The critical piece of proving any disability claim is getting the written support of your doctor. However, it is not nearly enough for your doctor simply to write a note stating you are disabled. The regulations and the judges who interpret them require your doctor to explain what specific limitations you have and provide reasoning for those conclusions. Unfortunately, the regulations that determine the disability decision are complex and precisely worded. It is unlikely your doctor will happen to say exactly what is needed to precisely meet the disability requirements given that your doctor is not trained in the exact wording of the disability regulations. We are. A big part of what we do to help your win your case is provide your doctor with the language that correlates to the limitations he has observed. We also encourage your doctor to explain her reasoning to the extent that is required.
Even if you have the support of your primary care physician, often that is not enough to be considered disabled. If your condition is of a type that ideally needs to be treated and diagnosed by a specialist, then you should seek treatment with a specialist so the specialist can also provide an explanation about your diagnosis and the severity of resulting limitations. For instance, if you have chronic pain, it can be very difficult to prove the level of severity of your pain. It is best for us to be able to speak with a number of doctors who have treated you, such as your primary care physician, neurologist, orthopedist and pain specialist. The more doctors supporting you and acknowledging your obvious and genuine pain the better. Often that is the only way to prove chronic pain.
All of this sounds complicated. We can simplify it just by saying that if you file a claim and you are told that you have too much income or resources or if you are told that you have not worked enough, you just need to take that to a lawyer, sit down and make sure that is right. Make sure there is nothing that can be done.
It is not enough to prove you are disabled
Most people think that if you can’t work you are going to get Social Security Disability or SSI. I think all doctors think that. That is not necessarily so. There are two common programs under which people get a check from the Social Security Administration if they are disabled and several uncommon programs. Each of these programs has requirements besides the disability requirement. Here is a list of the different programs and what you have to prove under each.
Social Security Disability
The most common program that people use is the Social Security Disability program. To get benefits from that program, you have to prove you are disabled and you have to prove you have worked enough. What is enough? Well, the short answer to that question is to find out, go down and apply for Social Security and if the Social Security Administration says you have not worked enough, order a copy of your Earnings Record by going to www.ssa.gov website or by calling 1-800-772-1213. As soon as you have your Earnings Record, take that down to a lawyer who handles Social Security and ask them if the Social Security Administration is right.
Here is a slightly longer explanation. For people who are 30 and over, if you have worked roughly five out of the last ten years, you are probably qualified. For people under 30, if you have worked roughly half of the time between when your 21st birthday and the present. People under 21, you only have to have worked a little bit.
To give you a little bit more detail, you have to earn a certain amount of money during a year to get a credit. The amount goes up every year. For example, in 2010, if you earned $1,120.00 and remembered to report, then you should get one credit. You can get a maximum of four credits every year. You get credits for self-employment work as well as work you do for wages. You do not get credit for money you make that you don’t work for. For example, if the bank is just handing you interest because you have money put in the bank. If you are 30 or over, you are eligible once you have 20 credits within a 40 year period. If you are between 21 and 30, you are eligible if you have twice the number of credits as there are years from your 21st birthday. If you become disabled before age 24, you only need six credits in the three years before you became disabled in order to be eligible. If you are not sure if you have enough credits, you should call the Social Security Administration at 1-800-772-1213 or go to the website at www.ssa.gov and order your Earnings Record. Look and make sure all of the earnings you have actually made are on the Earnings Record. If not, you need to get them put on there by telling the Social Security Administration. If they are on there, try to work it out yourself or any lawyer who handles Social Security can do the calculation.
Here is an important point about earnings. Often the Social Security Administration will simply say that you are not eligible for Social Security Disability, you have not worked enough. You might just be one credit short. You might be able to go down to your church on Wednesday nights with a box full of Amway and say “please will somebody buy this garbage from me.” If you can sell $1,120.00 in 2011 (the amount goes up every year) and if you remember to report it on a self-employment return, you might be eligible and there is nothing the Administration can do about it. The fact that you earned the money mainly to become eligible for Social Security is completely irrelevant. If you earned money in a way like that, you want to make sure you document it well. You should never decide you have not worked enough until you and your Earnings Record are present in a lawyer’s office and he makes a calculation and assures you there is nothing you can do to become eligible.
SSI, or Supplemental Security Income
The second program that is most commonly used by people who are disabled is the SSI program or Supplemental Security Income Program. For that program you have to prove that you are disabled and that you are broke. Very broke. The Social Security Administration looks at your income and it looks at your resources.
Resources. Here is all I need to say about resources: if you have too many resources to qualify for SSI, a good lawyer should be able to solve that problem. It is a very bad idea to just give the resources to your son or your daughter, etcetera, because you can get into the terrible situation of not having the resources, but, because you have tried to sneak the resources out of your name and into someone else’s, the Social Security Administration treats you as having the resources. But since your son or daughter actually has the resources, they probably can spend the money on themselves and forget about you. Yet the Social Security Administration counts the money as yours, so you can’t get SSI!
So, before you start moving assets around, you need to talk to a lawyer. However, it can be done and done legitimately. Just to give you one or two examples, the Social Security Administration doesn’t count the value of one house that you actually live in. So, let’s say that you have $5,000.00 in the bank, you are going to make the payments on your house anyway and you just take the $5,000.00 and hand it to your mortgage company or take $3,000.00 and hand it to your mortgage company, since they also ignore at least $2,000.00 in cash and sometimes more. Then, bam, you are suddenly eligible and it hasn’t really cost you any money. Another thing you can do is get a small paid up burial insurance policy which they do not count. You can always cash that policy in later if you need the money, but they will not count that policy. There are a number of other things you can do like that. In short a problem with assets can be solved by most normal Americans.
Income is a different question. Sometimes that problem can be solved, sometimes it cannot. The Social Security Administration of course will count your income against you and if your income is too high, you are not eligible for SSI. It is rare that you will be disqualified in this way because presumably if you are disabled you are not working. However, they also count your spouse’s income and if it’s too high a lot of times there is nothing you can do. And I might add that if you move out, now you are going to have to pay for two refrigerators, two stoves, two freezers, two rent payments, and you are not really going to get ahead by doing that. However, again, if the Social Security Administration says your income is too high for SSI, before you accept that you ought to check with a lawyer.
Disabled Adult Child’s Benefits
There are several other programs that you might qualify under if you don’t qualify under those programs. If your disability began before age 21 and your parent is either disabled or retired, you might be able to get benefits on your parent’s record. There are some very tricky rules involved here that I won’t go into. In short, if you feel that your disability began before you were 21, you shouldn’t accept the Social Security Administration’s statement that you are not qualified. If they turn you down, you ought to get a lawyer and make sure that there is nothing to be done about that.
If you are over 50 and you are a widow or widower, you can draw on your deceased spouse’s records if you can prove that you are disabled and if you can show that you became disabled in a certain time from his death. That time is roughly seven years, but the seven years can be extended during any time that you drew mother’s benefits as the mother of his children.