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Thursday, July 4, 2013

Social Security Basics: “How long do I need to be off work?”


If you, or a loved one, are diagnosed with a severe or aggressive condition, you may qualify to be immediately approved!

Today's post comes from guest author Lauri Watkins from Causey Law Firm.

One question that I am asked frequently by folks considering applying for Social Security Disability is “How long do I need to be off work?”  This question is based on a slight misunderstanding of the Social Security rules.  Your medical condition, or combination of conditions, that prevents you from working must have lasted or be expected to last a minimum of one year, (or be expected to result in death), in order for you to qualify for Social Security Disability.  That year does not need to have passed, in order for you to file your application.  If your condition is not expected to get better, or if a long course of treatment is planned that would take you out past one year, then you can file your initial application.  If there is clear medical evidence that you will be unable to work for at least a full year, there is no need to wait for the year to elapse before starting!
If you have not been off work for an entire year, but your condition is expected to last at least that long, you should apply right away.
      If your condition is not expected to get better, or if a long course of treatment is planned that would take you out past one year, then you can file your initial application.  If there is clear medical evidence that you will be unable to work for at least a full year, there is no need to wait for the year to elapse before starting!

     If you have not been off work for an entire year, but your condition is expected to last at least that long, you should apply right away. Benefits can’t begin until you have been disabled for five months, and an initial application usually takes 3-5 months (sometimes longer) to process, so the sooner you file your application, the sooner you may get your benefits.

     Of course, Social Security may deny your claim initially anyway, in which case you should appeal the decision.  We have had several clients who hit the one-year duration mark while we were in the appeals process.  A Social Security claim can take up to two years (sometimes longer) from the initial application until adjudication at a hearing, so the sooner you start, the better.

     If your diagnosis is terminal, Social Security will make every effort to expedite the processing of your claim.  I find it heartening that we don’t receive many inquiries for assistance from people with terminal conditions; I take this to mean that Social Security is doing the right thing and approving them right away.

     Social Security has a list of conditions that are automatically approved, called Compassionate Allowances Conditions – if you, or a loved one, are diagnosed with a severe or aggressive condition, you may qualify to be immediately approved!  Check the following list at Social Security’s website:
http://www.ssa.gov/compassionateallowances/conditions.htm

     When you file your application, be sure to point out that you believe your condition is on the list.

     I also receive calls with a variation on this question, from folks who are still working: “How can I get my Social Security started, so I can stop working?”  This call is not from people who are attempting to somehow ‘game’ the system, but rather folks who have been told by their doctors that they should stop working, or people who know that their work activity is exacerbating their medical conditions – but who can’t afford to stop working without a guarantee of income.  Unfortunately, this is one of the many Catch 22s of the Social Security Disability world – there is no way to get your benefits started up, until you stop working*. 

     One of the first things that Social Security will do, when you file your application, is look up your recent and current earnings.  If you are still working at a level considered above SGA (Substantial Gainful Activity), then they will not even order your medical records.  The fact that you are working, proves that you can – whether or not your doctor has said that you shouldn’t, whether or not you are in pain, whether or not working is causing your condition to get worse.

     Please, do not hesitate to contact us if you have questions about Social Security Disability.

*There is a level of earnings under which Social Security doesn’t count your income against you; this level is called “Substantial Gainful Activity”, and it can vary from year to year. In 2013, earnings under $1,040 per month are considered less than Substantial Gainful Activity, though any earnings will cause Social Security to more closely scrutinize your claim (considering, for example, whether you could perform your currently part-time job on a full-time basis, etc.).  A year-by-year look at the Substantial Gainful Activity amounts can be found at http://www.ssa.gov/oact/cola/sga.html

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