claim process involves obtaining your medical records, which can be a time consuming process as the Social Security Administration has to get your records from many medical providers. Also, if Social Security has medical questions, they send you to a doctor for an evaluation. A disability examiner will work with a state agency doctor to make the initial decision on your claim. As such, the period for the initial evaluation may take between 3-5 months.

  • What happens if my claim is denied? 

    If your claim is denied, the next step will be to file for reconsideration. At reconsideration, the claim is evaluated by a different examiner and state agency physician. If the claim is denied at reconsideration, you may request a hearing before an administrative law judge. Please note there are strict time deadlines to appeal decisions or file for reconsideration, and if you file late, then you have no recourse and have to start over. Usually, this is the point at which you will want to hire an attorney. Many claims are denied by Social Security in the initial stages. However, a majority are then approved at the hearing level. You have a good chance of winning at hearing level so it is important not to give up.

  • What if I cannot afford an attorney? 

    Attorneys’ fees are both approved and regulated by Social Security. Many attorneys work on a contingency fee. This means that you do not have to pay attorneys fees if you do not recover. Contingency fee percentages are capped at 25 percent of the “past due” benefits with a cap not to exceed $6000.00. Social Security will pay the attorneys’ fees amount to your attorney at the conclusion of your case out of your past-due lump-sum benefits. At that time, you may also have to pay your attorney for any out-of-pocket expenses such as ordering medical records; copies and postage.

  • Can I work and still collect Social Security Disability? 

    You cannot be engaged in “substantial gainful activity.” 20 C.F.R. 404.1571. In 2016 there is a presumption that a claimant earning $1010.00 a month is engaged in “substantial gainful activity.” This means that if you are paid more than this for work in one month despite a disabling condition, your claim will be denied. However, an attorney can help you determine if this work constituted an “unsuccessful work attempt” or whether the actual earnings should be reduced due to “impairment related work expenses” or whether it was really “subsidized work.”

  • What happens when I reach retirement age? 

    Once you reach age 62, your disability benefits will be automatically converted to retirement benefits by Social Security.

  • Are children entitled to receive Social Security Disability? 

    An adult child becomes disabled before the age of 22 may be entitled to draw SSDI benefits based upon the Social Security eligibility of his or her mother or father. The parent must be deceased or drawing SSDI disability or retirement benefits. It is not necessary for the adult child to have an earnings record with Social Security as the adult child can utilize the parent’s earning record. However, the disabled adult child cannot be engaged in substantial gainful employment. Children under the age of 18 may be entitled to receive SSI benefits if they meet the criteria for being disabled and their family income and assets meet the eligibility requirements.

Do you still have questions? Call us today at 850.437.9600 for a free consultation.

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