The social security disability program administered by the federal government is a necessary benefit for many individuals. This program helps individuals who suffer from a severe physical and/or mental impairment that prevents them from engaging in regular work. Applying for these benefits is not an easy task for several reasons. One of the main reasons applying for disability benefits can be difficult is the time it takes for the social security administration to fully review a claim and make a decision. The second reason these claims are difficult is the durational requirement to qualify for the program. What I mean by the durational requirement is that to qualify you must show you have a severe medical condition that impacts your ability to work for a minimum of twelve months. This is not a short-term disability program. The third reason these claims tend to be difficult is the terminology used by the social security administration. The words and phrases you will read and hear throughout your claim review are not common terms you would normally hear. Below is a list of commons terms you will likely come across throughout your claim review.
Administrative law judge. A federally appointed official, more often a licensed attorney, presides over hearings and makes rulings on Social Security application and benefit decisions.
Appeal. This is a procedure for challenging a denial decision received in response to an application for benefits with the Social Security Administration. Just because your initial application was denied does not mean your claim is finalized. There are several appeal stages including the following:
- Reconsideration or asking Social Security to review their prior decision, generally reviewed by a supervisor
- Administrative Hearing before an administrative law judge
- Appeals Council review
- Federal court
Appeals Council. This body under the social security administration will review rulings made by administrative law judges. There is only one appeals council for the United States.
Application for benefits. A form or questionnaire is required to start your claim for social security disability benefits.
Claimant. The individual for whom an application for benefits has been submitted.
Consultative Examination. An examination is scheduled by the social security administration to have a medical doctor review your conditions and resulting symptoms to provide evidence regarding the severity of your impairment(s).
Decision Notice (award letter or denial letter). When you apply for Social Security, you will receive a decision letter in the mail from the social security administration indicating if your claim is approved or denied. If your claim is denied instructions will be included as to how to appeal the decision. If approved, your letter will include information as to your monthly benefit, the date your benefits will begin, and any retroactive benefits you may be eligible for.
Disability. A severe illness or injury that prevents you from engaging in full-time employment for at least a year or is expected to result in death.
Disability benefits. This is the monthly payment you will receive if you are found disabled. This benefit is based upon how much you have paid in taxes into the social security system over the years.
Hearing. This is an administrative hearing held before an administrative law judge. There is no opposing counsel or representative from the federal government, aside from the administrative law judge who is supposed to be an unbiased entity.
Insured Status. When you work and pay taxes into social security on your earnings, those taxes make you eligible not only for retirement benefits but disability benefits as well as long as you have paid enough into the system in taxes and claim them during the insured period.
Medical Expert. A medical doctor that has been qualified by the social security administration to review disability claims, respond to interrogatories, and attend hearings. These experts are required to know the rules and regulations of social security benefits. They are also required to testify as an unbiased witness even though social security pays them a fee.
Medicare. Federally run health insurance for those that are found disabled or have attained the age of 65.
Onset date. Your alleged onset date or AOD is the date on which you became disabled under social security’s definition of disability. This is the first date after you stopped working and your medical conditions prevented you from engaging in employment. Your onset date is important as it determines when your benefits start and if there are any retroactive benefits due and owing to you.
Protective filing date. This is the day you contacted social security to begin your initial application for social security disability benefits. You have 6 months from the protective filing date to submit a completed application for review. Another important point of the protective filing date is that if approved you are only eligible to receive benefits up to twelve months before your filing date. Meaning, that if you are alleging an onset date that is more than twelve months before the date you started your application you will not receive benefits for that full-time frame.
Reconsideration. This is the first step in appealing a denial decision from the social security administration. Generally, you have 60 days from the date of denial to submit an appeal.
Representative Payee. An individual assigned to manage your benefits for you.
Retroactive benefits. These are benefits paid from the date you became disabled up until the date your claim is approved. Remember, you will only receive retroactive benefits up to twelve months before your filing date, assuming your alleged onset date is before your filing date.
Social Security. Social Security is a federally mandated insurance program protecting your rights to retirement, disability, and Medicare benefits.
Social Security Act. The social security act of 1935 first established the social security program.
Social Security Administration (SSA). The federal agency that runs Social Security, Supplemental Security Income, and Medicare.
Social Security Disability Insurance (SSDI). This is a monthly benefit available for individuals that meet social security’s definition of disability along with those who have paid taxes on their earnings for the past five out of ten years. This benefit is calculated based upon the individual’s taxes they have paid into the social security system.
Substantial Gainful Activity. An income-based factor is used by the social security administration to determine a monthly threshold of being able to work and still being eligible to receive disability benefits. The threshold for substantial gainful activity in 2022 is $1,350 per month.
Supplemental Security Income (SSI). A federal welfare program designed to provide benefits for low-income individuals.
Vocational Expert. An individual with a background in job placement, job statistics, and requirements. This individual is most often called by an administrative law judge at a hearing.
While this list of terms is not exhaustive, it is meant to provide you with some of the more common terms and phrases you will come across when applying for disability benefits. To have the best chance of winning your claim for benefits, you should hire an experienced social security disability attorney. At the LaBovick Law Group, we provide free consultations to our clients to determine if this is even the right program for you. Call us today at (561) 625-8400 to see if you qualify for benefits.