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Social Security Disability Insurance

Social Security Disability (SSD) is an insurance program sponsored by the U.S. government under Title 11 of the Social Security Act. It is a monthly cash benefit for a disabled worker and/or family.

Is It For Me?

For purposes of entitlement to disabled worker's benefits, disability is defined by Social Security 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. A person must not only be unable to do his or her previous work but cannot, considering age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.”

If you have a psychiatric disability you will need to have your psychiatrist fill out a medical report form. The form will ask your psychiatrist for a psychiatric history of your condition. The form will also ask for the following information:

What is your diagnosis?
When did it begin?
How does it limit your activities (especially work-related activities)?
What does a current psychiatric examination indicate?
What treatment have you received?

The psychiatrist makes an assessment of your condition; Social Security employees make the decision regarding your eligibility for Social Security Disability Insurance.

You should be familiar with the process Social Security uses to determine if you are disabled. It's a step-by-step process involving five questions. They are:

Are you working? If you are and your earnings average more than $830 a month in 2005, you generally cannot be considered disabled.
Is your condition severe? Your impairments must interfere with basic work-related activities for your claim to be considered.
Is your condition found in the list of disabling impairments? Social Security maintains a list of impairments for each of the major body systems that are so severe they automatically mean you are disabled. If your condition is not on the list, Social Security determines if it is of equal severity to an impairment on the list. If it is, your claim is approved. If it is not, Social Security goes to the next step.
Social Security has a guide for health professionals, which outlines the medical criteria Social Security employs in determining disability claims. The guide contains a list of both child and adult impairments that are considered disabling. Bear in mind that Social Security also looks at your age, education, skills, and work experience when determining disability status. This guide is also referred to as The Blue Book and can be found by logging on to: http://www.ssa.gov/disability/professionals/bluebook/.
Can you do the work you did previously? If your condition is severe, but not at the same or equal severity as an impairment on the list, then Social Security must determine if it interferes with your ability to do the work you did in the past. If it does not, your claim will be denied. If it does, your claim will be considered further.
Can you do any other type of work? If you cannot do the work you did in past years, Social Security then looks to see if you can do any other type of work. Social Security considers your age, education, past work experience, and transferable skills, and reviews the job demands of occupations as determined by the Department of Labor. If you cannot do any other kind of work, your claim will be approved. If you can, your claim will be denied.

Persons who can qualify for benefits on the basis of disability are:

A disabled worker under 65 who is covered by Social Security
A person disabled since childhood (before age 22) who is a dependent of a deceased parent covered by Social Security or a parent entitled to SSD or retirement benefits.
A disabled widow or widower age 50-60 if the deceased spouse was receiving benefits under Social Security

Most people need 20 Social Security credits (5 years of work) to qualify for SSD benefits. Younger people need fewer credits to be eligible for disability benefits or for their family members to be eligible for survivor benefits if they die.

If you have a psychiatric disability or another type of disability and it has been determined by Social Security that you are unable to engage in “substantial gainful activity”, you may be able to receive Social Security Disability (SSD) benefits. The rules and exceptions to those rules in determining whether you are an insured worker can be complex. To find more information about earnings and length of work requirement for SSD eligibility click on http://www.ssa.gov/OP_Home/handbook/handbook.05/handbook-toc05.html.

You can also work and continue to receive SSD benefits. Social Security rules make it possible for you to test your ability to work without losing their cash or medical benefits. These rules are called “work incentives” and they may provide:

Continued cash benefits
Continued help with medical bills
Help with work-related expenses or
Vocational training

For more information about work incentives, ask any Social Security office for the publication: “A Summary Guide to Social Security and Supplemental Security Income Work Incentives for People with Disabilities.” Click here to go to a listing of Social Security offices in Westchester County.

Also, since there is pending legislation regarding the liberalization of these work incentives, please click on to these web sites for up-to-date information.

http://www.ssa.gov/disabilityresearch/siteindex.htm

http://www.ssa.gov/work

There is also a helpful web site that will assist you in determining whether you can be eligible for a “Pass Plan” which will assist you with work-related expenses. Please click on http://www.nls.org/pass-art.htm.

What Are the Benefits?

SSD benefits are cash payments to you or your family member based on computations of your average monthly earnings. After you go through a disability review determination and are deemed eligible, you will receive a “Certificate of Award” which explains how much your disability benefit will be and when payments start. It also shows when you can expect your condition to be reviewed to see if there has been any improvement. If family members are eligible, they will receive a separate notice and a booklet about things they need to know.

Additionally you can be eligible for Medicare benefits. After you receive disability benefits for 24 months, you will be eligible for Medicare. You will get information about Medicare from Social Security several months before your coverage starts.

When Do the Benefits Apply?

The law provides that, under the SSD program, disability benefits for you cannot begin for 5 months after the established onset of the disability. The 5-month waiting period does not apply if you are a disabled child (under age 22) of an eligible SSD recipient.

Social Security benefits are paid each month. The notice you received from Social Security telling you that your benefit application was approved also tells you when you will receive your monthly benefits. Generally, your benefit will arrive on the second, third or fourth Wednesday of the month, depending on the birthday of the worker on whose records you receive benefits.

For example, if you receive benefits on your own earnings record as a disabled worker, your benefits will be determined by your birth date. If you receive benefits as a spouse of a retired or deceased worker, your benefit payment day will be determined by your spouse's birth date. Here is how it works:

Birth Date On	Benefits Paid On
1st - 10th	Second Wednesday
11th - 20th	Third Wednesday
21st - 31st	Fourth Wednesday

Your disability benefits generally will continue for as long as your impairment has not medically or psychiatrically improved and you cannot work. They will not necessarily continue indefinitely.

Because of advances in medical science, psychiatry and rehabilitation interventions, an increasing number of people with disabilities recover from serious accidents and medical and mental illnesses. Also, many individuals, through determination and effort, overcome serious conditions and return to work in spite of them. Social Security will review your case periodically to make sure you're still disabled. In addition, you are responsible for promptly reporting if your medical or psychiatric condition improves, if you believe that you can work or when you actually do return to work.

How Do I Apply For the Benefit?

You can apply at one of the following Social Security offices in Westchester County:

5 Stevens Avenue
Mount Vernon, NY 10550
914-663-9306
85 Harrison Street
New Rochelle, NY 10801
914-636-6915
One Park Place, 3rd Floor
Peekskill, NY 10566
800-772-1213
297 Knollwood Road
White Plains, NY 10605
914-682-6205
20 South Broadway, 10th floor
Yonkers, NY 10701
800-772-1213

You can also call Social Security at 800-772-1213 for an appointment with a Social Security representative who will help you apply. You can speak to a service representative between the hours of 7:00 AM and 7:00 PM on business days. Parents or guardians can apply for blind or disabled children under 18.

You should have the following things before you apply. Even if you don’t have all of the things listed, sign up anyway. The people at the Social Security office can help you get whatever is needed. Please bring:

Your Social Security card or a record of your Social Security number
Your birth certificate or other proof of your age
Information about the home where you live, such as mortgage or your lease and landlord’s name
Payroll slips, bank books, insurance policies, car registration, burial fund, records, and other information about your income and the things you own
The names, addresses, and telephone numbers of doctors, hospitals and clinics that have seen you
Proof of U.S. citizenship or eligible non-citizen status

Generally, application forms are filled out in your local Social Security Administration’s office. A personal interview is usually conducted, and the Social Security claims representative sends all the forms to the New York State Division of Disability Determinations. This is the state agency that does disability determinations for the federal Social Security Administration.

If your initial application for benefits is denied, the New York State Division of Disability Determinations (DDD) will reconsider your application if you file an appeal. An appeal should be made within 60 days of a notice of denial. According to the New York State DDD, the average time for them to reconsider your claim is 45 days.

If you are denied a second time, you can request an in-person hearing with a Federal Administrative Law Judge.

Is There Any Cost To Me?

There is no cost to receive Social Security Disability benefits. Depending on your circumstances, you may have to pay taxes on your Social Security benefits. For further information call your local Social Security office or call toll-free 800-772-1213 and ask for “What You Need To Know When You Get Disability Benefits” Publication No. 05-10153.

Who Provides the Benefit?

Social Security is a federal program supported by tax dollars.

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