When you are dealing with a serious physical or mental illness, you may find that your symptoms prevent you from holding a job. People in this situation often apply for a form of government benefits known as Social Security Disability Insurance (SSDI), which is provided by the Social Security Administration to individuals nationwide who meet certain criteria. As you go through this process, advice from a knowledgeable attorney may help you understand your options and present your case for eligibility. Massachusetts Social Security lawyer Russell J. Goldsmith has been advising and assisting Massachusetts residents seeking SSDI benefits for more than 30 years and we are here to assist you as well. We can explore the details of your situation and provide the zealous advocacy that you deserve, whether you are filing for the first time or you are appealing a denial of a claim.The Process of Establishing Eligibility for SSDI
Broadly speaking, there are two main components in the process of showing that you are eligible for receiving SSDI benefits. These are known as the earnings requirement and the medical requirement. First, the earnings requirement is based on the number of years that the claimant has worked at a job from which contributions to Social Security were deducted through the claimant’s paycheck. These result in work credits that accumulate on an annual basis. The amount of work credits necessary to meet the earnings requirement is usually calculated according to the individual’s age.
Once the SSA has determined that a claimant meets the earnings requirement, it will forward the application and supporting documents to the branch of Disability Determination Services (DDS) that is located in the claimant’s region. An examiner at DDS will review this material to determine whether the applicant meets the medical requirement. To establish eligibility, a person seeking benefits would need to show that a severe physical or mental impairment has impacted him or her to the point that he or she has been unable to engage in substantial gainful activity (or meaningful work) for at least one year (or that the illness or injury is expected to result in the death).
The Social Security regulations contain what are called Medical Listings of Impairments: these are both physical and mental health conditions that, due to the severity of the conditions outlined, are deemed to be severe enough to automatically qualify one for benefits. Each of these Listings provides a detailed medical description of the symptoms from which an individual must suffer to meet its criteria, as well as the impact that they must have upon the applicant’s ability to function. Many claimants find that their symptoms do not exactly match any particular Listing, however, and they will still be able to assert their claim for benefits based on an inability to work gainfully as a result of their disability condition. Each individual claimant’s situation is different, and the SSA recognizes that the Listings of Impairments is not an exhaustive list of medical conditions that prevent an individual from working.
The next step in the evaluation process, assuming one does not meet a medical listing of impairment, is for the state agency to determine an individual’s Residual Functional Capacity (RFC) and how it impacts their ability to perform both their past relevant work as well as other work that exists in the national economy. During this process, DDS examiners consider the medical documentation provided by the applicant in addition to any reports provided by the claimant and his or her family and friends that address how his or her condition(s) affect their ability to function. In some circumstances, the disability adjudicator may request what is called a consultative examination with one of Social Security’s doctors so as to get further clarification as to the nature and severity of the medical conditions one is suffering from, along with an idea of how the condition(s) may impact one’s ability to function both at home and in the workplace. Ultimately, the two main questions the disability adjudicator must answer is whether the individual would be able to return to any of their past relevant work (that is to say, jobs one worked in the 15 years prior to becoming disabled) or any other job that exists in significant numbers in the regional or national economies. Someone who is not deemed capable of returning to either work, hypothetically, would be found disabled under Social Security’s rules and deemed entitled to the receipt of SSDI benefits.
It is far from unusual that an applicant will be denied benefits on an initial claim, only to receive them through an appeal. The SSA offers four main levels of appeal, through which a claimant must proceed in order. The first three take place within the agency: a Request for Reconsideration (where your claim will be assigned to a new disability adjudicator), a Request for Hearing before Administrative Law Judge (ALJ), and a Review by the Appeals Council. An applicant who does not establish his or her eligibility through the Agency may, ultimately, be entitled to bring his or her case on appeal to the Federal District Court (and have their case heard before a Federal District Court judge), who can decide whether the SSA made a mistake in denying benefits.Enlist a Massachusetts Social Security Lawyer for Your Pursuit of Social Security Disability Insurance (SSDI) Benefits
At every stage of the SSDI process, whether the initial claim or an appeal, you are well advised to have an experienced attorney at your side. This does not require any upfront payments (as cases work on what is called a contingency basis, with the attorney only getting paid if you win): you will not need to pay anything for advice from a legal professional unless we are successful in obtaining benefits for you. Dedicated SSDI attorney Russell J. Goldsmith has more than 30 years of experience helping people in Massachusetts and other states pursue the financial assistance that they need. Contact the Law Offices of Russell J. Goldsmith by calling toll-free at (800) 773-8622 or completing our online form.