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Applying for benefits from the Social Security Disability Insurance (SSDI) program is complicated and very often confusing. The application can be time-consuming, and applicants must usually wait several months to get a response from the Social Security Administration (SSA). An experienced and knowledgeable SSDI attorney can help you present your case efficiently and effectively, and can guide you through the maze of offices, procedures, bureaucrats, and regulations that make up the Social Security system. Choosing the right SSDI lawyer for you is important. You want someone who knows the law and the system, and who can also address the specific needs of your case. A good SSDI lawyer can take much of the burden off of your shoulders by dealing with the SSA on your behalf.

At what point in the process should I hire an SSDI lawyer?

If you are planning on filing an SSDI claim, or are even merely thinking about planning, it is never too early to consult with an SSDI lawyer to learn more about the process. If you have already filed an SSDI claim, you may seek the assistance of an SSDI lawyer at any time. An SSDI lawyer can get involved in your case at any stage of the process, from an initial filing to a final appeal.

What information will an SSDI lawyer need?

To make an effective case for disability benefits to the SSA, you need to show that you have an injury or medical condition that is expected to last for at least a year or longer or constitute a condition that is expected to result in death.   This may be established by meeting the criteria of one of the Social Security Listing of Impairments (a designated list of medical conditions under Social Security’s rules that, if met, constitute automatic eligibility to Social Security disability benefits), or by showing that one’s functional abilities to work or so limited (that is to say, that their Residual Functional Capacity (RFC) is so limited) that they remain incapable of performing either their past relevant work or other work that exists in significant numbers in the national economy.   An experienced Social Security lawyer will be able to evaluate these factors for you when they speak with you. Likewise, you must also establish that you have enough work history to make you eligible for SSDI benefits. The above considerations require that they obtain from you extensive information regarding your past employment, the conditions of that employment and past work,  education and training, your medical history, your current diagnosis or diagnoses, your current treatment plan, any future treatment or surgeries you anticipate needing, and any other information they know the SSA will deem relevant to your claim.

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The term “Social Security” can refer to several different types of benefits paid by the Social Security Administration (SSA). The agency is perhaps best known for its retirement and disability benefits programs. The Old Age, Survivors and Disability Insurance (OASDI) program includes the SSA’s retirement program and the Social Security Disability Insurance (SSDI) program. The SSA maintains another benefits program that may be available to disabled individuals, known as Supplemental Security Income (SSI). Since the abbreviations “SSDI” and “SSI” are nearly identical, some confusion quite understandably exists about the two programs and how they are different from each other. Disabled individuals in Massachusetts and elsewhere around the country should be familiar with how each program might benefit them.

Work History

Eligibility for SSDI benefits depends on a claimant’s work history. Claimants must show that they are “insured” by the program through their payroll tax contributions. The SSA typically measures work history in yearly quarters. A claimant must have worked a certain minimum number of quarters in their lifetime—at least six (and this is the bare minimum, with the minimum number depending on a variety of factors for each individual, including but not limited to one’s age) —to be “fully insured.” They must also be “currently insured,” meaning that they worked a certain number of quarters immediately prior to the month they became disabled. The number of quarters largely depends on the claimant’s age at the time of his or her disability.

The SSI program, meanwhile, has no work (and earned quarters of coverage) requirements. SSI benefits therefore might be available to people who do not have enough work history to qualify for SSDI or who may never have worked previously.

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Applying for benefits through the Social Security Disability Insurance (SSDI) program can be a time-consuming process, with long periods spent waiting for a response. The denial rate for initial applications is high, and sometimes as high as 70 percent of applications are denied, but a denial is not the end of the road. The next step in most states is to file a request for reconsideration, in which a different examiner with Disability Determination Services (DDS), part of the Social Security Administration (SSA), will review your application.

DDS offices in several states, including New Hampshire and New York, no longer offer reconsideration of SSDI claims. Applicants in those states must go directly to the next stage of review, which involves requesting a hearing before an administrative law judge (ALJ).

The Application Process:  A Review

The first stage of a SSDI claim is the application itself. You must show, to a DDS examiner’s satisfaction, that you are suffering from a condition that renders you unable to work, and that this disability is likely to persist for 12 months or longer, or result in death. An SSDI application requires a substantial amount of documentation, including medical records that indicate how your condition precludes you from working. A knowledgeable and experienced Social Security disability attorney can help you present your case in the best way possible.

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The Social Security Administration (SSA), through the U.S. Department of the Treasury, maintains multiple accounts for funds held in trust to pay benefits under various programs. Benefits payable through the Social Security Disability Insurance (SSDI) program are held in the SSDI Trust Fund. This account is running out of money, and it is expected to be depleted by the end of 2016. At that point, the SSA would have no choice but to make substantial cuts in SSDI benefit payments.

People have been calling on Congress to address this problem for years, but it seems as though Congressional leaders are only just beginning to recognize the need for action. What they have done so far does not seem to be enough, and what they should do instead is a matter of much dispute.

What Is the SSDI Trust Fund?

The SSDI Trust Fund is an account in the U.S. Treasury that receives funds from payroll taxes withheld from employee paychecks and paid by employers under statutes like the Federal Insurance Contributions Act (better known as FICA). The SSA has automatic spending authority, without needing periodic Congressional approval, to disburse SSDI benefits from this account.

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Social Security Disability Insurance (SSDI) has gained a fair amount of attention in recent months, as the U.S. Congress finally begins to take notice of some serious problems that it and other Social Security benefit programs are facing. The general consensus is that the SSDI Trust Fund, from which the Social Security Administration (SSA) disburses disability benefit payments, will run out of money by the end of 2016. Without further action by Congress, this could result in cuts of up to 20 percent in benefit payments. SSDI beneficiaries and claimants, as well as the disability attorneys who advocate for their rights in Maine and elsewhere around the country, eagerly await some positive news on this issue.

Much of the attention Congressional leaders have given to the SSDI program, however, focuses on details like alleged fraud among some beneficiaries, rather than the bigger picture. Congress has held numerous hearings on the issue of beneficiaries who receive payments from both SSDI and federal or state unemployment insurance programs. Several bills currently pending in the House of Representatives and the Senate would limit people’s ability to receive benefits from both sources, despite valid reasons that they might do so.

SSDI versus Unemployment

Unemployment benefits are financed through payroll taxes collected by state and federal agencies, and they are administered by state agencies, such as the Maine Unemployment Insurance Program and the New Hampshire Employment Security program. These programs support people who are temporarily out of work while they look for a new job. Benefits are restricted to a relatively brief time period, usually six months or less.

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Social Security Disability Insurance (SSDI) is a Federal program supporting workers with disabilities who have worked long enough and paid sufficient Social Security taxes through their past employment. In order to get SSDI benefits, you must first apply through the Social Security Administration (SSA), which complex set of procedures can be made much simpler with the assistance of an experienced Social Security attorney.  The application process is detailed and lengthy, and it can take several months before you receive a decision approving or denying the claim.  Even if approved, SSDI benefits are not payable until after a full five month waiting period has been met.

Meeting with a knowledgeable attorney before you decide to apply for SSDI benefits can be beneficial in understanding your rights and protecting your interests. If you retain the help of a qualified attorney, your attorney will initiate the application process for you. Applicants can also apply online through the SSA website or by appointment over the phone or at a Social Security office. Your attorney can advise you as to the information and records required for the application, as well as help you gather the materials. This will generally include information regarding your birth and citizenship, marital status and children, any military service, work history and employers, education, financial asset information, and your medical treatment providers, and possibly additional information and documentation. Applicants must also sign and submit a form authorizing the release of their medical records. Once the application and all required forms are submitted by you and your attorney, SSA will verify that you meet the non-medical requirements for SSDI benefits. These requirements are based on your age at the time of disability, how long and how much you paid Social Security taxes and where these earnings fell in relation to when your disability began.  If you meet the earnings qualification, SSA sends your case to the Disability Determination Services (DDS) office in your state for a medical assessment.

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What is SSDI? An Overview for Residents of Massachusetts and Other States

Social Security Disability Insurance (SSDI) is a government program enacted to assist people who are unable to work due to serious and long-term physical or mental disabilities. The program aims to address the needs of injured individuals and their families who are struggling with finances as a result of their inability to work.  SSDI is funded with Federal Insurance Contributions Act (FICA) taxes, which are paid by both employees and employers from their payroll taxes.

Federal SSDI Benefits

SSDI benefits consist of monthly payments for individuals who have worked in a job covered by Social Security and who meet the federal definition of “disabled.” These federal benefits are available to residents of every U.S. state, including Massachusetts, New Hampshire, and Maine. Specifically, the Social Security Act provides that the worker must be unable to engage in any substantial gainful activity due to a medically determinable physical or mental impairment that is expected to last for a continuous period of at least one year or result in death. Generally, if a worker is earning more than a certain amount of money each month, he or she may be considered to be engaged in substantial gainful activity. For 2015, that amount is $1,090 (net of disability-related work expenses) for workers who are not blind, and $1,820 (net of disability-related work expenses) for workers who are blind. These amounts have historically increased for each passing year. If the Social Security Administration (SSA) determines that an applicant is engaged in substantial gainful activity they will deny SSDI benefits.

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In order to qualify for Social Security disability insurance (SSDI) benefits, it is necessary that one contribute sufficient Social Security payroll tax payments through their employment.  Most individuals do participate in Social Security Disability Insurance (SSDI) program via their Federal Insurance Contributions Act (FICA) contributions as part of their payroll taxes.  However, there are many individuals whose employer may take part in a state disability and retirement program (for example, many teachers that work for the state may contribute to their state retirement and disability program and may not have FICA taxes deducted from their payroll).  Assuming one has paid sufficiently sufficient Social Security taxes to qualify (and have earned sufficient “quarters of coverage”) , then if in fact they become unable to work due to a long-term medical condition, they may be entitled to payments under the SSDI program. Even with a long-term injury or medical condition (which may or may not be related to their job), one can receive SSDI benefits if they cannot perform what is called “substantial gainful activity” (or what is deemed at present to be the ability to earn $1090.00 per month on a regular and continuing basis).  These federal insurance benefits are available to residents of every state, including New Hampshire, Maine and Massachusetts.

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The Social Security Disability Insurance (SSDI) is a Federal program that pays benefits to individuals with disabilities and certain members of their family if they have worked long enough and paid Social Security taxes as part of that employment.  It is available to qualified residents of any state in the United States, including Maine, Massachusetts, and New Hampshire. Arguably, the most difficult part of qualifying for SSDI benefits is meeting the strict definition of “disability” under federal law. The Social Security Act defines “disability” as the inability to engage in any substantial gainful activity due to a severe medically determinable physical and/or mental impairment(s), which can be expected to result in death, or which has lasted, or can be expected to last, for a continuous period of one year or longer.

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