Social Security Disability Basics

1. Social Security Disability Basics Prepared by: Saundra McDowell Based on material from websites provided by SSA and NOSSCR in addition to experience in SSD field.

2. Types of Disability Benefits • Disability Insurance Benefits (DIB) • Supplemental Security Income (SSI) • Disabled Widow/Widower Benefits (DWB) • Childhood Disability Benefits (CDB)

3. Eligibility Requirements for Social Security Disability Insurance Benefits (SSDI) • A Claimant must have worked for five of the last ten years to be within their Date of Last Insured (DLI). • A Claimant’s disability must have lasted (or be expected to last) longer than 12 months. • To meet this requirement one must be, or expected to be, disabled for 12 months or the disability is expected to result in death. • A Claimant must be under the age of 65. • A Claimant must be unable to perform “substantial gainful activity.” • Substantial Gainful Activity is the ability to perform work or work-like activity. If you are able to perform any type of work, even if it is not your previous job (depending on your age), it may be determined that you are capable of performing substantial gainful activity. • A Claimant must provide a doctor’s diagnosis and medical evidence that supports their disability claim. • If a Claimant does not qualify for SSDI, they may still qualify for Supplemental Security Benefits (SSI).

4. Eligibility for Supplemental Security Income Benefits (SSI) • A Claimant must have limited income and resources; • Income/resources can not be worth more than 2,000 for a single person or 3,000 for a couple. • Some things are not counted such as your home and one car. • SSI is for elderly people as well as blind or disabled people of any age, including children. • One may have to meet certain other requirements. • Monthly payments for 2011 is the same nationwide: • $674 for one person; or • $1,011 for a couple.

5. Stages in Applying for Disability Benefits • Application • Initial Determination • Reconsideration (in some states) • Request for Administrative Hearing • Appeals Council • Federal Court Review

6. What a Claimant Will Need When They Apply at the Initial Application Stage • Medical Documentation • The Claimant will need: • Information on all previous and current doctors’ visits and hospitalizations; • Dates and places of lab reports, x-rays, and other clinical diagnostics that provide evidence of impairments; an d • A list of current medications and dosages. • Work History • SSA will need to know the name and location of previous employers for the last 15 years, the job description of the positions held at those jobs, and how long the Claimant worked at each job. • W-2 forms will need to be submitted as well. • Other Documentation • Included by not limited to: Marriage Certificate, Certificate of Divorce, Birth Certificates, Death Certificates, Social Security Card, Military Service or discharge paperwork, and Documentation of Child Support Payments.

7. What SSA looks at to Determine Whether a Claimant is Disabled • There are 5 Steps to the Analysis of Disability • Step One – Eligibility • Step Two – Severe Impairments • Step Three – If they meet or equal a listing • Step Four – If they can return to any of their prior work from the past 15 years. • Step five – If there is other work in the national economy that the Claimant could perform with his/her current limitations.

8. When Claimants are 50 Years or Over • While it is not the only factor, age is an important factor in determining whether one is approved for SSDI and/or SSI. • When a Claimant is 50 years old or over different rules apply to their claim. • They must prove they can not perform their previous work from the past 15 years. • Judges do not expect Claimants to go out and learn other work when they are 50 and over and are significantly limited because of their impairments.

9. Administrative Law Hearings What to Expect • The Administrative Law Judge hearing is a relatively informal process. • Before the hearing, the attorney will gather evidence to support the claim and prepare the Claimant for testimony at the hearing. • This significantly increases the chance of success at the hearing stage. • The attorney will represent claimant at the hearing and will present evidence on his/her behalf. • The attorney will also have the change to question the Vocational Expert and the Medical Expert if one has been retained for the case.

10. Benefits of Representation • The process is lengthy and complicated for the average person. • Attorneys collect and organize medical records and other documentation needed to file requests for reconsideration, hearings, and appeals in a correct and timely manner. • Attorneys prepare claimants and witnesses for Administrative Law Judge (ALJ) hearings and Appeals Council hearings. • Attorneys make the hearing process easier as they are at the hearing to give legal advice, to help Claimants better understand the process, and to help put them more at ease in a normally stressful situation. • No upfront costs to having legal representation. • Legal fees are mandated for Social Security Cases so even after a Claimant wins, the legal representatives only gets paid a percentage of their back pay with a maximum allowable fee of $6,000.

11. Forms to Submit at the Hearing • Medical Source Statements • Medical Source Statement – Physical (MSSP) • This provides physical limitations based on the Claimant’s physical impairments. • Make sure the appropriate physician fills this out and signs it. • If more than one physician is seeing the Claimant for physical problems, have each of them complete a MSSP • Medical Source Statement – Mental (MSSM) • This provides mental limitations based on the Claimant’s mental symptoms • Make sure a psychologist or psychiatrist fills this out and signs it. • If Claimant is only seeing a therapist, counselor or primary care provider for their mental symptoms, their opinions are better than none.

12. Frequently Asked Questions (FAQ’s) For Claimants • How do I apply for Social Security Disability Benefits? • Go to nearest Social Security office in person and wait to see someone to file a claim in person, contact SSA by telephone and arrange for a telephone interview to file a claim or go online to the SSA website and file your claim online. • Am I allowed to collect unemployment or worker’s compensation benefits when I am applying for disability? • Yes, but benefits may be offset, which reduces the amount you may get for SSDI or SSI. • If I expect to return to work in the future, should I still file for disability? • Yes, if you expect to be out of work for a year or more on account of an illness or injury, you should file.

13. FAQ’s continued… • What can I do to improve my chances of winning my disability claim? • Be as open and honest with SSA as you can when giving them information on your medical impairments and what keeps you from working. Many people fail to tell SSA about any mental impairments or learning disabilities that may keep them from working. Problems with learning, concentration, and memory as well as any symptoms you may have from depression or anxiety significantly effect your ability to work a full time job. • Also, make sure you see a medical provider for any and all impairments, complain about all of your symptoms and go to see them as much as possible in order to get adequate documentation on your disabilities.

14. FAQ’s continued… • How do I get the medical documentation I need if I do not have the money to go to the doctor? • You should apply for Medicaid. There are also some free clinics in the area that your legal representatives can give you information on that you can get treatment and some medications for free or at a reduced cost. There may be a wait time to get into some of these free clinics so it is better to call sooner rather than later.

15. Resources • Free or Reduced Cost Medical Care • Kansas City Free Health Clinic • Samuel U Rodgers Health Center • Swope Health Central • Truman Medical Center • Northland Medical and Wellness Center • Comprehensive Mental Health • Johnson County Mental Health Center • ReDiscover (formerly Research MH Services) • Tri-County Mental Health Services • Wyandot Center • Mental Health Association of the Heartland

16. Different Types of Resources • Shelters • Metropolitan Lutheran Ministries of Kansas City (MLM) • Kansas City Rescue Mission • City Union Mission • reStart Inc. • Hope Faith Ministries • Mt. Carmel Community Outreach Ministries • Joyce Williams Shelter

17. Contact Information: • Saundra J. McDowell • Peterson & Associates, P.C. • 801 West 47th Street, Suite 107 • Kansas City, MO 64112 • 816-LAW – FIRM • sjm@petersonlawfirm.com