Articles Posted in Supplemental Security Income

Proving qualification for federal benefits is almost never a simple matter.

This is true whether you are applying for Social Security Disability Insurance in Massachusetts or Supplemental Security Income. The government almost never considers such determinations a simple matter, as the case of Bates v. Astrue well illustrates.

The U.S. Court of Appeals for the Seventh Circuit recently reviewed the case, which originated out of Indiana, where a widowed and orphaned mother of six had been denied SSI benefits – a decision that was affirmed by an administrative law judge and a district court before the appellate court reversed and remanded.
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If you become disabled due to an injury or serious illness, you may be unable to work for a living as a result of your impairments. If this occurs, you have several different potential sources of income to turn to: Social Security Disability benefits (SSD), workers’ compensation disability (available only if you are injured on-the-job) and private disability insurance.

While private disability insurance could supplement benefits received through other state and federal disability programs, our Boston disability lawyers know that most people do not have access to these types of benefits. In fact, Life Health Pro recently took a close look at the private disability insurance market and identified three challenges or barriers that prevent most people from taking advantage of this type of insurance protection.
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If you live in a particularly economically depressed area, you could have a tougher time securing Social Security Disability Insurance benefits.

Our Boston SSDI lawyers know that this seems incredibly unfair, as your need for benefits is likely compounded by the fact that even if you were able to work, you can’t find it.

But per a recent Social Security Administration bulletin, this is precisely why it will be tougher. The agency indicates that when the economic climate is less than ideal, there will be those who are only “marginally qualified” seeking benefits, in addition to those who have an even greater need.

While the decision of whether to award you benefits will be based heavily on your actual needs, the administration identified three outside factors that could affect your decision:

• The demographic characteristics of the applicants;
• The diagnostic mix of applicants;
• The local labor market conditions.

As we are still recovering from an economic recession, there are many sectors of the labor market that are still struggling. With a higher level of scrutiny being applied to all cases in recent years, one of the best ways you can improve your chances for success is to hire a skilled SSDI claims attorney to effectively present your case.

The SSA reports that when adverse labor market conditions exist, not only will marginally-qualified applicants be more likely to file claims, but those who are more significantly disabled will apply sooner than they might have otherwise.

Additionally, the longer time goes on, the more income people lose and the greater the chances that a person might qualify for Supplemental Security Income, available to those under the age of 65 who are below the poverty line, yet don’t meet disability requirements. Many times under these conditions, applicants end up eligible to receive both.

Generally, the higher the unemployment rate in a given region, the lesser your chance of being approved in the initial stages of your application. Chances of approval in any case are already slim – about 3 out of 10.

But this is all the more reason why you can’t simply give up. You must understand that the SSA, as much as it is responsive to the needs of those who are disabled, it must also be accountable to taxpayers who demand restraint.

There are many reasons why the Social Security Disability Insurance program has grown in recent years, and very little of that has anything to do with abuse or exploitation of the system. However, that’s what is often hyped in the media, and the SSA is sensitive to that.

There is some positive news, however, as SSA researchers noted that between 1993 and 2008, Massachusetts had a higher-than-average allowance rate for SSDI benefits, as compared to other states.

Among those applicants most likely to receive a favorable result:

• Older adult disability applicants;
• Adults who had a diagnosis of conditions other than a primary underlying musculoskeletal condition;
• Adults who had genitourinary, neoplasms and intellectual disability diagnoses;
• Living in a state with a lower unemployment rate.

No matter what your situation, call us today to learn more about how we can help.
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Addiction is a powerful and often fatal disease that affects more than 20 million people in this country each year.

There is no question it is a clinical medical condition and yet, our Boston Social Security Disability Lawyers know that obtaining benefits for it can be quite difficult.

The administration has ruled that while beneficiaries can’t be denied solely on the basis of their addiction, they can be denied if the foundation of the claim is predicated on the addiction.

Potential effects of addiction include: anxiety, depression, paranoia, major organ damage (heart, kidney, liver, brain), seizures or strokes, respiratory problems. Any of these consequences may involve irreversible damage that would qualify a person for disability payments. Some of these conditions may be permanent, regardless of whether you are able to quit. And that’s ultimately what the administration is after.

Section 12.09 of the administration’s disability listing holds that the question has less to do with whether the disabling condition was caused by the condition and more to do with whether the condition would improve if the substance abuse was halted.

While it seems like a fairly straightforward explanation, in practice, administrative law judges and reviewers were too often finding it difficult to separate the addiction from the condition, as both were often innately intertwined.

That’s why effective later this month, the administration has announced the passage of Social Security Ruling 13-2p, replacing SSR 82-60 with regard to addiction evaluation.

Rather than expecting evaluators to arbitrarily determine whether a person’s addiction is material to the condition, the agency has spelled out a list of flow-chart guideline questions for reviewers seeking to make an accurate determination.

So the questioning starts with whether the individual in fact has a drug or alcohol addiction. If the answer is no, then the issue is moot.

If the person is deemed to have an addiction, the reviewer must decide whether, considering the entirety of the situation, the person would be considered disabled. If not, the claim would be denied.

If, however, the answer is yes, the question then becomes whether the addiction in and of itself is the only addiction. If it is, that’s the end of the road, and the claim will be denied.

If it’s not, the next question is whether the other impairment is disabling just by itself, even while the individual continues to abuse alcohol or drugs. If the answer is no, then that means the addiction is material to the claim and the claim will be denied.

However, if the answer is yes, the follow-up question is whether the addiction itself has caused or somehow affected this other disabling impairment. If not, the claim will be granted. Even if the answer is yes, the claim can still be approved if the impairment is irreversible regardless of whether the substance abuse stopped.

If the answer is yes, but it’s not clear to what extent, the final question is whether the condition COULD improve to the point of a non-disability if the person stopped abusing substances. If so, the claim is denied. If not, it will be granted.

The bottom line is that to obtain benefits on the basis of an addiction-related condition requires you to reach a high threshold, one that you are unlikely to prove without the assistance of a skilled SSDI attorney.
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A newspaper in Florida recently profiled the plight of a working single mother whose miscalculation of SSDI and SSI benefits has prompted the Social Security Administration to halt her benefits altogether.

Our Boston SSDI attorneys recognize that as much as obtaining benefits can be a struggle, keeping them can be a battle as well.

The Supplemental Security Income is a program that pays benefits to both disabled adults and children who have limited resources and income. Approximately 8 million Americans receive SSI. The amount of benefits one can receive is based upon a combination of factors and is largely influenced on your monthly income versus expenses.

In some cases, people may receive both SSDI and SSI.

An overpayment is when the administration pays you more than it should have, resulting in you having to either pay the money back in full, have a percentage of your future payments docked or have your payments halted altogether.

Potential causes of overpayment include:

• A change in living situation or marital status;
• Having an income that is higher than you estimated;
• Having more resources than the allowable limit;
• You aren’t disabled any longer, yet continue to receive benefits;
• You don’t report any changes to the administration in a timely fashion;
• The administration incorrectly figures your benefits due to incorrect or incomplete information.

Of course, the process can be quite confusing, so it’s no surprise that mistakes are sometimes made. If the administration determines that you have been overpaid, it will send you a brief explanation in the mail with a request asking for a full refund within 30 days. If you fail to do so, the administration may take action by withholding your federal tax refund, deducting a percentage of your future benefits or even reporting this non-payment to the credit bureaus. For those who are already scraping by, this can be extremely worrisome.

The good news is that with the help of an experienced SSDII attorney, you can often successfully appeal to limit or eliminate your obligation to repay an overpayment. The goal of the appeal is to show that either you haven’t actually been overpaid or that the overpayment amount was inflated. Alternatively, even if the overpayment notice is correct, you may be able to file a waiver showing that the error was not your own and that forcing you to cover the amount would cause undue financial hardship.

Proving this is no easy task, which is why having a legal advocate on your side can make all the difference.

In the Florida case, the single mother works part-time as a dishwasher for $9 an hour, yet receives SSDI due to a learning disability. She also receives SSI payments for her two sons – one of whom has a speech disability and the other ADHD. The administration determined that over the course of the last several years, it has overpaid her nearly $35,000 because her income as a dishwasher wasn’t properly reported. Despite the fact that even with the benefits she is far below the poverty line, the government has cut off the SSI payments to her children.

She is working to appeal that decision, and the case is pending.

Amid constant public pressure to reduce expenditures, the administration is constantly looking for ways to cut costs. However, this should not be at the expense of those who truly need the help.
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