If you are unable to return to your job due to an illness or injury, contact Fusco, Brandenstein & Rada, P.C. for assistance with applying for Social Security Disability benefits. If you have already filed a claim and received a denial, we can review your case to determine if you’re eligible to file an appeal.
Social Security Disability supplements lost wages for disabled individuals who can no longer maintain gainful employment and earn a living. Whether you have been out of work for a year or many years, you deserve the benefits that may be available.
You may have heard that it’s not easy to get Social Security Disability, or that it’s a minefield stacked against the claimant. For sure, the regulations are very strict, and that’s why you need someone with the knowledge and experience to help you navigate the process. Our attorneys possess in-depth knowledge of the potential hurdles you might face, and proactively leverage that knowledge to create well documented applications and conclusive appeal arguments that can make all the difference in whether or not you receive the benefits you deserve.
Our team of New York Social Security Disability attorneys is led by Victor Fusco, a Past-President of the New York Social Security Bar Association as well as the National Organization of Social Security Claimants’ Representatives and author of numerous articles, and Milan Rada, a former Attorney-Advisor at the Social Security Hearing Office.
Our New York Social Security disability attorneys will fight to protect your rights. We even handle cases for clients in surrounding states. Our goal is to see that your disability doesn’t negatively impact your financial status or result in additional hardship. Call Fusco, Brandenstein & Rada, P.C. for a free consultation at 516-496-0400.
- What Is Disability?
- Differences Between Social Security Disability and Supplemental Security Income
- Other Benefits
- Why Income Is Important When Calculating Benefit Payments
- When Should I Begin the Application Process for SSDI?
- How to File a Social Security Disability Claim
- Common Reasons Social Security Disability Claims Are Denied
- Levels of Appeal
- Fusco, Brandenstein & Rada, P.C. Will Help You Fight for the Benefits You Deserve
- You Can Afford Us!
What Is Disability?
According to the Social Security Administration, a “disability” means the inability to participate in gainful activities due to a medically diagnosed physical or mental impairment that will last for at least twelve months or result in death. Medical evidence must show physiological, anatomical, or psychological condition(s) documented by clinical, laboratory and electro-diagnostic diagnostic testing. Your statement about your symptoms is not enough to prove there’s a disabling physical or mental impairment.
Common conditions typically covered by Social Security Disability include:
- Traumatic Injuries
- Spinal disorders
- Significant dysfunction of major joints
- Severe amputations
- Tissue injury or dysfunction needing multiple surgeries
- Inflammatory Disorders
- Cardiac Diseases
- Lung Disorders
- Kidney Disorders (Renal)
- Hepatic Disorders (Liver)
- Gastro-Intestinal Disorders
- Blood Disorders
- Neurological Disorders
- Brain Injuries / Strokes
- Auto-Immune Conditions, such as Lupus
- Mental Disorders
- Neurocognitive dysfunction
- Hematological Conditions
- Visual Disorders
- Dermatological Conditions
- Diabetes & Endocrine Disorders
- And Many Other Conditions
If you have been diagnosed with any of these conditions, or the many others that can affect your ability to work, you may be eligible for Social Security Disability benefits. Contact our New York SSDI claim lawyers today to speak with a qualified attorney.
Differences Between Social Security Disability and Supplemental Security Income
Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are different federal programs that provide wage replacement benefits for injured and ill workers.
Social Security Disability Benefits are funded by Social Security taxes taken out of each paycheck when you work. When you apply for disability there’s a five-month waiting period before you are able to collect benefits.
The amount of your benefits depends on the average of your total wages before you became disabled and the number of years in which maintained gainful employment. The more extensive your work history, the higher your benefit will be. Once you have been disabled for 30 months you become eligible for Medicare coverage. Your spouse and children under age 18 may also recover SSDI benefits on your account in many cases.
Supplemental Security Income (SSI) is funded by the general tax fund. While the disability standards are the same as in Social Security Disability, your income and resources are also counted to determine if you’re entitled to SSI. There is no long waiting period with SSI. Most people receive their first benefit payments effective the month of application assuming they have proof of disability from the beginning of the impairment. For example, a person injured in a sudden accident might be able to prove they immediately became disabled.
Whether you can get SSI, also depends upon your “income and resources.” An individual may have no more than $2,000 in assets and earn a limited income for SSI approval. If you’re a part of a couple, you may only have a maximum of $3,000 in assets, however there are many exclusions from the list of items considered “resources.”
You might be able to apply for food stamps and Medicaid while you’re receiving disability payments through the Supplemental Security Income program as well as other benefits offered through your county Department of Social Services, which is not to be confused with the Social Security office.
- Mother’s Benefits, if you become disabled, depending on your benefit rate, your family may be entitled to auxiliary benefits in a total amount up to 50% of your benefit. Not only your children, but their mother (if not working) is entitled to a portion of those benefits.
- Grandchildren and Stepchildren can additionally receive dependent or auxiliary benefits through your SSDI account if the child’s parent(s) are disabled or deceased, the child is 18 years old or younger and lives with you and you funded at least half of the child’s support in the year prior to your disability eligibility date. If the child is under one year of age, you must have provided at least half of his or her financial support since birth.
- Disabled Adult Child Benefits: If you get disability and have an unmarried disabled child over 18 age, he or she you could qualify for benefits as a “disabled adult child,” provided it can be proven the child has had a disability which began before reaching age 22. Frequently, this is a difficult test. Our firm handles such cases.
Why Income Is Important When Calculating Benefit Payments
If you have a physical or mental impairment that prohibits you from completing job-related duties you might qualify for disability. Even if you’re doing some minimal work you might be a candidate for disability benefits. If you are working and your average earnings are more than $1,260 a month, the Social Security Administration will likely deny your claim. However, that dollar amount is adjusted annually.
Other than limitations to income, you must have an impairment (or combination of impairments) that:
- Has lasted longer than one year or is expected to last at least one year, or
- Will likely lead to death.
Other eligibility requirements that could affect your SSI claim include:
- Your age on the date you claim to have become disabled;
- Your education;
- Your recent work history, (usually within the last 15 years);
- Your ability to do types of work different from that which you used to do;
- Total Social Security credits you’ve earned
- Whether your disability arose during the period in which you had insured status for Disability Benefits (usually – but not always – within 5 years of the month in which you last worked).
If your income has been limited and/or you don’t have a substantial employment history, you may not be able to collect SSDI benefits. However, you might nevertheless be eligible for SSI payments. New York State supplements these benefits. Your New York Social Security Disability attorney will review your case to determine which program would work best for your situation.
When Should I Begin the Application Process for SSDI?
To be eligible for SSDI benefits, you must first have a qualifying long-term or permanent disability. Because the disability needs to last or be expected to last for more than than one year, you can wait a sufficient time to permit proof of its permanency. However, the process of applying is complicated and can take some time to complete.
In some cases it might be in your best interest to begin right away, because it can takes months for the Social Security Administration to decide your claim. In other cases, an early application may be the worst mistake you can make. That is where the expertise of an experienced disability attorney can be the key to whether your application will be successful. You can receive up to 12 months of retroactive benefits on a well-timed application.
After your application has been filed, the Social Security Administration will look over everything you provided to determine if you qualify for benefits. This also is where an attorney’s expertise can be of great benefit. At this stage an attorney will gather up all your relevant evidence and submit it with your application. Once the application has been submitted to the District Office (it is usually done electronically these days) the medical portion of the claim will be submitted to your State Office of Disability Determinations where an analyst will take into account:
- Whether you’re currently employed, and if not, when you last worked.
- The reason(s) you stopped working.
- What your doctors have documented in the medical evidence provided.
- Whether they want to send you for an examination by one of their doctors.
- Whether your condition meets certain Social Security medical guidelines, for a medical approval; if not
- What work-related tasks you can perform despite your medical conditions (if any) and if you can;
- Are there jobs you might be able to perform despite your impairment(s),
- If not, is the disabling medical condition serious enough to prohibit you from maintaining gainful employment;
- Social Security does not have to show there are “job openings,” only that suitable jobs exist.
- Social Security does not take into account that the “suitable jobs” do not pay the type of wages you are accustomed to earning.
Because your application is an important process, Fusco, Brandenstein & Rada, P.C. handles Social Security Disability cases at the initial application level. Many claimants who begin the process can readily appreciate the potential pitfalls, and thus seek to have attorneys prepare their Social Security Disability Applications, as so much is at stake.
After the State Disability Determinations agency approves or denies your claim, the Social Security Administration will review their decision and either agree or disagree with it. If they deny your claim, Social Security will mail you a written denial. You must appeal it (i.e. “Request Reconsideration”) within 60 days.
You might want to supplement the evidence in your file when you “Request Reconsideration.” If the Reconsideration also results in a denial, you must “Request a Hearing” within 60 days.
If Social Security approves your claim you will receive a “Notice of Award.” Sometimes these “favorable notices” do not give you everything you requested, and you should review it with an attorney. For example, in an application filed on July 5, 2020 you may have claimed you became disabled after an accident which occurred on January 5, 2019. Instead, the Social Security Administration determines your disability did not begin until December of 2020. You will have lost 17 months of past due benefits, even though your decision is “favorable.” You may want to appeal that decision amending your “onset date.” Frequently, the onset date can affect your entitlement to other benefits, such as pensions, or insurance claims. This is another reason why a lawyer’s careful fact gathering at an initial consultation and careful review of your decision(s) can be so important when dealing with Social Security claims.
How to File a Social Security Disability Claim
There are various methods to file your claim for SSDI or SSI benefits. Our office files most claims electronically. We do not file until we have assemble enough evidence to support a claim, as it is our goal to try and win your case as early in the process as possible.
If you chose to do it yourself, you can submit information online or by phone, (1-800-772-1213) or by appointment at your local Social Security District Office. During the COVID-19 Pandemic, many Social Security Offices are closed to the public. Check with Social Security to see if your office is handling in person appointments.
Social Security provides a disability starter kit for anyone interested in applying for benefits by themselves. It includes a checklist of information you need to file your claim and documents you must provide to prove your disability.
If you retain Fusco, Brandenstein & Rada, P.C. to represent, our attorneys and paralegals will walk you through the process of applying for benefits from start to finish. We will file your application and ensure all deadlines are met. Equally important, we will ensure the self-reported statements made in your application support a compelling argument for disability, as do the medical and other evidence needed to support your claim.
Medical record evidence is crucial when you are applying for Social Security Disability benefits. It will have a significant impact on the outcome of your claim. Medical records are especially useful during the application process. But equally critical are medical reports by your doctors documenting the disabling effects caused by your medical conditions(s) and how they prevent you from performing any type of work. Sometimes your doctors need to be provided with the correct forms upon which to document your disability. Sometimes doctors need to be informed of what is required to be included in the medical evidence submitted for your claim. Educating your doctors is one of the most important things our attorneys do.
Common Reasons Social Security Disability Claims Are Denied
In processing Disability claims, the Social Security Administration requires that you meet all deadlines and provide complete and accurate information about your disability. A small mistake could delay the process or cause a denial.
Here are some common reasons for SSDI and SSI denials.
Failure to Comply
A denial or dismissal of your claim, might result if If you miss a step or fail to produce or complete documents requested of you, or you fail to follow a direction.
There are deadlines you must follow throughout your claim. They are strict. Failure to take timely action might result in dismissal of your claim.
If you no longer have a disability, you might not qualify for disability benefits. The Social Security office will periodically check on your condition to confirm that you’re still unable to return to work due to your injury or illness. If Social Security determines that you no longer have physical or mental limitations, they might deny your claim or cease sending payments. However, even if you have recovered, if you were disabled for 12 or more consecutive months, you may be entitled to a “closed period” of benefits. If you recover while your claim is pending make sure you ask for a closed period.
If you previously applied for benefits for the same time period and your application was denied, you’ll likely get denied a second time if you try to file again. Instead of filing another claim, your best option is to file an timely appeal if you get a denial. In some instances a new application for a later onset of disability might be advisable. Get an attorney’s advice about this.
Missed Consultative Examination
If you did not attend the required appointment with the Disability Determinations Consulting doctor, this could result in an automatically denied claim. If you decide not to show up, they won’t have the documentation needed to complete work on your claim, or might deny the case for “failure to cooperate.”
Lack of Medical Evidence
Medical records are an essential part of any case. If you skip appointments with your treating doctors or if there are significant gaps in treatment, or missing records, Social Security analysts might conclude you didn’t suffer a disabling injury, or your condition is not serious enough to require medical treatment.
Definition of Disability
You must have a qualifying condition to be eligible for benefits. If your injury or illness does not match the Social Security Administration’s complex disability definition, your claim will be denied. Social Security’s Disability determination considers such factors as your age, education, work experience and your medical condition. So, in deciding your claim, in most cases “Disability” is not merely a medical condition.
Your income is important for determining your benefit rate in a Social Security Disability case, or for determining eligibility. You income is so low it’s not considered substantial, or if arises from work completed in the past, or perhaps a pension, it might not count against your claim of “disability.” Additionally your income information is vital in determining whether you meet the requirements for collecting Supplemental Security Income payments. If you earned more than the maximum limit, you won’t receive coverage.
Levels of Appeal
If the Social Security Administration denies your claim, you can appeal. You have only sixty days from the denial date to file. When you receive the letter with the SSA’s decision, it should include the reason for denial and instructions on how to file an appeal. There are four levels of appeal:
If Social Security denied your claim for a medical reason, you can appeal the decision online. For non-medical determinations, there’s another link you can go to for instructions on submitting an appeal and evidence you need to provide. Our firm handles “Reconsideration Requests.” If your reconsideration request is denied, the next step is a hearing before an Administrative Law Judge. Most denials are considered “medical determinations” even though other factors may have been considered.
If your reconsideration is denied the next step is, (within 60 days), to request a hearing before an Administrative Law Judge who has not been involved in the original or reconsidered denial of your claim. You’ll receive a confirmation packet with detailed information about how the hearing process works. The Hearing Office will choose a date, time, and location to listen to your arguments and review the documentation you provide. You must show up either in person before the judge or through a video link to a judge. During the COVID-19 Pandemic, many Administrative Law Judges are conducting hearings over the telephone. In either event you get to tell your side of the story to the Judge. However, because the Judge is a “neutral arbitrator” he or she must also develop evidence favorable to Social Security. The Judge may call such experts as a Medical Advisor and/or a Vocational Expert. Frequently, such expert testimony is not in the claimant’s interest. Vigorous cross-examination of such experts may be necessary. Thus it is crucial to have an attorney to help you present a strong case before the judge. Our attorneys handle several hundred hearings each year and win the majority of their cases.
Appeals Council Review
If you are dissatisfied with the decision made of the Administrative Law Judge, you can request a review by the Appeals Council. It is our practice to submit legal briefs to the Appeals Council, to point out errors in the Judge’s decision. The Appeals Council will decide whether it will review your case. If the Council agrees with the Administrative Law Judge’s administrative law judge’s decision, the denial will be upheld. However, if it is found that your case deserves a second look, it will return the case to an Administrative Law Judge to resolve outstanding issues.
Review by Federal Court
If the Appeals Council agrees with the decision to deny benefits, you can bring a civil suit in the United States District Court, to have a Federal Judge to review the Social Security Administration’s final decision. The legal standards in Federal Court are very technical. You should be represented by an experienced appellate attorney. Your case must be filed within sixty days of the Appeals Council’s decision. Fusco, Brandenstein & Rada, P.C. has been successfully handling such cases since our founding in 1978.
Fusco, Brandenstein & Rada, P.C. Will Help You Fight for the Benefits You Deserve
Our New York Social Security Disability attorneys understand what you’re going through. Disability can be a stressful experience. When you’re hurt and unable to earn a living, it’s overwhelming. How do you pay for necessary medical treatment? How do you support your family.
We are here to handle every aspect of your claim or appeal so you can focus on treating your disability.
We have in-depth knowledge and understanding of how the Social Security Administration handles claims. Several of our staff-members worked for them. That experience is invaluable in helping our clients move forward with their cases, answering all their questions and reaching favorable outcomes. When you retain Fusco, Brandenstein & Rada, P.C., we’ll assist you in navigating the process from the application forward; obtain sufficient evidence that proves you have a disability, and ensure there are no missed deadlines.
If you’ve been denied Social Security Disability Benefits at any level – application, reconsideration, hearing or Appeals Council, Fusco, Brandenstein & Rada, P.C. can become involved in your case to handle a hearing or appeal. We are well-versed in the complex laws associated with Social Security Disability benefits. We know how to best handle Social Security’s complicated procedures. Our team will advocate for your rights and fight for the Social Security benefits you deserve. Additionally, we will clue you in to additional types of benefits for which you may be eligible as well. You should not have to suffer through this ordeal alone. We’ll be by your side every step of the way to provide guidance and support.
If you have a disabling medical condition that keeps you from working, call Fusco, Brandenstein & Rada, P.C. today at 516-496-0400. One of our New York Social Security Disability attorneys will be happy to meet with you for a free consultation.
You Can Afford Us!
The U.S. Supreme Court has characterized the Social Security Disability process as a “maze!” In dealing with the complexities of Social Security Disability, you are best served by a law firm that specializes in Social Security Disability cases, as we have since 1978. In the majority of Social Security Disability cases we work “on contingency,” meaning we do not get paid unless we win. When we win we ask the Social Security Administration to approve a fee payable from your past due benefits. The Social Security Administration typically withholds 25% of your past due benefits from which attorneys’ fees will be paid. Only the Social Security Administration can determine and fix your attorney’s fee. While in some cases, we are required to file a listing of our work efforts, only the Social Security Administration (or a Federal Court) can determine the attorney’s fee. Since you only pay a fee if and when you win, you have nothing to lose and everything to gain by retaining experienced counsel to help you with such a claim.
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