Considerations for Claimants as They Proceed with an Application

What is a Representative Payee?

Published on: October 10, 2015 | Russell J. Goldsmith, Esq. (Law Offices of Russell J. Goldsmith)

The Social Security Disability Insurance (SSDI) program offers benefits to qualifying individuals who are unable to work because of an injury, illness, or mental condition. The program provides monthly benefit payments, but some SSDI beneficiaries are not able to manage their financial affairs on their own for a variety of reasons. In such situations, the Social Security Administration (SSA) may appoint a representative payee (RP) to receive the beneficiary’s payments and see to the beneficiary’s basic needs. The SSA will make the determination that a beneficiary should have a representative payee. A disability examiner or administrative law judge (ALJ) might recommend an RP, the beneficiary may request a particular person, or an individual may request appointment as RP.

Who Might Need a Representative Payee?

In general, minor children and “legally incompetent” adults must have an RP. The parent(s) or guardian(s) of a minor beneficiary typically serve in this capacity. The SSA may make benefit payments directly to a minor beneficiary, however, if they “show the ability to manage the benefits,” such as by living independently, serving in the military, or establishing a track record of receiving and managing SSDI benefit payments.

The SSA presumes that an adult beneficiary is competent to manage their benefit payments and finances, but it may decide to appoint an RP based on medical records and other evidence. Conditions that might result in the appointment of an RP for an adult SSDI beneficiary include an intellectual or cognitive disability, an injury causing a mental impairment, dementia, physical injuries or disabilities rendering them particularly vulnerable to abuse or exploitation, or drug or alcohol addiction.

SSDI Work Credits: What Are They?

Published on: September 26, 2015 | Russell J. Goldsmith, Esq. (Law Offices of Russell J. Goldsmith)

In order to be eligible to receive Social Security Disability Insurance (SSDI) benefits in Massachusetts and other states around the country, you must be able to demonstrate that you meet the work history requirements established by the Social Security Administration (SSA). You must have worked, and paid into the Social Security system through payroll taxes, for a certain length of time over the course of your life. The SSA assigns “work credits” to people, which enable it to determine whether a claimant is eligible for benefits. The number of work credits a claimant needs varies based on age. The SSA periodically adjusts annually the income requirements necessary to earn a quarter of coverage.

How the SSA Measures Work Time

The SSA measures people’s work history in three-month periods known as “quarters.” These are the same quarters used in business planning and accounting, with January through March being the first quarter of the calendar year, and October through December being the fourth.

People receive “work credits,” also known as “quarters of coverage” or “QCs,” from the SSA for each quarter they work and earn above a certain amount. They may receive a maximum of four work credits per calendar year. The maximum number a person will need over their lifetime is 40 work credits, or 10 years of qualifying work. Claimants can demonstrate their work and payroll tax history with copies of tax documents such as a Form W-2.

Failing to Follow Your Doctor’s Prescribed Therapy When Making an SSDI Claim in Massachusetts and Around the Country

Published on: August 21, 2015 | Russell J. Goldsmith, Esq. (Law Offices of Russell J. Goldsmith)

In order to obtain benefits from the Social Security Disability Insurance (SSDI) program, a claimant must establish that they have been diagnosed with a medical condition or injury (or, what is otherwise referenced in the regulations as a severe medically determinable impairments) that prevents them from undertaking any manner of gainful employment for which they are reasonably suited. The Social Security Administration (SSA), utilizing the assistance of state agency offices referred to as Disability Determination Services, reviews SSDI claims, and generally only approves about 30 percent of claims. A rejected claim is not the end of the road, though, since claimants may request reconsideration of their application or a hearing before an administrative law judge (ALJ).

Understanding the most common reasons for claim denials can help claimants prepare their initial applications. The SSA rejects many SSDI claims based on findings that the claimants are not following the treatment plan prescribed by their doctor or doctors.