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Businesses Know That Benefits For the Disabled Usually Denied When First Requested

Businesses Know That Benefits For the Disabled Usually Denied When First Requested

By Terry Cochran

Businessmen, entrepeneurs, and human resource personnel know a lot about SSD and SSI. But the actual applicants know little about the help they are applying for. They should, obviously.

The Social Security Administration pays Social Security Disability (SSD) payments and Supplemental Security Income (SSI) payments to persons who cannot work because of a medical condition or catastrophic injury.

The determining factor between SSI and SSD is income. SSI payments are intended for qualified disabled persons who are at lower income levels and SSD payments for all other qualified disabled persons.

Anyone whose injury prevents them from working and whose disability is expected to last for one year may be eligible for benefits. Application for benefits should be made as soon as possible after becoming disabled because it can take at least three to five months to process the application and longer for a final decision to be made.

A worker should expect that a business manager or entrepeneur will oppose a claim for workman's comp or disability. Do not take it personal; it is a business decision.

Anyone who believes they might qualify for SSD or SSI should go to www.socialsecurity.gov to review requirements, use the eligibility screening tool, and to apply online.

In deciding eligibility the Social Security Administrations considers whether the applicant is working, if the medical condition is severe, if the applicant can perform the work they did before, or if another type of work can be performed. The medical condition also must be on the List of Impairments of the state agency involved in the determination.

Almost 70 percent of all SSD and SSI claims are denied upon initial application. Anyone who has been denied should immediately call an attorney to insure that their appeal is filed in a timely manner and that it meets procedural and legal requirements.

Some applicants choose to work with an advocate rather than an attorney. An attorney, however, is better qualified to work for a client at an SSD hearing because an attorney possesses the training and knowledge needed to have the necessary proofs met at the time of trial. Medical records and depositions must be submitted properly to the administrative law judge to be admitted. Otherwise the judge might not admit important information that is paramount to winning a claim.

An applicant living in a No Fault state who is denied SSD or SSI especially needs an attorney who understands No Fault Law because in most instances medical insurance coverage cannot be made part of a workman’s comp settlement.

Victims eligible for SSD or SSI very likely also qualify for workman’s comp benefits but often some funds in a workman’s comp award have to be paid back to Social Security. An attorney will advise clients on the best way to satisfy this pay-back requirement.

An attorney who specializes in SSD or SSI cases is best suited to walk clients through the legal maze of establishing a Set Aside Trust and paybacks to Social Security when required. Failure to meet either of these requirements will be financially disastrous for victims.

When denied, the victim must file an appeal within 60 days. A hearing before an administrative law judge is then scheduled within a short period of time. The presiding judge will review medical records submitted to determine eligibility. Usually only the victim testifies. An attorney will prepare the victim to testify and make sure that the medical records the judge needs are submitted by the hearing date.

Although workman’s comp and SSD claims go hand in hand, there is no assurance that approval of one benefit will logically lead to approval of the other. It is common that a victim might be approved for Social Security Disability payments but denied a claim for workman’s comp, or vice versa.

Those who eventually receive benefits are patient, determined, and wise enough to seek assistance when initially denied. The process was not intended to be easy and smooth.





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Terry Cochran
(Visit Terry's Website) Terry Cochran is a senior partner in Cochran, Foley & Associates, P.C., a Michigan law firm specializing in personal liability, medical malpractice, and auto and truck accidents (http://www.youtube.com/watch?v=jpF U0CZv4pM). Cochran does not represent insurance companies or corporations but instead bases his practice upon representing individuals and families. www.cochranfoleypc.com

Terry Cochran is a Gold author on EvanCarmichael.com
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