Frequently Asked Questions
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What's substantial gainful activity and how is it calculated?
When you file an application for Social Security Disability Insurance (SSDI), you must meet eligibility requirements. One of the first things that the Social Security Administration (SSA) will look at when reviewing your application is whether or not you're working. If you're employed, you must not be engaged in substantial gainful activity (SGA) in order to receive benefits.
What Is Substantial Gainful Activity?
Substantial gainful activity is work that pays you a certain amount of money per month. If this is the case in your situation, the SSA may deny your claim for SSDI.
The SGA amount is set yearly, and changes based on fluctuations in the national average wage index. Here are the amounts for 2019:
- The amount for statutorily blind individuals is $2,040.
- The amount for non-blind individuals is $1,220.
The amount of SGA is different for individuals who are blind and those who are not blind.
Even if you make less than the monthly SGA, this doesn't mean you're determined to be unable to engage in employment. The SSA looks at the circumstances of your employment and why you're making low wages. For example, if you're a substitute teacher or bus driver and are only not employed full time due to the lack of work, you could be found to be engaged in SGA. In addition, if you're only working on a limited basis but volunteering on a regular basis, this may be considered substantial gainful activity. However, attending school doesn't make you ineligible for SSDI.
Can You Stop Working?
If you stop working after applying for Social Security Disability benefits, you'll need to show that your medical condition worsened enough so you were unable to work in order to meet the SGA requirements. The SSA makes a determination as to whether this was an unsuccessful attempt at working. In general, if you were only employed six months or less and had to quit or reduce your hours because of your disability, this time period won't be considered substantial gainful activity.
Do you have other questions about your eligibility for disability benefits? Call our office or fill out the form on this page to schedule a free initial consultation with our experienced Social Security Disability attorneys.
Will my family be allowed to collect my Social Security benefits after I die?
If your family depends on you financially, you may be concerned about how your loved ones will survive when you pass away. The Social Security Administration (SSA) allows families of workers to collect survivors' benefits, a monthly payment that helps ease financial burden.
However, a worker must have paid enough in Social Security taxes during his or her lifetime for the family to be eligible.
Who Can Get Social Security Survivors Benefits?
Spouses and families of Social Security claimants may be eligible for two different kinds of benefits after a worker passes away. A one-time lump sum death payment of $255 is available
to spouses or children who apply for payment within two years
of the family member’s death.
In addition, family members can collect survivor’s benefits, or a portion of the amount the deceased worker would have gotten at his or her full retirement age.
Family members who qualify for survivors benefits include:
- A spouse. Widows and widowers may be entitled to your Social Security benefits if they're 60 or older, or 50 or older if they're disabled. A spouse may be eligible regardless of age if he or she is caring for your disabled child under the age of 16.
- A divorced spouse. A divorced widow or widower can be eligible for your benefits if the marriage lasted 10 years or more. The rules and age limits for surviving divorced spouses are the same as those for current spouses.
- Children. Unmarried children who are under 18, or those are between the ages of 18 and 19 and enrolled full-time in a secondary school, could be eligible to receive your benefits. Additionally, benefits may be paid to a disabled child older than 18 who became disabled before the age of 22.
- Other dependents. In some cases, step-children, grandchildren, step-grandchildren, and adopted children are entitled to receive your Social Security benefits. Parents over the age of 62 who were dependent on the deceased for at least half of their income could also be eligible.
You should be aware that if your spouse works, gets remarried, or is eligible for his or her own retirement benefits, this can affect eligibility for your Social Security survivor benefits. If you have more questions about your Social Security insurance or want help with a claim, contact the lawyers of Johnson & Gilbert today.
How does my work history affect my Social Security disability insurance?
The Social Security program pays disability as a form of insurance: you pay into it with each paycheck, and you can make a claim if you paid into the fund for a long enough period of time.
To determine whether you qualify for the disability benefits program, the Social Security Administration (SSA) considers your physical condition, your work history, and your date last insured (DLI).
How Your Last Insured Date Affects a Social Security Disability Claim
The easiest way to think of a DLI is the last day you're eligible for disability benefits. Like any other form of insurance, your coverage has an expiration date.
Your DLI affects many aspects of a Social Security disability benefit claim, including:
- Technical eligibility. To technically qualify for the disability program, you must have worked the past five out of 10 years and worked 20 of the last 40 quarters in jobs that paid Social Security taxes. Both of these measurements can affect your DLI.
- Medical eligibility. Not only do you need to have an approved disability to medically qualify for Social Security disability, but you must also be able to prove that you became disabled prior to your DLI.
- Likelihood of approval. If your disability occurs before this date, you'll likely be eligible for benefits. If the date expired, the SSA will probably deny the application unless you're able to show why you didn't complete an application sooner. In many cases, claimants need the help of an attorney to make a case to SSA after their DLI has expired.
The amount of your disability payments varies widely, so it pays to consult an attorney who might maximize your compensation. Our attorneys can explain your options in your free consultation, and we don't collect any legal fees unless we win your case.
Simply fill out the quick contact form on this page today to schedule a consultation with our Social Security attorneys at no cost to you.
Can I get Social Security disability and workers' compensation at the same time?
Yes, but not exactly how you might think. While many people who are injured at work will be able to reenter the workforce in a short time, some will suffer temporary or even lifelong disability.
Employees who claim Florida workers’ compensation usually apply for Social Security disability benefits when they discover their injuries are permanent.
However, there just because you apply for both forms of compensation doesn't mean you'll be “doubling” your benefits.
Problems with Getting Both Social Security Disability and Workers' Comp
There are many areas of overlap in these two major benefit programs.
Workers’ compensation is issued by Florida state law to give temporary wage loss and medical benefits to injured employees.
Social Security disability insurance is a federal program overseen by the Social Security Administration (SSA) that provides payment to workers whose conditions prevent them from earning a sustainable living.
Although it's possible to collect multiple forms of benefits at the same time, the total amount you receive may be reduced due to:
- State laws. Unlike some other states, Florida workers' compensation laws prohibit injured workers from collecting temporary total disability or permanent total disability for any weeks where the claimant received re-employment assistance or unemployment benefits.
- Offsets. Florida law actually requires all permanent total disability claimants to apply for Social Security disability. If you're approved, the insurer who provides your workers' compensation insurance will likely reduce its payments. This places the burden of the employee’s injury on the state rather than a private insurer. This offset ends when the employee’s workers’ compensation payments end or when the employee reaches full retirement age.
- Settlements. If you secure a lump-sum settlement for your workers’ compensation claim, the amount you're given is still subject to offsets. Since there are limits on the amount of total public disability benefits you may receive, the SSA considers the amount of your settlement when calculating your disability benefits. It also reduces your disability payment if you're receiving other forms of benefits, such as civil service disability or government-issued disability or retirement.
The amount of income you receive each month varies widely depending on the type of benefits you collect. It's important to consult an attorney who can maximize your compensation. Simply fill out the quick contact form on this page today to schedule a consultation with our Social Security attorneys at no cost to you.
Can I receive Social Security disability and retirement benefits at the same time?
The Social Security Administration (SSA) primarily pays disability benefits to people who cannot work and are too young to retire. Since disability benefits automatically transition into retirement benefits, most people cannot collect both Social Security (SS) retirement benefits and SS disability benefits at the same time.
However, some claimants may qualify for both types of benefits as well an additional amount of income based on their circumstances.
How Retirement Affects Your Social Security Disability Benefits
The SSA allows people to receive SS retirement benefits when they reach full retirement age, which is 65 or 67 years old, depending on what year you were born. Since a person who is retired is assumed not to be working, disability payments stop and retirement benefits kick in at one of those two ages. While the type of benefit changes, payments continue automatically and the amount stays the same.
Although this is the general rule, some retired claimants can receive multiple kinds of SS benefits if they:
- Take early retirement. The SSA allows people to claim retirement benefits as early as age 62, but the amount these claimants received is reduced. However, if a person qualifies for both early retirement and disability, the SSA may provide a disability payment on top of their early retirement benefit that makes up the difference.
- Receive back pay. A retired person who qualifies for disability will also likely be approved for retroactive disability benefits for the months in which they were disabled before application.
- Qualify for Supplemental Security Income. If you're already receiving disability or retirement benefits, you could also qualify for Supplemental Security Income if you can demonstrate financial need and few resources.
If you're unsure what kinds of benefits you may qualify for, our attorneys can determine how much you've paid into Social Security during your past employment and see how your personal circumstances affect what you're owed. Simply fill out the quick contact form on this page today to schedule a consultation with our Social Security attorneys at no cost to you.
After I apply for Social Security disability, how long will I wait for benefits?
The timeframe between applying for Social Security disability and receiving benefits varies from person to person. Some applicants receive a determination within a month, while others can wait a year or more before their benefits are paid. In most cases, it depends on the stage at which your claim is approved.
The Different Stages of Social Security Disability Approval
The Social Security Administration (SSA) can potentially approve disability applications at many different points in the claims process. The more steps it takes to approve your claim, the longer you'll wait for benefits.
The length of time before you receive benefits will depend on whether your application is approved:
- The first time. It takes up to 90 days to get a decision on a new disability claim. However, many claims are denied the first time, so it's likely you'll have to proceed to a first appeal.
- On reconsideration. If your first application is denied, you can appeal the decision by filing a request for reconsideration. Appeals generally take between 60 and 90 days to process and notify the claimant of the determination. If the appeal is denied, the next step is to request a disability hearing with an administrative law judge.
- At a disability hearing. There's typically a backlog of cases waiting to be heard by a judge, so it can take anywhere from a few months to over a year to schedule a disability hearing. However, disability applications are more likely to be approved at a hearing than at any other level of the process.
- For a terminal condition. Claimants who apply for benefits based on a terminal condition or a class of severe disabilities may receive expedited benefits through the Compassionate Allowance Program and quick disability determination programs.
There are many things claimants can do to speed up their cases and increase their chances of approval. Providing complete and convincing medical information and filing for disability as soon as you're unable to work can both increase approval rates, as can hiring a Social Security disability attorney to present your case.
Simply fill out the quick contact form on this page today to schedule a consultation with our Social Security attorneys at no cost to you.
How does Social Security issue back pay on disability benefits?
It can take several months for the Social Security Administration (SSA) to issue a decision on a disability claim. For this reason, nearly every person who is awarded Social Security disability will be owed past due benefits, also called disability “back pay.“
However, the amount of back pay granted to each claimant varies depending on the date used to calculate benefits.
Dates That Affect the Amount of Social Security Disability Retroactive Benefits
Claimants can receive up to 12 months of Social Security disability back pay for the months in which they were waiting for benefits to be paid. After the claim is approved, the full amount of retroactive benefits is issued in one lump sum, with regular monthly benefits continuing as usual.
The number of previous months for which you will be awarded benefits depends on three different but important dates:
- Date of disability. When the SSA approves an application for benefits, it decides a date on which the claimant's disability began. This is known as the established onset date (EOD), and is determined by a disability examiner using the claimant’s medical records and work history. An EOD can be several months before the application date, greatly affecting the amount of back pay. For this reason, it's not uncommon for a claimant and a disability examiner to disagree on the exact date of disability. A Social Security disability attorney can help by gathering additional medical information and other evidence to prove the claimant wasn't able to perform work.
- Application date. Claimants can receive benefits back to the date they applied for disability, as long as their medical evidence supports they were disabled on or before this date. If their medical evidence shows they were disabled in the year before applying for benefits, retroactive payments may be granted for the months before the application date.
- End of the waiting period. Social Security disability benefits have an automatic five-month deduction to allow a reasonable period for benefit processing. In other words, a person isn't entitled to benefits until five months after his or her disability began. For example, let’s say a claimant files an application on December 1 and is given a disability date of January 1 of the same year. Although the claimant has been “officially” disabled for 11 months, he or she will only be entitled to six months of retroactive benefits.
Make the Process Easier With Our Help
As you can imagine, the established date of your disability can have a big impact on the amount of benefits you receive. If you win your disability claim on appeal, you could potentially get back pay for the many months you were forced to live without your rightful benefits.
If you're having trouble collecting rightful payment from Social Security, simply fill out the quick contact form on this page today to schedule a consultation with our attorneys at no cost to you.
What is Supplemental Security Income (SSI)?
The Social Security Administration (SSA) provides disability payments to workers who previously paid taxes into the Social Security system but now have a condition that makes maintaining employment difficult. The SSA also has an entirely separate disability program called Supplemental Security Income (SSI) that pays benefits to claimants who are unable to work and live on an extremely low income.
Who Is Eligible to Receive Supplemental Security Income?
Supplemental Security Income is a purely needs-based program for people who have limited income and resources. Unlike Social Security disability benefits, SSI is paid out of general taxes rather than Social Security taxes. This is important because people applying for SSI don't need to have work in jobs where they paid Social Security taxes—in fact, they don't need to have worked at all in the past to be eligible for benefits.
In order to qualify for SSI benefits, there must be proof that you:
- Are disabled. If you're under 65, you'll need to prove your disability matches the SSA’s definition of long-term disability. This includes a complete inability to do the type of work you've done in the past, as well as an inability to be retrained into other kinds of work available in your area. If you're over 65, you may be able to collect if you're not disabled but are in financial need. If you're applying for benefits on behalf of a child with disabilities, you'll still need to prove his or her condition and limited financial resources.
- Have limited resources. SSI is reserved for people with a demonstrated financial need. Claimants must prove they have less than $2,000 worth of assets and possessions available to them, not counting one car and the house in which they live. A person may be denied SSI benefits if he or she lives with multiple people who are able to earn a living, have more than $2000 in a savings account, own multiple vehicles, or have other potential income available to them.
If you do qualify for SSI, you can make a claim for these benefits at the same time you apply for Social Security disability. If you need help with an application or need to appeal your Social Security benefits decision, fill out the quick contact form on this page today to schedule a consultation with our attorneys at no cost to you.
Could I receive both Social Security disability and Supplemental Security Income benefits?
The Social Security Administration (SSA) offers different kinds of disability income depending on a beneficiary’s specific needs. Social Security disability is for people who have paid enough taxes into the Social Security system to draw upon the fund if they become disabled. The other form of payment, Supplemental Security Income (SSI), is reserved for beneficiaries with disabilities who have low income and few financial resources.
Who Qualifies for Both Social Security Disability and SSI?
The biggest difference between Social Security disability and SSI is that SSI is a needs-based program. Just as people who have never paid into Social Security aren't eligible for benefits, people who have access to stable sources of income, property, or other assets aren't eligible for SSI benefits.
However, there are some cases where people may qualify for both types of disability benefits—sometimes called “concurrent benefits.” You may get concurrent benefits if you're approved for Social Security disability, but receive a low monthly payments due to your work history.
Claimants may collect both benefits with proof that they:
- Worked in the past ten years prior to becoming disabled
- Worked long enough in jobs where they contributed to Social Security
- Have medical records that show clear evidence of disability due to an injury, condition, or treatment for a condition
- Have a disability which has lasted for one year, is expected to last over a year, or will eventually lead to death
- Own less than $2,000 worth of total countable assets as a single person
- Own less than $3,000 in total countable assets if claiming disability as a married person
You may apply for SSI benefits after you're approved for disability, or you can apply for both types of benefits at the same time.
If you have trouble collecting Social Security benefits, simply fill out the quick contact form on this page today to schedule a consultation with our Social Security attorneys at no cost to you.
Can I win my Social Security disability case if I haven’t seen a doctor for my condition?
It will be difficult to win your Social Security disability claim if you don't treat with a doctor. This is because the Social Security Administration (SSA) evaluates your case partly on medical records.
However, you may still be able to win your case if you haven't had regular medical appointments due to the cost of these appointments.
Claiming Social Security Disability When You
Can’t Afford a Doctor
Generally speaking, the SSA won't look sympathetically on applicants who claim to suffer from a serious medical condition but haven't seen a doctor. Few people live with a disability that hasn't been diagnosed or under treatment unless they have a good reason, such as an inability to pay the high costs of medical bills.
If you cannot afford medical treatment, there may be low-cost ways to benefit both your health and your application for benefits. For example, you'll greatly improve your position if you:
- Apply for subsidized health insurance. Florida provides qualified low-income residents with free healthcare through Medicaid. The Affordable Care Act can allow patients to get healthcare at a price they can afford.
- Seek out public benefits. There are many state and federal organizations which offer income assistance, food coupons, and health benefits. Even if you may not qualify for healthcare, the savings from other benefits may allow you enough financial leeway to see your doctor.
- Visit an emergency room or urgent care for treatment. Some people have insurance that only covers emergency care. If you have coverage that pay for you to be seen in an urgent setting, these visits establish some testing and guidance and provide another entry on your medical record.
- Attempt to find a clinic offering low-cost services. Some providers offer payment plans or reduced-cost services to patients who don't have insurance. Others may provide free or lower-cost services to patients who can prove need or special circumstances.
If there isn't enough medical evidence in your case, the SSA may require you to undergo a consultative exam to determine your disability claim. While this doctor may evaluate your condition and the extent of your disability by performing testing, he or she doesn't provide treatment. His or her opinion greatly impacts the outcome of your case.
Even if you cannot afford to see a doctor, you still have the burden of proving to the SSA that you couldn't obtain low-cost treatment. If you're having trouble collecting Social Security disability benefits, we can help. Simply fill out the quick contact form on this page today to schedule a consultation with our Social Security attorneys at no cost to you.