Frequently Asked Questions

I service clients throughout Rhode Island, Massachusetts & Connecticut.

There are several kinds of disability benefits for which a person can be eligible. Depending  on the facts, you may be entitled to one of these benefits, or you may be entitled to more than one.  

The medical rules are the same for all categories. You must be just as disabled to qualify for one type of benefit as for another. The non-medical requirements are different for each category.  SSA will generally have you file for the correct program(s).

Simply stated, the attorney helps by analyzing what needs to be proven to win benefits,  figure out how to prove it, and gather the necessary evidence.  Some of the specific tasks performed by an attorney include;

• Obtain reports from treating doctors that are consistent with Social Security regulations
• Refer applicants to specialists for additional reports that answer questions raised by Social Security regulations
• Ask that a prior application for benefits be reopened
• Seek a waiver of a time limit
• Request a subpoena to insure the presence of crucial witnesses or documents
• Advise the claimant on how best to prepare for and testify at the hearing
• Object to improper evidence or procedures at the hearing
• Cross-examine adverse witnesses
• Present an opening or closing statement at the hearing
• Submit a written summary of the evidence and arguments, when necessary
• If the applicant wins, make sure the SSA correctly calculates the benefits
• If the applicant loses, request review of the hearing decision by the Appeals Council

Cases are generally handled on a contingency basis. This means that the attorney receives a fee only if you win your case. Normally the fee is 25% of your back benefits and must be approved by 

Social Security. If you do not win your case, there is no fee. There are also occasionally costs in each case for which you will be responsible. You can find experienced legal help even if you do not have any money at this time.

No. There are several ways to apply for a Social Security claim. The first is simply to go to any 

Social Security District Office and file the claim in person. A claims representative will assist you.  The second way is to call Social Security at 1-800-772-1213 and they will arrange a telephone interview for you with your local office and all the necessary forms will be mailed to you. The entire process can be completed without having to go in person to the Social Security office. The third way to apply is to file online per instructions on the Social Security website: www.ssa.gov. Currently, applying online is only available for applicants of SSDI benefits.

You can file for Social Security benefits any time, including as early as on the day that you become disabled if you believe that you will be out of work for one year or more.

The Social Security Act requires the Social Security Administration to consider age in determining disability. As people get older, they become less adaptable or less able to switch to different jobs to cope with health problems.

No.  If you have worked in recent years or if you are applying for disabled widow's or widower's benefits or Disabled Adult Child Benefits (DAC), it does not matter how much money you have in the bank.  There is no reason to wait to file for benefits.  SSI benefits, however, are contingent upon 

you having limited financial resources.

No, but it is definitely recommended. The process can be confusing,  intimidating, and frustrating. It involves precise legal definitions plus decisions on whether you must attend consultative evaluations. Any applicant can represent themselves in all stages of the Social  Security disability process. However, many applicants with experienced representation often win their cases more often than those who are not represented. Additionally, lawyers will represent you for free if you do not win your case.

In the beginning. The earlier in the claim process that you hire a representative, the better.  

You can retain an attorney before you begin the claims process. You can get an evaluation from your attorney of your claim even before you file. Representation can help you with the initial filing and ensure that important information is correctly provided at the beginning of the claim and throughout the entire claim process. You do not have to wait to be denied before you hire an attorney.

Yes.  An applicant for SSDI can still qualify for disability while working if the gross earnings are less than $1,310 for 2021. An applicant may also qualify for a Trial Working Period while disabled where they can have unlimited earnings for up to nine months.  SSI has different rules but also allows some work activity up to certain limits.  However, for every $2 earned by an applicant for SSI, the individual loses $1 from their SSI check.  They do, however, continue to qualify for 

the Medicaid coverage provided they are still receiving at least $1 in monthly SSI benefits.

Social Security defines disability as the "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 a continuous period of not less than 12 months." The disability may be, but does not have to be, permanent.

No. There are several ways to apply for a Social Security claim. The first is simply to go to any Social Security District office and file the claim in person. A claims representative will assist you. The second way is to call Social Security at

1-800-772-1213 or your local SSA and they will arrange a telephone interview for you with your local office and all the necessary forms will be mailed to you. The entire process can be completed without having to go in person to the Social Security office. The third way to apply is to file online per instructions on the Social Security website: www.ssa.gov. Currently, applying online is only available for applicants of SSDI benefits. The easiest, most stress-free way to apply for either type of benefit is to contact a reputable attorney who specializes in SS cases.

You can file for Social Security benefits any time, including as early as on the day that you become disabled if you believe that you will be out of work for one year or more.

If your answers match the ones below, you should apply for benefits:

1. Are you gainfully employed? No 
2. Do you have a severe impairment? Yes
3. Will your impairment last 12 months or result in death? Yes
4. Does your disability meet one of SSA's list of impairments? Yes 
5. Are you able to work? No

The Social Security Act requires the Social Security Administration to consider age in determining disability. As people get older, they become less adaptable or less able to switch to different jobs to cope with health problems.

No. You only have to have been disabled for at least one year, or be expected to be disabled for at least one year, or have a condition that can be expected to result in death within a year to qualify. You do not have to wait until it has been one year. You can apply and be approved if it looks like you will be disabled for at least one year.

The vast majority of initial claims are denied. Almost 9 out of 10 claims denied on initial review are then also denied at the second stage, reconsideration. Through the appeal process, however, and particularly with legal representation at the third level (Administrative Law Judge hearing), many appealed claims are ultimately approved.

Do not give up.

Possibly. If you have worked five out of the past ten years and paid Social Security taxes before becoming disabled, you will have enough earnings in the system to potentially qualify for SSDI benefits. For individuals under the age of 30, the requirements are a little different, since such individuals have not had as much time to work. Unless a person has been staying home and taking care of their children for a very long time, it is very possible that they will qualify for SSDI benefits based upon their earnings. Also, a homemaker with limited financial resources may qualify for SSI benefits even if he/she has never worked, or has not worked in a long time.

Social Security employees do not attempt to deliberately mislead someone, but you should not rely upon everything they tell you at Social Security. Questions about Social Security are often difficult to answer. Applicants make it difficult for Social Security because they may not know how to ask questions to get an accurate answer. Social Security has cut its workforce dramatically in recent years. The remaining employees are overworked and, as a result, often make mistakes. The problems are most severe with Social Security's 800 number service, whose employees are often poorly trained.

Yes, as long as you have been disabled for at least one year or expect to be disabled for at least one year. So, if you expect to be out of work for one year or more due to illness or injury, you should file for Social Security benefits. Most applicants do maintain the hope of someday returning to work.

If you have very limited income and resources, you may qualify for Supplemental Security Income (SSI) if you are disabled, even if you have not worked in the past. It is also possible to qualify for Disabled Adult Child benefits on a parent's work history if you became disabled before age 22, or for disabled widow's or widower's benefits on the work history of a late husband or wife.

If you are over age 50 and became disabled within seven years after your husband or wife died, or within seven years after you last drew mother's or father's benefits from Social Security, you can get disabled widow's or widower's benefits.

You do not have to wait until the Workers Compensation ends and you should not wait that long. An individual can file a claim for SSDI benefits while receiving Workers Compensation, and in many cases, can receive payments under both programs.

Yes. Social Security is required to consider the combination of impairments that an individual suffers from in determining disability. Many, perhaps most, applicants for Social Security disability benefits have more than one health problem and the combination of all the health problems must be considered.

In almost every case, no matter what the disease, the simplest answer is the same...."

"maybe." It depends upon how

badly you are affected by the disease. The mere fact that you have a disease with a certain name does not guarantee that you either will or will not be found disabled. It all depends upon your particular condition and degree of illness.

Social Security's position is that it is not up to your doctor to determine whether or not you are disabled. It is up to the SSA and they will make their own decision with what your doctor thinks being only part of the evidence. The better the documentation from your doctor, the more binding your doctor's opinion becomes on the SSA.

For disability insurance benefits, it all depends upon how much you have worked and earned in the past. The average worker's rate for 2020 is approximately $1,503 per month. For disabled widow's or widower's benefits, it depends upon how much the late husband or wife worked and earned. For disabled adult child benefits, it all depends upon how much the parent worked and earned. For all types of SSI benefits, there is a base amount (see 2B above) that an individual with no other income receives. Other income that an individual has (e.g. spouse's income, rental income, in-kind support, etc.) reduces the amount of SSI which an individual can receive.

It is Social Security's position that the VA decisions are not binding upon them. Social Security and the VA have different procedures and standards for approving disability claims. However, VA rating decisions can be submitted to be part of your SSA claim.

For Disability Insurance Benefits and for Disabled Widow/Widower benefits, after a five month waiting period, the cash benefit begins on the sixth month after the person becomes disabled. However, benefits cannot be paid more than one year prior to the date of the completed application.

Childhood Disability Benefits begin as of the onset date, but benefits cannot be paid more than six months prior to the date of the application.

SSI benefits begin at the start of the month following the date of the application.

The short answer is that Medicaid is a poverty program and Medicare is not. Most disabled people who get Medicaid (Medical Assistance) get it because they are on Supplemental Security Income (SSI). To get SSI and thereby get Medicaid, you have to be poor and disabled. Medicaid does pay for limited prescription medication. Medicaid eligibility can be retroactive up to three months prior to the date of a Medicaid claim.

For Medicare, your personal financial information does not matter. Medicare eligibility starts on the 24th month after the onset of your disability for Disability Insurance Benefits, Disabled Widow or Widower Benefits or Disabled Adult Child Benefits. Medicare will pay doctors at a higher rate than Medicaid. Almost all doctors accept Medicare patients, whereas most private doctors will NOT accept Medicaid patients. Part A of Medicare is free, but Part B has a monthly premium of roughly $135.50 for 2019 and can be slightly higher for persons with higher income. Part D also has a monthly premium, which is for prescription coverage and varies by plan.

If you believe you are still disabled, you should appeal immediately. If you appeal within 10 days after being notified that your disability benefits are being ceased, you can ask that your disability and medical benefits continue while you appeal the decision cutting off your benefits. You may also want to talk with an attorney about representation on your case, but you should file the appeal immediately.

No. Not in all cases. Consultative examinations are only supposed to occur when your own physician does not provide sufficient information about your impairments for which he/she treats you. Your attorney can best advise you as to circumstances under which you can properly decline to attend a consultative examination.

No. If this is your only disability, benefits will not be approved. If you have other independent disabling impairments, then benefits can be paid due to those medical problems, despite the presence of drug or alcohol issues. Ongoing substance abuse significantly complicates establishing disability when your other impairments are strictly mental illness issues. Payees may be required when there is active or a strong listing of substance abuse.

SSDI benefits CAN be taxable. It depends on the total income of your immediate family. SSI benefits are NOT taxable.

Lack of regular medical treatment or lack of credible documentation in the medical notes as to continuing symptoms and their severity. Doctors are not trained to routinely record this type of information and frequently they neglect to record the degree of your subjective complaints and the impact on your functioning in their records. Remember, your doctor is not present at your disability hearing. Only his or her medical records are present.

No, you do not have to wait until the sick leave is exhausted. You should file for Social Security disability benefits now if you believe that you will be out of work for a year or more.