Social Security Disability (SSD) and Supplemental Security Income (SSI)

How We Can Help

Social security is a complex area of law and an individual should have reliable representation when seeking social security benefits. Buzgon Davis is experienced in all aspects of the social security disability process, including the initial application, the appeals process, and any issues relating to cessations and overpayments. The attorneys at Buzgon Davis have helped hundreds of clients succeed in their disability claims at each level in the disability process, especially at the appellate level before an Administrative Law Judge.

To learn more and discuss your specific case with a skilled disability attorney, contact our office at 717-274-1421.

What You Want to Know

The Basics- Adults

The Social Security Administration has two programs that provide disability benefits to an individual who suffers from a serious physical or mental condition that has lasted 12 months or is expected to last 12 months, or ultimately result in death.

The first program is Social Security Disability (SSD). SSD is for individuals who have earned enough work credits based on their past employment and payments into his or her FICA contributions. The second program is Supplemental Security Income (SSI). SSI is a needs based program for individuals who do not qualify for SSD.

While there are complex distinctions between the two programs, which are better reserved for discussion with an experienced attorney, the primary distinction is monetary. Specifically, SSD can pay more in monthly benefits than SSI. As SSI is a needs based program, the monthly benefits are capped at what is known as the “Federal Benefit Rate.” For 2017, the “Federal Benefit Rate” is $735 for an eligible individual and $1,103 for an eligible individual with an eligible spouse. There is no difference between the two programs regarding the medical requirements to obtain disability.

In addition to having a serious physical or mental condition under either the SSD or SSI program, the individual must also be unable to engage in “substantial gainful activity” as a result of his or her physical or mental condition. “Substantial gainful activity” in simple terms refers to your ability to work. Social security will measure you ability to work by looking at an individual’s gross (pre-deductions) monthly earnings. The Social Security Administration sets the substantial gainful activity amount each year. If an individual earns more than the substantial gainful activity amount, it will affect that individual obtaining SSI or SSD benefits. For the 2017 year, the substantial gainful activity amount is $1,950 for blind individuals and 1,170 for non-blind individuals.

The Basics- Children

Children can also obtain disability benefits if he or she suffers from a serious physical or mental condition that has lasted 12 months or is expected to last 12 months, or ultimately result in death. Social security will consider the income and resources of the family members living in the child’s household, which can affect a child’s ability to obtain benefits.

The Process

The process for obtaining SSI and SSD benefits for adults and children both start by applying with your local social security office. At the local level, the Social Security Administration will ask you to fill out forms and may send you to a medical professional to have your disabling condition evaluated. Social security will also obtain your medical records from every treatment provider as it relates to your claimed disabilities. Thereafter, the local office will make a decision on your case.

The majority of cases at the local level are denied. This should not discourage you from filing an appeal. An individual has sixty (60) days from the date of his or her denial to appeal a local level denial/decision. When appealed, the matter gets sent to an Administrative Law Judge (ALJ). The ALJ will schedule a hearing to review the case without being bound by the decision at the local level. The time between an initial denial and a hearing before the ALJ can vary between 12 to 18 months.

The Decision

When an individual finally reaches his or her hearing date with the ALJ, the disabled individual will be required to present his or her case and answer questions by the ALJ. The ALJ will then conclude the hearing and make a determination on the case based on the testimony at the hearing and the medical records in the individual’s file. If benefits are granted, the case is returned to the local office for calculation of payment. If benefits are denied, an individual can appeal further or re-file with the local office.

If Approved, What Happens Next?

An individual with an approved disability is expected to continue to treat for that disability. Failure to do so may result in the Social Security Administration ceasing the disabled individual’s benefits, also known as social security sending out a cessation letter.

An individual receiving SSI or SSD benefits is also expected to not be working above the substantial gainful activity amount. If an individual receiving SSI or SSD is working, his or her benefits can be significantly affected, either being reduced or ceased all together. A common occurrence of an individual working while receiving SSI or SSD benefits is that social security will send out an overpayment letter to the individual receiving SSI or SSD benefits, thus, requiring the individual to pay back monies to the Social Security Administration.

*****The information is for informational purposes only and is NOT to be construed as legal advice and does not create an attorney/client relationship. If you have any questions specific to your case, you should consult an attorney as each individual’s case and the law applicable thereto varies on a case-by-case basis.