Wakefield Social Security Lawyers – Marasco & Nesselbush
Our Social Security disability attorneys are here to help injured and disabled Wakefield residents get approved for disability benefits. We have helped hundreds of disabled people to present their cases in the best possible way and be awarded the benefits they so desperately needed.Contact for a free consultation
SSDI or SSI – What’s the Best Fit For Me?
Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are both managed by the Social Security Administration (SSI), but are two different programs designed to help different groups of people with different work history and current circumstances. It is important to understand the differences between the programs in order to make sure to apply for the one that’s the best match for you.
SSI is a needs-based program and is awarded based on the recipient’s income and assets. Also called a “means-tested” program, it is designed for people who wouldn’t qualify for Social Security Disability Insurance because of insufficient work history or whose SSDI benefits would be very low due to the limited number of years they worked and paid Social Security taxes. To be eligible for SSI, a person must have no more than $2,000 in personal assets ($3,000 for couples) and very limited or no income. Other requirements include:
- the applicant must be at least 65 years of age or,
- the applicant must be legally blind (see the SSA definition of blindness below) or,
- the applicant must be otherwise disabled (see the SSA definition of disability below)
SSDI eligibility depends on a person’s work history. This program is called insurance because it’s recipients paid into the Social Security trust fund during the years they worked. In order to be eligible for SSDI, a person must have worked a sufficient number of years in order to earn a sufficient number of work credits. The SSA has a special system by which it calculates and converts yearly earnings into work credits. The number of years a person must have worked in order to gain sufficient work credits depends on a number of factors, for example, the age of the applicant. Nevertheless, most people will need to have paid into Social Security for at least 10 years in order to be eligible for SSDI.
Despite substantial differences between SSI and SSDI, both programs share some common requirements. These include:
- Disability – an applicant must be able to prove that they are suffering from a disability. The SSA provides a list of impairments that may qualify a person for the benefits. If a certain impairment or disability does not appear on the list, the SSA will closely analyze the condition in order to decide if it qualifies a person for benefits.
- Severity of the condition – the disability must be considered severe. This means that it is expected to last at least 12 months, or that it is considered terminal. It also implies that the condition severely limits the applicant in terms of:
- engaging in basic work activities
- performing the tasks associated with their previous employment
- adjusting to another type of employment
In short, the disability must be severe enough to prevent the applicant from engaging in what is known as “substantial gainful activity”.
- Substantial Gainful Activity – if a person is earning more than a certain amount, it will be considered substantial gainful activity and the person will not be considered eligible for either SSDI or SSI. As of 2018, the minimum monthly amount earned, which is considered substantial gainful activity, has been set at $1,180, or $1,970 for statutorily blind individuals.
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- Initial Application – at this stage, you need to file your application along with documentation of your complete medical history and other documents which may pertain to your disability. You can submit this at your local SSA office, (the nearest ones to Wakefield are located in Malden and in Lynn) online, or over the phone. It can take up to 3 months for the SSA to process your application and get back to you with a response. Only about 30% of applicants are granted benefits at this stage.
- Reconsideration – 70% of those who apply are initially denied and may choose to appeal the decision. The first available means of appeal is called reconsideration. An applicant has 60 days to make this appeal. The application is sent back to the SSA and given a second review. The reconsideration process may take 3 to 5 months before the SSA issues another decision. Less than 15% of appeals are granted at the reconsideration stage.
- Hearing before an Administrative Law Judge (ALJ) – if your application is denied at the reconsideration stage, you have 60 days to apply for a hearing before an ALJ. It is important that you request this hearing as soon as possible. Wait times are notoriously long due to a massive backlog of cases. In Rhode Island, the current wait time for a hearing before an ALJ is 11 months. When the time for your hearing comes, your case will be reviewed by an ALJ who will interview you and other witnesses to clarify any issues with your claim. You will testify under oath. The ALJ may also interview a vocational expert and a medical expert. The questions asked may have to do with the limitations your disability has imposed on your life. Many people get denied at this stage because they fail to present their case effectively. Representation by an attorney at this stage is crucial. Your attorney will prepare you for the question the ALJ and the experts may want to ask you, and will represent your case in a way that will greatly improve your chances of a favorable decision. At the hearing stage, 63% of applicants are granted benefits.
- Appeals Council – if you are denied by the ALJ, you have another 60 days to appeal before the SSA Appeals Council. This body will review your appeals application and may deny it if they judge there are no reasons to believe that the ALJ’s decision was incorrect. They may also decide to review your case again and overrule any previous decisions, including those that were made in your favor. The Appeals Council can take anywhere from 6 months to a year to process your case and arrive at a decision. Only 2% of cases are won at this stage.
- Federal District Court – if the Appeals Council denies your claim, you may appeal to a federal district court. Your attorney will help you decide whether there are good reasons to bring your case before a federal district court and will advise you on your chances to win. Your attorney will also decide on the objective of this appeal – whether it is to remand your case back to an ALJ or whether the case is to be argued fully before the federal court.
How Can a Social Security Disability Attorney Help Your Claim
- After reviewing your case and medical documentation, your attorney may determine that you need additional testing. We pay put you in touch with a highly-experienced doctor to schedule an examination
- Your attorney will also decide which medical documents to submit to the SSA for review and ask your doctors for statements explaining and supporting your limitations
- Your attorney and our supporting technical staff will see that your appeals applications are submitted within the required timeframes and that they do not contain any technical errors or omissions that could jeopardize your claim
- Before the hearing with an Administrative Law Judge, your attorney will review with you the questions you are likely to be asked by the ALJ
- At times, a testimony from a witness or witnesses can help your case during the hearing. If your attorney thinks this will be helpful in your case, he or she will choose the witnesses and prepare them for the hearing
- Your attorney will develop the best line of presenting and defending your claim and vigorously represent your interests before the ALJ and even before the federal court if necessary
No Fees Unless We Win
Having an attorney at your side greatly improves your chances of success at every stage of the process. Schedule a free consultation with us at our Wakefield offices to see how we can help you get benefits.