When a person becomes unable to work due to a severe physical and/or mental impairment, she may be eligible for Social Security disability insurance and/or supplemental security income. Often, the process is confusing and overwhelming. We assist claimants with all levels of the process including the initial application. If you need assistance with an appeal, please call the Peña & Bromberg, PLLC. You do not pay a fee unless we win the case. The fee is limited by law to 25% of your back pay up to $6,000.00. If the Social Security Administration has denied your claim, call us right away!
Today, more and more Americans are unable to work and earn a living due to illnesses and injuries. Not only is this a traumatic experience both physically and emotionally, many disabled individuals are left wondering how they will provide for themselves and their families. That’s the bad news.
The good news is that the Social Security Administration (SSA) offers two different benefit programs that provide assistance to the disabled – Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Nonetheless, navigating the vast federal bureaucracy can be complicated and the majority of initial claims are denied. For this reason, it is crucial to have an experienced disability benefits attorney by your side.
Peña & Bromberg, PLC provides comprehensive legal services to the disabled and their loved ones throughout Central Valley, California and across the United States. We are well versed in the complex rules related to disability benefits and patiently guide clients through each phase of the process – from initial application and appeals to administrative hearings and final approvals.
What is a Disability?
According to the SSA, a disability is defined as the inability to engage in any substantial gainful activity (SGA) due to a physical or mental condition that has lasted, or is expected to last, at least one year or result in death. Although there are many medical conditions that seemingly meet the criteria, the SSA maintains a list of qualifying medical conditions in the Blue Book.If your medical condition is included in these listings, or medically equal to a listed impairment, you may be eligible for benefits, however, the application process is complicated. If you do not meet the criteria, there are errors in the application, or any required information is missing, your application will be denied.
What Types of Social Security Disability Benefits are Available?
The SSA offers two types of disability benefits – Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI):
- Social Security Disability Insurance (SSDI) – Offered to individuals older than 18, but under the age of 65, who have paid into the Social Security system through income tax deductions. In order to qualify, it is necessary to have sufficient work credits, which are earned based on the number of quarters the disabled individual has worked each year. These benefits are not “means tested,” which means they are awarded regardless of a person’s financial status.
- Supplemental Security Income (SSI) – Only available to those who are disabled, blind or over 65. SSI is available whether or not the applicant has paid into the Social Security system, however, these benefits are means tested. This means that the applicant’s income and resources cannot exceed a certain threshold – $2,000 for an individual or $3,000 for a couple. The value of a primary residence, however, is not included in this determination.
While this seems straightforward, determining whether you have acquired sufficient work credits or your medical condition qualifies for SSDI is more complicated than it seems. Similarly, there are a number of factors involved in calculating income and determining what assets are considered resources under the SSI program. Understanding these complexities requires the knowledge and skill that Peña & Bromberg, PLC is uniquely qualified to provide.
Disability Benefits: The Applications Process
Applying for disability benefits is complicated since the application must be submitted correctly, and there are also numerous forms that must be included. Additionally, a significant amount of medical information supporting the claim must be provided. This includes doctor’s reports, treatment notes, lab tests, radiological exams and any other pertinent information that will verify the diagnosis and prognosis. In short, it is necessary to show that the claimant is incapable of performing any substantial gainful activity (SGA) due to his or her disability. At Peña & Bromberg, PLC, our legal team routinely guides clients through the disability benefits application process.
Disability Benefits Claim Denials
While these vital public benefits are designed to assist the disabled, the majority of initial applicants, nearly two-thirds in fact, are denied. Although the most frequent reason cited is insufficient work credits, applications are also denied due to errors or because the submitted medical information did not support the claim. At the same time, SSI is only available for those whose financial resources are limited and the method of determining income and assets is complicated.
Disability Benefits Appeals Process
If your Social Security disability benefits application is denied, you have the ability to file an appeal, provided that you act quickly. First, it is necessary to file a request for reconsideration within 60 days of receiving the denial notice. Once this request is received, an SSA medical consultant and an examiner who were not involved in making the initial decision will reevaluate the application. Nonetheless, many reconsideration claims are denied, unless there has been a new diagnosis or the condition has worsened.
If the reconsideration claim is denied, you can then request a hearing before an administrative law judge (ALJ) within 60 days of the denial. An ALJ is not a court judge, but rather an SSA attorney who is authorized to uphold or overturn the denial. Your chances of having a denial overturned by an ALJ are far greater when you have an experienced disability benefits attorney handling your case.
At the same time, appeal denials by an ALJ are not uncommon which leads to the next step, a claim review by the Appeals Council. The Council will either overturn the decision, deny the claim, or send it back to the ALJ for reconsideration. If the claim is denied by the Appeals Council, the final option is to file a lawsuit in federal court and ask a case judge to overturn the decision. As you can see, the appeals process is complex, and there are very strict deadlines at each level which makes it crucial to work with our experienced disability benefits attorneys.
Why You Should Call Peña & Bromberg, PLC
Let’s face it: becoming disabled is an overwhelming experience which can be made even more harrowing when an application for disability benefits is denied. Our dedicated legal team has a proven track record of helping the disabled obtain these vital public benefits and provides ongoing support to ensure that they maintain their eligibility for benefits.
We offer each client legal knowledge and compassion and a superior level of personal service. Over our many years of practice, we have gained recognition as dedicated advocates of the disabled and for helping our clients obtain the benefits they deserve. If you or a loved one needs assistance obtaining SSDI or SSI benefits, call our office today for a free consultation or complete the contact form on our website.
Located in Fresno, Peña & Bromberg, PLC serves clients throughout Central Valley, California including San Francisco Bay, Oakland, Bakersfield, Madera, Stockton, Fresno, Sacramento, & Modesto. The office assists Social Security Disability and Veterans Disability clients nationwide. Member – National Organization of Social Security Claimants’ Representatives (NOSSCR).