Social Security Disability

If you are receiving Social Security Disability benefits, (Not SSI) you can work as long as your pre-tax earnings stay below the prescribed limits. (If you receive SSI benefits the rules are different for you; refer to our section on working while receiving SSI payments.) This means you can work and supplement your Social Security check, possibly even get health insurance without worrying about Social Security cutting off your Disability benefits.

The catch is you have to be very careful and monitor your monthly gross income so that you do not go over the limits. If you do go over the limit, Social Security could place you in what they call “Disability Cessation” due to your earnings. If this happens to you they will stop your monthly check and could charge you a hefty overpayment by backdating the time your record went into “Disability Cessation.”

How do you safely work and keep your benefits? Always keep your earnings below the pre-tax limit; in 2006 this pre-tax limit is $860 per month. (If you are blind this amount is higher: $1,450 per month.) This $860 amount is what Social Security refers to as “Significant Gainful Activity” or SGA. If you are working and earning over this SGA amount Social Security figures you can work full time just like everyone else and don’t need Disability payments.

Understand that this SGA amount ($860 for 2006) is the upper limit for your earnings. There is another amount that Social Security tracks when it comes to your earnings. This amount is called a “Trial Work Month.” When you receive Social Security Disability benefits you are eligible for 9 Trial Work Months every five years. A “Trial Work Month” is any month that your earnings are higher than $620 pre-tax. ($620 is amount for 2006)

Trial work months are unique because you can earn any amount you like; these months are not subject to the SGA limit. For example, if you went over the limit one month and earned $1200, you’re still okay because Social Security will count this month as a trial work month. (As long as you haven’t used them all up, remember you only get 9 every 5 years) You can use your trial work months as a safety cushion if you go over the $860 limit. Don’t make a habit of going over because if you use up all your trial work months Social Security will evaluate your disability and could stop your benefits.

To be safe, never earn over the $860 limit. You will use up all of your trial work months doing this; however, Social Security will not stop your benefits or charge you a hefty overpayment. Remember that all of the dollar amounts quoted here are pre-tax amounts; this is before anything is deducted from your gross earnings. As soon as you start working be sure and notify Social Security by calling their toll-free number.

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If you are a disabled widow age 50 or older you may be able to receive benefits off your spouse’s (or former spouse’s) Social Security record. If your spouse or former spouse has recently passed away you should notify Social Security as soon as possible. Contact the Social Security Administration at 1-800-772-1213.

If you are a widow from a spouse you were divorced from, you may still be eligible to receive disabled widow benefits even if you are not eligible for Social Security Disability on your own record. To be eligible you need to have been married to your spouse for 10 years or longer and meet the medical requirements for disability benefits under Social Security. This includes being evaluated by your State disability determination agency. Additionally, your spouse needs to have earned a minimum of 40 credits (40 credits is 10 years of work) from working in jobs that pay Social Security taxes.

If you were married to your spouse when they passed, Social Security does not require that you were married for 10 years. In either case, you will need to provide proof of relationship in the form of your marriage certificate or divorce decree, along with your spouse’s death certificate when you file for benefits. As the surviving spouse you will be eligible for a one time payment of $255. This one time payment is only paid to a surviving spouse or a dependent child.

When you apply for disabled widow benefits the State will evaluate your medical condition. This process typically takes 120 days. If approved, you will be eligible to receive benefits as long as you continue to meet the disability requirements until age 65. At age 65 you may be converted to a retirement benefit on your own record if that amount is higher; if the amount is not higher you will continue receiving widow benefits but will not be receiving them for disability. Disability benefits are not paid after the age of 65.

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If Social Security denied your claim or stopped your benefits for any reason you have the right to file an appeal. What type of appeal you file depends on where you are in the appeals process and what State you are living in.

The appeal process for Social Security is relatively straightforward. The process for appeal is Reconsideration, Hearing, Appeals Council, and Federal Court. If your disability or SSI claim was initially denied by the State, the first step is called Reconsideration.

Request for Reconsideration

Reconsideration means that your claim is sent back to the State disability agency that denied your claim for reevaluation. Your claim will be assigned to a different examiner that had nothing to do with the original decision. The State will reconsider all the medical evidence submitted along with any new evidence have. It takes on average 120 days for the State to evaluate a claim. This 120 day time period applies to initial claims and reconsiderations handled by the State.

Not all states process reconsiderations. There is a pilot program designed to streamline the appeals process that eliminates the reconsideration step and sends your case directly to a hearing. States participating in this pilot program are called Disability Redesign Prototype States. If your initial claim for disability or SSI is denied in one of the Disability Redesign States you will be sent a hearing package to appear before an administrative law judge. These States include:

Alabama, Michigan, Alaska, Missouri, California, New Hampshire, Colorado, New York, Louisiana, and Pennsylvania

Social Security Hearings

If you live in one of the Disability Redesign States listed above or had your request for reconsideration denied by the State agency, your next step in the appeals process is a hearing. Hearings are held in Social Security’s Office of Hearings and Appeals (OHA). At your hearing you and a representative (if you choose one), will appear before an administrative law judge and make your argument as to why you should receive disability and/or SSI benefits.

The administrative law judge you appear before will not have been involved in the prior processing of your claim in any way. After you file the request for a hearing the regional hearing office in your area will contact you to schedule a time for you to appear. This can be a lengthy process; hearing offices are heavily backlogged with cases and it can take over a year to receive a hearing date.

When you attend your hearing you have the right to representation by an attorney and the right to present witnesses on your behalf. You will have the opportunity to review your files and present new information pertinent to your case. Your doctor, relatives, caseworker, and attorney can all attend the hearing and speak on your behalf. It is not required for you to attending the hearing; however, it is in your best interest to go.

After your hearing is held it usually takes the administrative law judge 30 to 60 days to render a decision. You will receive a letter advising you of the decision at that time.

Social Security Appeals Council

If you receive an unfavorable decision at your hearing, the next step in Social Security’s appeals process is review by Appeals Council.

The appeals council will review your request for review. The appeals council may not take your case if they agree with the decision made by the administrative law judge. If the appeals council decides to accept your case for review they will either render a decision or send your case back to the hearing office for another review. You will receive a letter with the outcome of the Appeals Council review usually within 60 days.

If the appeals council refuses to take your case or denies your appeal, the final step in the appeal process is to file your case in Federal Court.

Federal Court

The final step in Social Security’s appeals process is to file against the Social Security Administration in Federal Court. You will need an attorney to assist with your case in Federal Court.

You have the option of filing a new claim at any time after the reconsideration state in addition to your appeal rights. If your new claim is approved and you then receive a favorable decision for your appeal, Social Security will back pay you to your original filing date for the first claim.

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