Applying for disability.
Moms View Message Board: General Discussion: Archive November 2006:
Applying for disability.
What steps does someone need to take to try to get on disability?
He does need to go to the dr. as much as needed. The Social Security Administration (SSA) does request all of these records.
Not working for the past year is a good thing. Before that, did he work? If he worked basically five out of the last ten years, he is eligible for Disability Benefits, which ARE NOT based on income level, assets, or anything. You can own as many homes and vehicles as you like, and there can be additional income coming into the home.
SSI which is Supplemental Security Income, is completely based on your income and assets. This is available to those who have not worked enough to be eligible for Social Security/Disability. You have to have a very low income, and you can not have extra assets, as they are counted towards your "income".
The first step is applying with the local SSA in your area. He can either get the forms from the office, or call and do an application over the phone (they'll set up a time for a phone interview, and they'll tell you the info you'll need for this) and they will then mail him the additional forms needed. Or you can apply on-line at their website.
At this point, a lawyer really isn't necessary. The only thing they will do is give you the forms, and set up an interview time.
I suggest he first apply, and then when he gets what is called the initial denial, he see an attorney. There is a 99% chance of being denied the first time, and even the second time. This is just part of the process. It is very important to file the appeals in a timely manner so that the person filing is still eligible for backpay and the case doesn't start over. There will be an initial denial, then a reconsideration appeal, then a recon denial, than a request for a hearing. At this point, you definitely need an attorney, and should have one prior to this so he can be getting the file together and requesting all medical records.
At the hearing, there will be a judge, and maybe a couple of "experts"- a medical expert, and an expert to tell if he is able to work any jobs, and what jobs those might be. The person filing and the attorney will also be present.
After the hearing, the judge will write up a decision to award or deny disability. This is the stage where most are awarded. But if by chance a person isn't, there are still appeals to go through, and the attorney can help with this.
The main thing to remember is yes, there will most likely be denials. But don't take this personally. This is how they weed out a lot of people filing. Don't let a denial stop you. Keep appealing, and once you get the first denial letter, that is the best time to get an attorney.
If you have any other questions, just let me know. I worked in a lawyer's office for a few years as the Appeals Paralegal. I was the one who worked with the clients throughout their entire case, filing appeals for them and getting the right forms to them and from them. I know quite a bit about it.
Also, a few years ago, I was on the other end of the system. I became disabled and had to file for my disability, and went through all the steps through the hearing. The judge awarded me at the hearing level.
As for getting medical records, if SSA doesn't get them (and even if they do), he can give someone - probably his lawyer - a HIPAA qualified authorization for the release of medical records, and the lawyer can get them by mail. Or he can authorize a family member or friend to receive the records. It will cost - but some states have limits on what doctors can charge.
And yes, he should be seeing his doctor at least twice a year. I realize this man has serious medical problems, and I suspect that he is also struggling with depression or, more likely, not trying to fight the depression. And I don't blame him for being depressed. But right now he is being his own worst enemy by not seeing his doctor, not going through all the steps the system requires, etc. Yes, assets can make a difference, but different assets - residence, cars, investments, life insurance, etc. - are treated differently, and he has a spouse who owns half the assets.
I strongly suggest the family needs to do everything and anything they can to make him go through the system, including getting the forms, talking to the SSA people to learn the rules and requirements (including those relating to assets, whether he has worked 5 of the last 10 years, etc.) It sounds to me like he won't do it on his own, but he will complain about it.
I agree, he probably doesn't need a lawyer at this stage. What he needs is someone who is willing to take on the task of gathering all the information, records, etc., making sure the forms are filled out correctly, and getting them signed and filed. And if he isn't willing to cooperate or assist, that won't be easy.
Adena clearly knows the system and is willing to help, so maybe the two of you can communicate by email about this situation, so you can go into more personal details. I applaud your wish to help this family, but do realize that if he won't do it and the family can't make him do it, there is not much you can do. You have done a good deal already by seeking information and advice, and Adena sounds like just the right person for you - and the family - to be talking to.
A lawyer who is experienced with disability law can make things so much easier, and will know all of the rules and can explain them up front. But, the lawyer will get, I believe, 20% of whatever disability payments he is awarded indefinitely. So if he is willing to cooperate with a family member or friend, he can save that 20%.
Oh, and the family doctor ought to be able to obtain the records from all the specialists, including the back doctor. Do they know if the family doc already has these records? My specialists send reports to my primary care doctor automatically, and any time my primary care doctor wants more detail he just requests copies of the specialist's records. And my primary care doc can get all hospital records too, and knows how to keep the costs down by getting just the right records (for instance, if you are hospitalized, your records will have 3-6 pages every day of nursing care notes, which are not needed for this kind of thing).
Adena, would you please e-mail me.
Sent you an e-mail...
Adnea, I think it is terrific that you have this knowledge and are willing to help out.
Thanks, Ginny. The system just makes it so difficult to work through, that I want to help anyone I can. Unfortunately, I saw too many clients (and some became friends) die from their disabilities before they could convince the SSA that they were indeed disabled. So many people give up, and this is what the SSA aims for, and I try to encourage those who truly need it to just keep on working through the paperwork and red tape.
Adena, I'll e-mail you tomorrow, I haven't had time today.