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Winning SSDI Benefits: Expert Advice

Part 3 of 4 - Guide To Winning SSDI Benefits On The First Try

By Carol & Richard Eustice, About.com

Updated: May 29, 2006

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Question: Many people who are not ready now to apply for Social Security Disability realize that it most certainly lies in their future. What recordkeeping can they be doing already which will help make the application process easier when the time comes?

Stan: The scope of this question should probably be limited to those still working full time who believe it is only a matter of time before their health forces them to quit. If one is not working due to a disability, and considering Social Security Disability, they should probably go ahead and file.

The steps that the "working wounded" should take include the following:

  • Explore whether long-term disability benefits are available through their employment. If available, get a copy of the policy and review what is required to qualify.
  • Discuss the situation frankly with your physician. Ask her whether she thinks you should continue to work, whether she would support your disability claim, etc.
  • Review your financial situation. Most Social Security Disability applicants continue to wait at least two years to win their disability claim.
  • Question: Do you turn down a potential client if you believe they have no chance of being awarded SSDI?

    Stan: Since attorneys receive a fee only if the claim is won, it is impossible to stay in business and represent claimants with meritless claims.

    Question: What are your fees? Do you only collect if your client is awarded SSDI?

    Stan: All fees collected by an attorney in representing a Social Security Disability applicant must be approved by the Social Security Administration. Fees are not approved by Social Security if the claimant is not awarded benefits. Attorneys typically charge the lesser of 25% of back benefits or $4000, whichever is less. (Editor note added 2006: The fee specified in the agreement does not exceed the lesser of 25 percent of the past-due benefits or $5,300. For fee agreements approved before February 1, 2002, this maximum dollar limit was $4,000.)

    Question: What are the problems encountered if a person applies too soon for SSDI, or on the flip-side, waits too long to apply for SSDI?

    Stan: I have never seen a claimant make a mistake in filing too soon. Since the legal definition of disability under the Social Security Act requires that the disability last or be expected to last 12 months, claimants who have not been out of work for 12 months are uniformly denied benefits by social security on the ground that their disability does not meet this "duration requirement". Yet because the system is so backlogged it is a mistake for a claimant to delay filing until he or she has been out of work 12 months. A disability claim can always be withdrawn if you get better and get back to work within 12 months. Our advice in general is to file for disability benefits as soon as your disability forces you to leave the job, and you think you might be out of work due to disability for at least 12 months.

    Question: If a person is collecting SSDI and later finds a job they can do, the person must go through a trial work period. Could you briefly describe what Social Security considers a trial work period?

    Stan: The trial work period (TWP) is a 9-month trial work period to "test" ability to work. In a TWP month the claimant continues to receive SSDI benefits even he is performing "substantial gainful activity" ("SGA", generally more than $700 a month from employment). Once a claimant has completed 9 months of trial work in a rolling 60 month period, the claimant will not receive Social Security Disability benefits for months in which he performs SGA. The Ticket to Work and Work Incentives Improvement Act, (the "RTW Bill") signed by President Clinton on December 17, 1999 makes important changes to Social Security work incentives and the implementation of the various provisions of this bill occur over several years. Claimants on Social Security Disability and considering a return to work should carefully consider the decision with a full understanding of the present situation.

    Go On To Part 4 --- Guide To Winning SSDI Benefits --->

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