Articles Posted in Considerations for Claimants as They Proceed with an Application

As a Social Security Lawyer practicing in New Hampshire for many years, I have come across numerous misconceptions about the system.  We are many times contacted by individuals who are either looking to file an initial claim for benefits or who have recently been denied benefits based on either misinformation they have received from friends or family or their own misconception as to what one needs to prove in order to qualify for benefits and the manner in which payment takes place if indeed one is approved for benefits. Continue Reading ›

There are a number of benefits available to children under the Social Security disability system, including benefits under one’s parent’s record assuming the insured wage earner has worked sufficiently to qualify for a benefit to their minor child.  Such benefits can continue until the child reaches the age of 18, or up until the age of 19 years and 2 months assuming the child remains in secondary school.  Likewise, the Social Security regulations do provide for benefit programs to younger individuals who may become disabled from working at a young age and do not qualify for benefits under their own earnings record as they have not paid sufficiently into the Social Security disability insurance benefit program: 1) they may qualify for a benefits under the welfare Supplemental Security Income (SSI) program and, additionally,  2) they may qualify for a lesser known benefit as an “adult disabled child” and obtain what is deemed to be a survivor benefit under their retired, disabled or deceased parent’s record.   Continue Reading ›

When filing your claim for Social Security disability benefits, it is important to establish appropriately your “alleged onset date.”  Evaluation of The Social Security Administration will use your alleged onset date (AOD) in determining how far back your retroactive benefit payments can be paid.  Benefits are only payable as far back as 1 year prior to the date of your filing, assuming you have met a full, 5 month waiting period.

The Social Security Program Operations Manual System (POMS) provide that “[i]n title II disability claims and title XVI adult disability claims, the AOD is always the date the claimant alleges he or she became unable to work because of his or her medical condition, whether or not that date appears to be appropriate.”  See DI 25501.210   The standard for showing eligibility to Social Security disability insurance benefits is whether one remains totally disabled from all forms of substantial gainful activity (SGA) for what is expected to be a year or long (with substantial being defined as involving significant physical or mental activities, and with gainful activity being defined as work ordinarily performed for profit).  The Social Security regulations provide that work performed at a level of $1130.00 or more in 2016 is ordinarily considered to be at a level of SGA.  While at times it’s appropriate to use as AOD the date that one last undertook SGA level earnings, there are a number of exceptions to this rule. Continue Reading ›

For those receiving weekly Workers’ Compensation (WC) benefits and considering an application for Social Security Disability Insurance (SSDI) benefits, there are offset considerations that need to take place.  Unfortunately, our office has seen that many attorneys fail to properly advise their clients as to how the offset provisions work and what can be undertaken to minimize the consequences of such an offset.

When one is injured as a result of a work-related accident in Maine, Massachusetts or New Hampshire, it is rather commonplace for an individual to be entitled to receive weekly lost wage replacement benefits while they remain out of work.   As one becomes long-term disabled from working, and it becomes more evident that one will remain totally disabled from working for what is likely to be a year or longer, consideration needs to given to applying for SSDI benefits.   Unfortunately, many WC lawyers are not aware that they should be advising their clients that they may be entitled to additional benefits in the way of SSDI benefits.   There are a number of additional considerations that do need to take place in this set of circumstances. Continue Reading ›

The Social Security Disability Insurance (SSDI) program provides benefits to qualifying individuals who are unable to work due to an injury, illness, or other condition.  Congress has further defined the term “disability” under the Social Security disability program (for purposes of claiming entitlement to Title II Social Security disability insurance (SSDI) benefits or Title XVI Supplemental Security Income (SSI) benefits as meaning an inability to “engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for for a continuous period of not less than 12 months.”  42 U.S.C. § 423 (d)(1)(A)

The Social Security Administration (SSA) the Social Security Administration (SSA) is not looking to see if  It is not any manner of work that one can perform, but rather what is defined as the ability to undertake Substantial Gainful Activity (SGA).   The first step in the sequential evaluation process is to determine whether one is undertaking Substantial Gainful Activity: if so, a claimant is deemed “not disabled” under Social Security’s rules.  Generally, if one is earning in 2015 $1090.00 per month on a regular and ongoing basis they will be deemed “not disabled” from the outset of their application.  Continue Reading ›

The Social Security Administration (SSA) manages multiple benefit programs, including Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Each program has its own set of criteria for qualifying for benefits, but all of them require an applicant to submit income information. SSDI  and SSI claimants in New Hampshire and around the country should understand the types of income considered by the SSA for its various programs and the reasons behind Social Security’s rules with reference to these different types of income.

Income Limits vs. Substantial Gainful Activity

The Supplemental Security Income (SSI) program is specifically intended as a welfare program meant to assist those who are disabled from working and whose household income cause them to fall below federal poverty guidelines and whose assets remain quite limited.  The SSDI program, on the other hand, is geared towards people who likewise remain long-term disabled from working but who have sufficiently paid into the Social Security disability trust fund through their past wages or self-employment income to qualify for an SSDI benefit: these benefits are not needs based benefits (that is to say, welfare based) but rather is income that is in the form of an insurance benefit that one has paid for through their payroll taxes.  While SSDI does take an offset for certain forms of public pension benefits and workers’ compensation benefits, it does not look to whether one is in need of money when determining the benefit: rather the benefit is based on the amount of contributions one made through their payroll taxes.

Whether one is applying for SSI or SSDI, the SSA looks to see whether a claimant remains capable of undertaking work that rises to the level of “substantial gainful activity” (SGA) on a “regular and continuing basis.”  A person who is deemed capable of performing SGA level earnings is not considered disabled and therefore is not eligible for SSDI benefits. The determination can be very complicated, but SSA has established that income received from employment or other work at or above a certain level constitutes evidence of the ability to undertake “gainful “activity.  In 2015, income of at least $1,090 per month for a non-blind claimant, or $1,820 per month for a blind claimant, is considered to be “gainful” activity.  SSA Levels  SSA defines Substantial Gainful Activity is defined as significant physical and/or mental activities ordinarily performed for profit or pay.  Social Security Handbook Section 603  Social Security Ruling 96-8P makes clear that a “regular and continuing basis” generally means 8 hours a day, 40 hours per week. There are many times when an individual’s earnings fluctuate vastly from one month to another given the episodic nature of their disabling medical impairments: in such situations, it becomes imperative that one speak with an experienced Social Security disability lawyer so as to determine whether one’s condition might meet what is called an unsuccessful work attempt (which rules will be the subject of a subsequent article given the complex nature of these rules).

It is likewise important to keep in mind that SSA is not simply looking to see whether one’s earnings have reached SGA levels such that they are deemed capable of undertaking SGA level work, but is also looking to see whether one remains “capable” of undertaking such employment.  Thus, even if one is earning for example $800.00 per month, SSA may look at these earnings as evidence of one’s “capability” of  undertaking substantial gainful activity.   In other words, they may find that the claimant could undertake additional hours for additional pay either at the same type of employment or at an occupation potentially more suitable to their medical conditions.  A lack of income, by itself, does not serve as evidence of disability for the SSA, nor does it necessarily prove that a claimant is unable to do SGA. The SSA will look at a person’s actual income, their claimed disability, and their potential ability to work in determining whether they remain capable of SGA.

Continue Reading ›