Social Security Regulations Archives

Applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) can be a complex and lengthy process. For individuals who are unable to work due to a disabling condition, understanding the timeline for social security disability claims is crucial

When it comes to disability benefits, one document stands out in importance: the disability doctor’s letter. Whether you’re applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), this letter holds the power to validate your claim and sway the decision. It serves as a bridge between your medical condition and your eligibility for financial support

A Social Security Disability hearing holds the key to accessing essential benefits, but the process can be intricate and overwhelming. With proper preparation and knowledge, you can boost your chances of triumphing in this critical moment.

For individuals receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), a Continuing Disability Review (CDR) can bring both anticipation and anxiety. A CDR is a routine evaluation to determine whether you still meet the eligibility criteria for disability benefits.

The journey toward obtaining Social Security Disability (SSD) benefits is a complex one, marked by intricacies and challenges. Amidst this complexity, the dialogue between patients and their medical professionals emerges as a pivotal factor.

San Diego Social Security disability lawyers regularly help applicants apply to receive benefits if they are unable to perform any easy work they have done in the past. This may seem like a simple process, but San Diego Social Security disability attorneys frequently need to guide clients through the often complicated yet necessary procedures.

Because the Social Security Disability application and appeals process can be difficult, especially when a claimant may be suffering from multiple medical impairments, it is crucial to hire an attorney that specializes in Social Security Disability Income (SSDI) and Supplemental Security Insurance (SSI) claims.

Aline Gaba, attorney and founding partner of the San Diego Disability Law Group (SDDLG) recently participated in a webinar for the San Diego County Bar Association. In this webinar, she discussed the role of Social Security Disability Attorneys in helping their clients, along with the differences between SSDI and SSI claims. One particularly valuable focus included how medical evidence helps in achieving successful SSDI and SSI claim outcomes.

You can watch the discussion touching on the points above through the recorded 23-minute webinar published here: https://www.sdcba.org/index.cfm?pg=ssi

Below, we will review some of the main points from the webinar. If you still have questions, please feel free to call the San Diego Disability Law Group at (619) 338-9000 or contact us via email and we will do our best to get your questions answered as quickly as possible.

SSI Claims vs SSDI Claims

It is important to know the difference between a Supplemental Security Income (SSI) claim and a Social Security Disability Insurance (SSDI) claim. 

SSI is a needs based program for individuals who have a severe impairment that prevents them from being able to sustain gainful employment.  There are different financial requirements depending on your marital status; however, SSI does not require any work history or qualifying quarters. As such, an individual may qualify for SSI if they have never worked a day in their life so long as they meet the financial and medical requirements for SSI.  For this reason, SSI benefits are usually much lower than SSDI benefits.

SSDI also requires a severe impairment that prevents substantial gainful employment; however, you must also have sufficient qualifying quarters.  In other words, you must have sufficient work history as well as a medically determinable impairment in order to be eligible for SSDI.  Because SSDI is based on your earnings, these benefits are usually much higher than SSI benefits.

Why Hire an SSDI/SSI Attorney?

What does an SSDI attorney really do, and is hiring one actually necessary? A Social Security Disability attorney, like Ms. Gaba, has many years of knowledge and experience in dealing with the processes and procedures of the Social Security Administration (SSA).  You could say that we are fluent in the language that the SSA speaks, which makes us uniquely qualified to address the many problems and pitfalls that may arise during the application and appeals process. 

Attorneys who specialize in Social Security Disability, like Ms. Gaba, are well versed in the SSDI and SSI application and appeals process.  We analyze each case from start to finish, including status of the claim, pending appeals, and hundreds to thousands of pages of medical records.  Over the course of this long process, we work closely with and get to know our clients so that we can develop a comprehensive strategy to give them the best chance of winning their claim. 

The Use of Medical Evidence in an SSDI/SSI Claim

It is important to note that the role of medical evidence is critical to the successful outcome of the SSDI/SSI claims process.  An experienced Social Security Disability attorney, like Ms. Gaba, will review your entire medical file and ensure that the SSA has all of the necessary and relevant information.  Your SSDI attorney will identify and request any missing records, ask your doctors for opinion letters, and work with you to gather any additional evidence that would support your claim. 

In the webinar, Ms. Gaba also discusses the impact of the current Coronavirus pandemic situation on the processing of disability claims. Due to COVID-19 related business closures, the backlog of cases waiting to be processed by SSA quickly increased early on. However, the SSA has recently pushed though cases at a more rapid pace, which helped in reducing the claim processing delay. In addition, all of the San Diego Social Security hearings are currently being held telephonically instead of in person to comply with the related health requirements and to prevent further delays in processing claims.

SDDLG Can Help With Social Security Disability Claims

Many claimants find the Social Security Disability process daunting and discouraging due to the high rate of denials and the obscure nature of dealing with a large bureaucracy such as the SSA. However, you don’t have to go through the process alone.  Please contact the San Diego Social Security Disability lawyers for a free consultation.

RELATED: Excuses for Late Disability Appeals

You can reach the offices of The San Diego Disability Law Group by calling 619-338-9000, or contact us here.

Social Security Disability and Reflect Sympathetic Dystrophy – Is rsd a disability? We presently  have a client who has  been diagnosed with REFLEX SYMPATHETIC DYSTROPHY (RSD) also known as COMPLEX REGIONAL PAIN SYNDROME (CRPS).  RSD is a unique clinical syndrome that may  develop following trauma, severe or minor.

San Diego Social Security disability lawyers regularly help applicants apply to receive benefits if they are unable to perform any easy work they have done in the past. This may seem like a simple process, but San Diego Social Security disability attorneys frequently need to guide clients through the often complicated yet necessary procedures.

Defining the Term “Disabled”

San Diego Social Security disability attorneys are aware that the Social Security Administration defines the term “disabled” in a particular way. “Disabled” applicants are those who can no longer complete any “past relevant work,” and must meet the following criteria:

  1. The applicant must have been employed in the occupation within the last 15 years or 15 years prior to the most recent disability requirement check (whichever was earlier).
  2. He or she must have performed the work for a significant period of time. (Any applicants unsure about whether their work qualifies should consult their San Diego Social Security disability lawyers.)
  3. The applicant must have earned a certain amount of money throughout the working period.

Qualifying for Disability Benefits

San Diego Social Security disability lawyers may test whether an applicant may qualify for disability benefits by following a two-step process:

  • The San Diego Social Security disability lawyers will first conclude which occupation fits the “past relevant work” criteria and is the least strenuous.
  • Then, they may investigate why the applicant can no longer perform the occupation.

Level of Exertion Required to Perform Job Duties

An applicant will not qualify for benefits if his or her San Diego Social Security disability lawyers cannot show that he or she is unable to complete a former job of average difficulty. In addition, the Social Security Administration will ask the San Diego Social Security disability attorneys whether the applicant’s past performance corresponded to the difficulty level of each position.

Medical-Vocational Guidelines

The Social Security Administration will utilize the Medical-Vocational Guidelines to determine a candidate’s degree of disability. San Diego Social Security disability lawyers will need to prove that the applicant cannot perform any commonly available job.

Contact San Diego Disability Law Group

Many candidates find the application process confusing. If you are disabled and would like to apply for benefits, consult with San Diego Social Security disability lawyers at the San Diego Disability Law Group by calling 619-338-9000, or contact us here.

All is not necessarily lost if you don’t get your Social Security Disability appeal filed on time. The Social Security Administration (SSA) regulations recognize several excuses as “good cause” for missing the appeal deadline. An experienced San Diego Social Security attorney can help you establish good cause, or, even better, help you meet the time requirement in the first place.

Procedure for Raising Excuse

The first thing you need to do with a late disability appeal is getting it filed. If it has clearly missed the deadline, you’ll need to include a detailed letter telling the SSA exactly why you are filing late.

If the SSA finds that your explanation amounts to “good cause,” it extends the deadline, magically making your late disability appeal a timely appeal.

Who Determines “Good Cause”

The SSA’s lengthy Program Operations Manual System gives the authority to decide if there is “good cause” to the “individual from the component that has the authority to adjudicate the appeal being filed.” In practical terms, this means that the official who determines good cause depends on which filing is late:

  • If the Request for Hearing is late an administrative law judge (ALJ) determines good cause
  • If the Request for Review of Hearing Decision is late, the Appeals Council determines good cause
  • If the deadline to file in federal court was missed, the Appeals Council again determines good cause

What Excuses Amount to “Good Cause”

There are SSA regulations describing, at general level, what amount to “good cause”:

  • The specific circumstances which led to the untimely filing
  • Whether the claimant was misled by any action of the SSA
  • Whether the claimant understood the time requirement

A more specific regulation provides that SSA will consider whether the claimant had any physical, mental, educational, or linguistic limitations—including any lack of facility with the English language–which prevented a timely filing, or which prevented the claimant from understanding or knowing about the need to file a timely request for review.

SSA has issued a Ruling on the lack of mental capacity, which states that tardiness will be excused when claimants lack the capacity to understand the procedures for requesting review, and had no one legally responsible for prosecuting the claim, such as “a parent of a claimant who is a minor, legal guardian, attorney, or other legal representative.” In applying this standard of mental incapacity, it doesn’t matter how much time has passed since the decision the claimant wants to appeal.

Reasonable doubt about the claimant’s capacity is resolved in favor of the claimant.

Get Social Security Disability Help

Establishing good cause is something best left to an experienced disability attorney in San Diego. Get the help you need to protect your right to benefits; if you need a lawyer for ssi appeals, call George Heppner and Aline Gaba at (619) 338-9000.

RELATED: Why Applying for Disability isn’t always easy