The application process for Social Security Disability Insurance benefits has been designed to be intimidating. The New Jersey Social Security Disability lawyers understand that most claims for benefits are denied, and these denials can cause a lot of financial struggles for the applicants.
Individuals that are already unable to work because of a disability face additional struggles when their claims are denied. Thankfully New Jersey Social Security Disability lawyers are here to help. When you have been denied Social Security Disability Insurance (SSDI) benefits, your attorneys can help you successfully win the appeals process.
In fact, your lawyers encourage you to contact one of our qualified SSDI attorneys before you begin the process so that they can help you right from the start. The knowledge of the Social Security system allows them to help their clients make a successful claim for benefits.
How To Apply For Social Security Benefits In New Jersey
When you have been involved in an accident that causes a disability, or if your doctor diagnoses you with the condition that is considered a disability, you should begin the application process for Social Security Disability (SSDI) benefits. You can begin the process online through the Social Security Administration website, or by calling the Social Security office and requesting an appointment with a representative.
The Social Security Administration (SSA) will appoint a case representative for you when you apply. This representative will manage your application, request documentation, and ultimately decide if you qualify for benefits. Your representative will evaluate what programs you are qualified under and if you have enough work credits to claim benefits.
The representative of your application is not exclusive. They handle many different cases each day. It is very easy for paperwork, requests, and general mix-ups to occur if you are not prepared for the application process.
SPEAK WITH AN ATTORNEY before you file for SSDI. The lawyers have a working knowledge of the application process and know exactly what you need and when you need to file the paperwork so that your case processes smoothly.
Types of Social Security Disability Benefits
There are three main categories that people can make a claim for benefits under the Social Security Disability program. These programs should not be confused with Supplemental Security Income (SSI), a program designed to help lower-income families that are caring for disabled children or lower-income retirees that may need income assistance.
Disability Insurance Benefits – SSDI
This is the most common form of disability payment. This program is available to any person who held recent employment but is now considered disabled. This is a very common program for people who have been involved in an accident or have recently been diagnosed with a debilitating disease.
To be eligible for the program, applicants must show that they worked a minimum of five out of the last ten years. In Social Security terms – the applicant must have at least 20 work credits. A person earns four work credits per every full year that they work.
SSDI benefits may also be available for the spouse and dependent children if the parent is approved for benefits. The number of benefits that are received is based on your work history and your earnings.
Disabled Adult Child Benefits
A disabled child between the ages of 18 and 22 may qualify for SSDI benefits if their parent is currently receiving Social Security disability benefits, Social Security retirement benefits, or if their parent is deceased.
Disabled Widow or Widower
Any person over the age of 50 who becomes disabled after their spouse has passed away may qualify for disability benefits. To qualify for benefits, the marriage must have been in place for a minimum of 10 years, and the living spouse must have become disabled within seven years of their spouse passing away.
Supplemental Security Income For Disabled Children
Supplemental Security Income (SSI) is often available to families that have a disabled child and limited income and resources. If approved, these benefits are paid for the entire period that the child is disabled. Parents do not have to be disabled or receiving benefits to continue receiving assistance for their children.
To qualify for SSI for a disabled child, the child must meet the following guidelines:
- The child must have limited functioning due to severe physical or mental disabilities.
- These disabilities have lasted for at least 12 consecutive months
- The disability will most likely be the cause of their deaths
- The disability prevents them from having gainful employment or supporting themselves.
SSI is applied for through the Social Security Administration and is not considered a part of the SSDI or Retirement program.
How Do I Know If I Qualify For Social Security Disability Payments?
The Social Security Administration has created a five-step process for approving Social Security Disability benefits. Each step of the process must be approved before the applicant can proceed to the next step. If all steps are not completed, the application is denied.
Step One – Is The Applicant Currently Employed?
If the applicant is not employed due to their disability, the application is automatically forwarded to the next step for review. If the applicant is working, the administrator of the case will determine if the applicant falls within the SSA guidelines for benefits.
As of 2019, the MOST that an applicant can make each month is $1,220 dollars and still be considered for Social Security Disability benefits. If you are working at all, your case administrator will carefully review your claim for disability before approving it to go to the next step. If there is any chance that you could be gainfully employed, or make more than this amount each month, the administrator may stop the claim at this point.
Step Two – Severity of the Medical Condition
The case administrator will review the disability that is claimed and determine if that disability has prevented the applicant from performing their job duties for at least the previous year. If it is determined that the disability or condition is inhibiting work performance, the administrator will send the case to step three.
Step Three – Is the Medical Condition on the List Of Disabilities?
The Social Security Administration has a list of medical conditions that they feel inhibit the ability of a person to work. Although some of these conditions may be considered common, the SSA will look at the severity of the condition that the person is suffering. Some of the conditions include:
- Mental Disorders. This includes conditions such as PTSD, Autism, Panic Attacks or Anxiety, Depression, Bi-Polar Disorder and Schizophrenia
- Musculoskeletal Disorders. This would include conditions like Spine and Back conditions, Fibromyalgia, Amputations, Arthritis, Scoliosis, Carpal Tunnel Syndrome
- Skin Disorders. Including Burns and Scar Tissue, Psoriasis and Ichthyosis
- Senses. Loss of Sight, Hearing or Speech
- Neurological Disorders. Including Epilepsy, Parkinson’s Disease, Cerebral Palsy, Stroke or Traumatic Brain Injury (TBI)
- Cardiovascular Disorders. Heart Failure and Cardiovascular Disease
- Endocrine System Disorders. Diabetes, Neuropathy, Obesity and Thyroid Disorders
- Respiratory Illnesses. Asthma, Cystic Fibrosis, Emphysema, Primary Pulmonary Hypertension (PPH), Lung Transplants
- Blood Disorders. Such as Sickle Cell Anemia and Hemophilia
- Renal Disease. Including Kidney Disease and Failure and the Need for Dialysis
- Multi-Body Impairments. Includes disorders that affect the entire body like Lyme Disease and Metabolic Disorders
- Digestive Disorders. Such as Crohn’s Disease and IBS
- Liver Diseases. Such as Hepatitis and Liver Disease
- Immune Disorders. Including HIV/AIDS, Rheumatoid Arthritis, Lupus and Multiple Sclerosis (MS)
If your injury or disorder is not a part of the list, your administrator will most likely send you to Step four anyway for a review of the injury facts. However, they can deny your claim at this point.
To avoid the delays and potential denial from Social Security Disability, you are encouraged to work with a New Jersey Social Security disability attorney to file your claim for benefits. Your attorney can provide the SSA with the relevant information to show how your claim for compensation is valid, even if your disorder is not on the list.
Step Four – Review Of Condition and Ability to Work
Step four is the crucial point in the application process. Your case administrator will review all of the information that you have submitted and make a decision based on their own opinion if you can return to work or if you are disabled.
It is at this point that over 60 percent of denied applications occur. You must remember that the person reviewing this information is not a medical professional who has a deep knowledge of these medical conditions. Your case representative is someone who was trained to review applications and make a judgment call.
If your paperwork is incomplete, not detailed enough, or fails to show the severity of your condition, your caseworker could simply say “denied.” This is why it is very important to seek legal representation right from the start of the application process.
If your case administrator believes that you are qualified under the guidelines of the program, your paperwork moves to the final step.
Step Five – Is The Applicant Capable Of Other Work?
The final step of the review process will determine if you are capable of doing any other type of work. Your case representative will look at your age, job history and positions, education, and potential in the job market to determine if there is other work you could do instead of your current position.
If it is found that you are not qualified for another position, the administrator will approve the disability rating and your claim. If the administrator finds that there are other job opportunities available that will meet the needs of your condition, they may deny your claim.
If your claim has been denied, you will be given a chance to appeal the denial. You have a limited time to appeal the decision. If you have received a denial from Social Security for disability benefits, speak to an attorney today.
Our new Jersey Social Security Disability lawyers can help you build a solid case for your appeal. Your attorney will be able to help you file your appeal and seek compensation for the back payments you should have received once your appeal has been approved.
Additional Reasons Your Claim For Disability May Be Denied
There are some reasons that you may be denied Social Security Disability benefits that are not directly related to your physical disability. These reasons include:
Potentially – Past Convictions
In general, being convicted of a crime does not disqualify you automatically from receiving disability benefits. However, there are some circumstances where a prior conviction may lead to your disqualification from this program.
- If the injury or condition was a result of actions taken during the commission of a crime
- If the condition was acquired or made worse while incarcerated
- You have violated probation or parole
- You have purposefully widowed or orphaned yourself so that you can receive benefits
Your Disability Is Related To Alcohol or Drug Addiction
If drug or alcohol abuse is the main contributing factor to the disability, you will not qualify for disability payments.
Refusal To Cooperate With SSA Medical Requests
The Social Security Administration relies heavily upon the medical information that you provide with your application to make a determination about your disability. If you refuse to submit records, have requested exams, or get an exam from an SSA doctor, you will be denied benefits. Missing appointments is also seen as a refusal for medical evaluations, so it is important to keep all scheduled doctors’ visits.
Short Term Disability
If your injury or condition will not last for at least 12 months, the SSA sees the condition as a short-term disability. Social Security disability is only available to those whose condition will last longer than one year or will eventually lead to death. The only exception is accidents or illnesses that cause blindness. Blindness qualifies for immediate benefits.
If the SSA suspects in any way that you are committing fraud, that your application contains fraudulent medical information, or that you are trying to obtain benefits under a fraudulent name, you will be denied benefits. In some cases, legal action will be taken.
What Happens If Your Claim For Disability Benefits Is Denied?
If you receive a letter in the mail stating that your application for Social Security Disability benefits has been denied, you can file an appeal. By law, you have 60 days to file an appeal with the SSA.
When you file an appeal, your case will go through a four-step process. This process is applied to every appealed case, regardless of why it was appealed. This keeps the appeals process fair to everyone.
It is important to understand that you have only one chance to appeal the decision of the SSA about your disability case. If you fail to file the appeal on time, or if you lose your appeal, you will have to start the process over. This could lead to years of waiting for benefits.
SPEAK TO A DISABILITY ATTORNEY. If you did not have an attorney help you with the initial application process, it is imperative that you have legal assistance through the appeals process.
The attorneys have been very successful in helping people win their appeals for disability. These clients also receive back benefits from the date of their original application once they win their appeal.
Appeals Process Explained
Once you have notified the SSA that you are appealing their decision, your case will move through the following steps:
Request For Reconsideration
The first step that must be taken is to request that the Social Security Administration reconsider your application. During this reconsideration period, your case file will be given to an independent case manager for review.
During the review process, you and your attorney can submit additional evidence to prove your case. This could be additional medical treatments or records or changes to your condition.
Your attorney will respond to any questions that the case manager has about your information. This manager will then give their decision on the case.
If your case was denied by the secondary case manager, your next option would be to request a hearing. Your case will be scheduled to be brought in front of an Administrative Judge for review.
Your lawyer will prepare you for any questions that the judge may ask. They will also have experts ready to testify on your behalf if necessary. Most cases that have been denied up until this point are approved during the Hearing.
However, if your case is still denied, you have additional options.
If your case was denied when heard by the Administrative Judge, you could request an Appeals Council hearing. The Appeals Council is reserved for cases where the applicant feels an error in law has been made.
In most cases, the Appeals Council will not accept the case. They are not required to review any case they don’t believe meets their criteria.
If your case is heard, the Council can award you benefits, deny you benefits, or send you back for a rehearing in front of an Administrative Judge.
If you are denied benefits, you only have one final option.
File A Lawsuit
Your final option if you are denied throughout the entire process is to file a lawsuit in federal court against the SSA. This is a very rare move, and most attorneys will not recommend this action due to the extensive time it would take to win and the exceptionally high costs.
Long Term Disability Insurance
Many people have invested in Long Term Disability (LTD) insurance plans. Some people have this type f insurance through their employer, through their pension plans or have purchased the policy separately for their own protection.
This type of insurance is similar to Social Security Disability because it is meant to supplement income in the event of a long-term disability. Sadly, these insurance companies make the application and approval process almost too difficult to accomplish.
Many LTD policies also stop making payments before the covered party is able t return to work. These policies cite many reasons for doing this, most of which are not really valid.
If you are having difficulties with claiming against an LTD insurance plan, you are encouraged to speak with one of our New Jersey Social Security disability attorneys about your case. Your attorney may be able to help you secure benefits from both your LTD plan and SSDI.
How Can A New Jersey Social Security Disability Lawyer Help Me?
Having an attorney represent your case before the Social Security Administration gives you many advantages. Applicants that use an attorney to help process their claim for benefits have a higher success rate in gaining approval.
Having an attorney will help you:
Prepare Your Case
Your attorney can help you prepare every aspect of your case. They will make sure that you file the appropriate paperwork in a timely manner, including all supporting documentation, and make sure that you have all the necessary medical records you need for a good case review.
Your attorney can manage all communications and requests between you and the SSA. This will ensure that all deadlines are met and that your best interests are always protected.
Finalizing The Claim
Once your claim is approved, your attorney will verify all information to ensure that you are receiving the proper benefits amount and the proper back pay.
If necessary, your attorney can represent your case throughout the entire appeals process.
Your lawyers know that everyone has a different set f financial circumstances, especially if they are currently unable to work. To ensure that everyone has access to quality legal representation, they work on a contingency basis. This means that there is never a fee for the services unless we win.
There is no reason to delay. If you need to apply for disability benefits, or if you need to file an appeal, speak to one of our New Jersey Social Security disability lawyers today.