Social Security Disability

Some people who receive Social Security or SSI benefits are unable to manage their personal business for themselves. This could be due to a disability or a medical condition. In these cases Social Security will designate another person or an organization to handle their benefits for them. This person is designated their representative payee. Some people think having “Power of Attorney” will entitle them to information, payment, and other dealings with Social Security. Social Security does not recognize “Power of Attorney.” This can be used as a basis for making someone the representative payee.

Representative payees are responsible for using the money from Social Security or SSI benefits for the needs of the individual. They are also responsible for saving any unused money and are required to account for how the money is being spent.

Children are required to have representative payees; this person is typically their parent or the guardian that has custody of the child. Whenever a child is approved for benefits from Social Security or SSI their parent or guardian is required to complete the representative payee application and present their identification in the Social Security office.

An adult that is determined to be incompetent will also be required to have a representative payee. The determination that an individual needs a payee can be made by the local Social Security office. A person’s family, social worker, or nursing home can also request that a payee be assigned to handle the benefits. If you need to apply to become a payee for a friend or relative, submit the application form SSA-11BK, along with your identification in your local Social Security office. Most payee applications require a face to face interview.

Representative payees are required to use the money from Social Security and SSI to meet the needs of the person receiving benefits. This includes seeing to the food, clothing, and shelter needs. Payees are required to save any unused money for future needs. Representative payees are also required to keep Social Security’s records current by reporting any changes of address, marital status, and employment status. They are responsible for seeing to the medical treatment of the individual and any Medicare claims that need to be filed. Payees are required to complete annual reporting of how the money is being used; they are responsible for any overpayments that may arise and ensuring this money is returned to Social Security.

Sometimes having a representative payee can cause a hardship for people receiving benefits from Social Security or SSI. Allegations of fraud and misuse of funds should immediately be reported to the local Social Security office. If you are payee for someone and no longer wish to continue in this role contact Social Security at 1-800-772-1213.

If you are receiving benefits from Social Security or SSI and have a representative payee but wish to manage your money for yourself, you will need to have your doctor write a letter stating you are able to do this for yourself. The doctor’s office will need to fax this letter to the local Social Security office. For more information on becoming your own payee contact Social Security at the 800 number given above.

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To be considered disabled under Social Security you need to have a medical condition that will last for 12 months or longer and prevent you from working in any capacity. Social Security Disability is considered long term disability and does not provide benefits for short term disability. Additionally, Social Security does not award partial disability like the Veteran’s Administration; under Social Security you are either 100% disabled or you are not.

In addition to the medical requirements for Social Security disability you need to have worked in jobs that pay the taxes for a minimum of 5 of the last 10 years prior to the onset of your disability to be insured under Social Security. Even if you are not currently insured for Social Security Disability you may still qualify if you met the insured status requirements prior to when you became disabled. For younger workers Social Security does make some adjustments to the 5/10 rule; to find out if you qualify based on the work history you have contact a Social Security representative at the national 800 number given below.

One way to check if you are currently insured for Social Security Disability is to look at your Social Security Statement. On page two of the statement it will tell you if you have enough credits earned on your work record to qualify for Social Security Disability, and gives an estimate of your benefit amount. Again, Social Security makes some exceptions for younger workers. Because a disabled younger worker has less potential to earn credits under Social Security they typically receive a higher amount for the work that they do have.

Assuming that your doctor has told you that you will be out of work for 12 months or longer (or you have a terminal condition) and you meet the work requirements for Social Security Disability, you need to file an application. There are several ways to file. If you are already familiar with the Supplemental Security Income (SSI) program and know that you do not qualify based on your household income or money you have in the bank, the simplest way to file is online at Social Security’s website. (See the link below)

If you are unfamiliar with the SSI program or would like a determination for SSI, you need to call Social Security’s national 800 number and speak to a representative. Before you call you’ll need to gather some information. The representative will need to know the date that you first became disabled, what the nature of your disability is, and when you stopped working. They will also need to know if workmans compensation is involved through your State. Additionally, for the SSI screening, they will need to know how much income your household has per month, and how much money you have in the bank. They also need to know about any investment accounts you have including IRAs, 401k plans, stocks, mutual funds, and CDs. They will need to know how many vehicles you and your spouse own, what kinds of property you own, and how many children you have.

This information is important because SSI is a “need based program” and if you qualify the money you receive is paid from Federal Tax Revenues, not from the Social Security Trust fund. Once you have scheduled your appointment or applied online you will need to provide proof of citizenship or resident alien status. This is done by providing your original birth certificate, passport, or Resident Alien card to the Social Security office processing your claim. This office will provide you an application for signature and a medical release form where you will be required to list all of the doctors, clinics, and hospitals where you have been seen.

After your records are complete in the Social Security office, your case is transferred to your State’s Disability Determination Service (DDS). It is important to know that Social Security does not evaluate your disability or approve your initial claim. The determination that you meet the medical requirements is made by an agency of your State’s government. Once this decision is made, and it typically takes the State 120 days to evaluate you, you will receive a decision letter in the mail.

If you are approved, your case is sent back to Social Security where your folder goes to one of the many regional payment centers that will start your payments. Once you have an approval letter from the state it will take Social Security 30-60 days to process your record for payment. At that time you will receive an award letter from Social Security telling you how much you will receive and when. If your claim is denied by the State agency you will need to file an appeal. This appeal will be reconsideration with the State or a hearing before an administrative law judge depending on the State you live in. For more information on appeals refer to our section on appealing your claim’s decision.

To contact Social Security for scheduling an appointment to file for Disability and SSI call 1-800-772-1213.

To apply for Disability only (not SSI) online visit Social Security’s website at: http://www.ssa.gov/applyfordisability/

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