SAN FRANCISCO SOCIAL SECURITY DISABILITY ATTORNEY

The Social Security Administration (SSA) offers several benefits from federal programs for disabled and senior U.S. citizens and eligible non-citizens. But, you may wonder what the difference between SSI and SSDI is? 

SSI is available to older persons or persons with disabilities (regardless of age) who have minimal income and few resources. SSI benefits in California may be supplemented by other social services such as Medi-Cal, CalFresh (or SNAP), assistance dogs, certain domestic services, and protection services. To be eligible for SSI, you cannot have more than $2000 in resources or $3000 for a couple. Your home isn't counted against your resources; typically, neither will a car. The rules are stringent, and these benefits will likely cease should you get a windfall or an inheritance. In 2022, California SSI benefits for blind, aged, or disabled persons range from $56.00 per month to $2,731.54, depending on a host of factors. 

SSDI is available through a federal program to qualifying individuals who have paid taxes into the Social Security trust fund through employment. Currently, eight million people under the age of 65 receive these benefits because an illness or disability prevents them from being employed. When you collect SSDI for more than two years, you automatically are eligible to receive Medicare benefits even if you aren't 65 or older. 

To qualify for SSDI, you have to meet two basic requirements which are:

Work history - You must have worked long enough to be covered by SSDI because it's an insurance program. This is different from SSI because there isn't a financial need attached to the eligibility. 

Disabled status - The SSA must decide if you meet their requirement of being disabled. To do this, they will look at five different criteria described in what is known as the Blue Book.

Should you fail to meet either requirement, SSDI will be denied.

Suppose you are unable to work because of a disability in San Francisco. In that case, you may be eligible for benefits under the Social Security System. To get SSDI, you must include a variety of personal information when submitting your application. Generally, the documentation you will need will be as follows:

Personal information - You'll be required to submit your full name, Social Security Number, birth date, marital status (if married, they'll need all of the same information for your spouse), and work history for the past 15 years.

Work credit information - You'll need to have proof of work credits earned to qualify for disability benefits. The work credit requirements change from year to year. However, in 2022, for every $1,510 in wages earned, you get one work credit. If you have made $6,040, you've reached the yearly maximum of four credits for the current year. The required work credits will depend on your age and when the disability started. Typically, you'll need 40 work credits, 20 of which will need to have been earned in the prior ten years before your disability began. 

Medical information - Individuals will need medical proof of total disability to qualify for benefits. This program does not pay for partial or short-term disabilities. The rules for qualifying require that you have evidence that you cannot work because of your condition or cannot do the work you used to because of your situation. You can't adjust to another sort of work either. Plus, you either have not worked for one year, or you are expected not to be able to work for at least one year. 

Medical documentation may include contact information for all doctors, hospitals, and clinics you've used to receive treatment for your condition. You'll need to supply medical records and a list of all medications you're taking.
 
Documents - You'll need proof of citizenship or proof of an accepted resident alien status, government-issued identification, and a certified copy of your birth certificate. As a veteran, you'll need a certified copy of your military discharge papers. 

When applying for SSDI, people will often be denied because they don't fill out the application correctly or are missing important information. If you haven't yet submitted your application and have questions, our San Francisco Social Security Disability lawyers may be able to help you.

The first thing the SSA will look at is if you are working. If you are working in 2022 and have earnings that average more than $1,350 in a month, generally, you won't qualify. Suppose you are not working or are working below substantial gainful activity. In that case, your application will go to the Disability Determination Services (DDS), which will determine whether you have a qualifying disability. 

When DDS looks at your condition, they will need evidence that it is severe, meaning you cannot do basic work activities such as walking, standing, lifting, sitting, and remembering for at least 12 months. If they find your condition significantly limits your ability to perform at work, they will look to see if your disability is on a list of disabling medical conditions. This list is known as the Blue Book.

Suppose your condition is not on the list. In that case, they will determine if your condition is severe enough to be equal to other severe conditions on the list. For example, leukemia is on the list, but perhaps you have multiple medical conditions like arthritis, diabetes, high blood pressure, and a history of debilitating migraines. It may be possible they will look at those conditions cumulatively and assess whether they are equal to a condition that is on the list. 

Next, they assess if you're able to do the work you previously did with your condition. If they find that you can do that job, you will not get SSDI benefits. However, if they think you cannot do the work you were previously engaged in, they'll look to see if you can do any other type of work. They'll look at your age, work qualifications, and education when determining this. SSDI benefits will be denied if they decide you can do other work with your condition. You'll be judged eligible for benefits if you can't do other work. 

SSA recognizes special situations for people who are blind or have low vision. Additionally, widows and widowers can receive benefits if they are disabled and their deceased spouse paid into the program before their death. Children of disabled parents can also receive assistance. Of course, disabled children with a qualifying disability may also receive benefits. 

Getting notice that your SSDI application is denied can be devastating news. You understand your physical or mental limitations. Why can't the SSA see it too? Fortunately, there is an appeals process. A staggering two-thirds of SSDI benefits applications are denied. It may be there were mistakes or omissions in the application, or you didn't have the required number of work credits, or the submitted medical documentation was insufficient to prove your disability. 

As for SSI, there may have been some mistakes in calculating income and assets. For either scenario, our San Francisco Social Security Disability lawyers can help you get back on the right track through an appeal.

However, once you're denied, you need to act quickly because the SSA has strict deadlines. Once you've received notice of denied benefits, you have just 60 days to file an appeal for reconsideration. During the appeals process, an SSA examiner and medical consultant who was not involved in the initial decision to deny benefits will review your application. 

It probably won't help if you simply resubmit the same information. You'll need to present new evidence that demonstrates your condition has worsened or you have a new diagnosis. At this stage, we can help you present the evidence in a light that best exhibits your disability. If the appeal is again denied, you'll have another 60 days to request a disability hearing with an Administrative Law Judge (ALJ).

It's vital to have your own legal representation during this kind of hearing. We will help you prepare for the hearing and can provide an expert medical witness that can testify to the extent of your disability. During the hearing, the judge will ask questions about your disability, work history, and how the disability has affected your life under oath. While honesty is crucial during this hearing, it's also essential to communicate to the judge effectively. We will coach you on how to do this. 

Should the ALJ continue to deny your claim, you have a right to ask the Appeals Council to review the ruling. The Appeals Council can either uphold or overturn the ruling or send it back to the ALJ for another review. Suppose all appeals avenues have been exhausted, and you're still not able to get SSDI benefits. In that case, the option of filing a lawsuit in a federal court may be possible. 

The bottom line is this. If we have evaluated your case and believe you should be eligible for benefits but are being unduly denied, we'll keep fighting for you. When we take on a case, it's because we believe it has merit. That's why we don't charge a fee unless we win. If you believe you should be eligible for SSDI benefits and have been denied, contact us at Morgan and Morgan Law Firm today for a free case evaluation.