Dennis W. Fox & Associates

 " Representing individuals before the Social Security Administration." Call 314-241-9666

 SOCIAL SECURITY DISABILITY

Applying for Disability Benefits
You can apply for disability benefits as soon as you become disabled. Generally, applications may be made by telephone or mail, as well as in person. You may call the Social Security office to see what arrangements can be made. If a disabled person in your family cannot manage his or her own affairs, the application may be completed by a spouse, other relative, friend or legal guardian. You can shorten the time it takes to complete an application and process your claim if you have the following information when you apply: The Social Security number and proof of age for each person eligible; names, addresses, and phone numbers of doctors, hospitals, and institutions that treated you and approximate dates of treatment; a summary of where you worked in the past 15 years and the kind of work you did; a copy of your W-2 or if self-employed, your federal tax return for the past year; dates of any military service and dates of prior marriages if your spouse is applying; and the claim number of any other benefit you receive because of your disability. If you're applying for benefits as a disabled widow or widower, bring the worker's death certificate and proof of the marriage. And if you're applying for benefits as a disabled surviving divorced wife or husband, bring proof that the marriage lasted at least 10 years.

For more information, talk with your local Social Security office or an attorney who is knowledgeable in social security law.

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Disabled Widow and Widower Benefits
When a worker entitled to Social Security Benefits dies, the surviving spouse, age 60 or older, may qualify for survivor benefits. A surviving spouse, age 50 or older, may qualify only if disabled. To be entitled to a widow's or widower's benefit as a disabled widow or widower, the law provides that you must have a medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than twelve months. The impairments must be of a level of severity to prevent a person from doing any gainful activity. There are other benefits which may be available to the surviving spouse and dependent children. If you would like further information on Widow/Widower's Benefits, talk with your local Social Security Administration or with an attorney who is knowledgeable in this area of the law.

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Defining Social Security Disability
The Social Security Administration defines disability as any physical or mental problem that prevents you from working; the condition must be expected to last at least a year, or result in death. Unlike some programs, social security does not pay for partial or short-term disability. It is intended to provide income for you and your family when you are unable to do any type of work for which your are suited. If you've worked under social security in the past, and are now disabled, you or your dependents may be eligible for social security disability benefits. If so, you will receive checks each month. Benefits will continue for as long as you are disabled, and cannot resume work. A person can receive social security disability at any age. If you are getting disability benefits at age 65, they become retirement benefits, but the amount stays the same.

For more information on who qualifies for disability, contact your local social security office.

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Disability Benefits for Children
Children may also be eligible for disability benefits. However, the definition of disability is somewhat different. First, the child is required to have a physical or mental condition that can be medically proven, and which causes marked and severe functional limitations. As with adults, the condition must be expected to last at least 12 months, or result in death. However, if a child is working at a job that is judged to be substantial work, he or she might not be considered disabled. When eligible, there are three ways a child can get disability benefits. They might receive SSI benefits, which stands for Supplemental Security Income.

SSI benefits are payable to children under age 18 who have limited income and resources. Or, a child under 18 may receive social security dependents benefits. The child must be a dependent of a parent who is receiving retirement or disability, or a parent who has died. In this case, the children themselves do not have to be disabled to get benefits. Finally, children could receive benefits as an adult disabled since childhood. In addition to being a dependent, the child must have a disability that began prior to age 22. This would allow them to receive benefits into adulthood.

For more specific information on disability for children, call the government's free information line, at 1-800-772-1213

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Disability Benefits for People with HIV Infection
When they are no longer able to work, people with hiv infection or aids may also qualify for disability benefits. These benefits could come from one of two programs: either social security disability insurance, or ssi - which means supplemental security income. Eligibility for both programs is determined by the same medical rules. However, social security disability covers those who have worked, and therefore paid social security taxes in the past. After receiving social security disability for two years, you may also qualify for Medicare. Medicare helps cover hospital, hospice and home health costs, lab tests, and other services. If you have not worked long enough to be eligible for social security, or have low social security benefits, you might qualify for S-S-I benefits. These benefits are designed for those with low income and limited resources.

People who receive S-S-I will often qualify for food stamps and Medicaid as well. In some states, Medicaid pays for hospice care, a private nurse, and prescription drugs used for H-I-V. However, the type of expenses covered may vary by state.

To find out more about benefits for those with H-I-V, contact your nearest social security office.

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Medicare If you are Disabled

In general, Medicare is designed as a national health insurance program for those 65 and older. However, if you are disabled, you may qualify for Medicare before that age. After a person has received disability benefits for two years, they are automatically enrolled in Medicare. There are two parts to Medicare: the first is hospital insurance, which helps cover a portion of your hospital bills and some other services. This part of Medicare is free, because it's financed by the FICA taxes you paid while working.

The other part of Medicare is medical insurance; it's used to pay doctors' bills and other health care. If you elect to take this part of Medicare, you have to pay a monthly premium. In some cases, disabled widows and widowers under age 65 may also be eligible for Medicare, based on their spouse's work record. If you receive a disability annuity from the railroad retirement board, special rules may apply; check with your local railroad retirement office for details. To find out more about Medicare benefits for disabled persons, contact the Social Security Administration, at 1-800-772-1213.

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Other Disability Benefits
Some disabled persons may also be eligible for other types of government benefits; when this happens, it can affect the amount of social security disability benefits you receive. Some examples of other benefits include worker's compensation, black lung or disability payments from certain local, state, and federal government, military or civil service programs. In most cases, the total combined payments to you and your family from social security and any of these other programs cannot be more than 80 percent of your average salary before you were disabled.

However, there may be some exceptions. If you will be receiving more than one type of disability payment, contact the social security office. They can help you determine if these payments will reduce the amount of social security disability you can receive.

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Rehabilitation
The social security and S-S-I programs have special work incentives, to help disabled persons who want to resume working. One of these is a vocational rehabilitation program. If it's thought that rehab will be beneficial for your condition, you'll be directed to a state rehabilitation agency.

Your rehab may include physical therapy, job training, and other related services. Social security covers the cost if you are successfully rehabilitated. While in rehab, should you recover so well that you will probably be able to support yourself, you can still receive disability benefits until the program ends.

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Reviewing Your Disability
Those who receive disability benefits are periodically reviewed, to determine if they are still disabled. How often you're reviewed depends on the nature and severity of your condition, and whether it's expected to improve. When improvement is expected, your first review is usually six to 18 months after you became disabled. When improvement is possible but unpredictable, review happens about once every three years. If improvement is not expected, a review is done every five to seven years. When it's time for your next review, you generally receive a letter in the mail. The letter will ask you to answer certain questions about your condition. Sometimes, the agency may decide your case needs no further review at this time. In other situations, they may request a full medical review, at which you must appear. You'll need to take any documents relating to medical treatment or work performed since the last review. A disability examiner and a doctor will carefully study all the facts involved. If you have more than one disabling condition, reviewers will look at the total effect upon your ability to work. Usually, the final decision is based on evidence from your doctors, hospitals or clinics.

For more details on disability reviews, contact the social security office.

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What is SSI?
S-S-I stands for Supplemental Security Income. Some people confuse S-S-I with social security disability, because both are handled by the Social Security Administration.

However, the programs are not the same. Social security disability insurance is funded by workers and employers; you qualify based on your work history. S-S-I is financed by general tax revenues, and is not dependent upon your work record. You may be eligible for S-S-I benefits if you have a disability, don't own much, and have limited income. Under S-S-I, income can include many items, such as cash, checks, gifts, inheritances, and food, shelter or clothing given to you by an individual. The property you own will also affect your ability to qualify for S-S-I benefits. Generally, a single person can own up to $2,000 worth of goods; a couple can have up to $3,000 worth. But not everything you own is counted. For example, your home and the land it's on do not count. Household goods, personal property and a car may not count, depending on how valuable they are. However, the government does count things like bank accounts, stocks and bonds.

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Rules for Blind People
Social security considers a person to be blind if your vision cannot be corrected to better than 20/200 in your strong eye, or if you have a visual field of 20 degrees or less, even with corrective lenses. Because blindness seriously affects your ability to work, many rules regarding disability benefits are different for the blind. For example, when a blind person is between the ages of 55 and 65, a more lenient rule is used to determine their eligibility. The person must only show that they cannot do the same or similar work they did before age 55, or before they became blind, whichever is later. The usual rule says that a person must be unable to do any reasonable type of work. There are also special rules for blind workers. If you receive social security benefits while working, you will generally have a higher earnings limit than the $500 per month allowed for non-blind disabled workers. Check with social security for current figures. Also, certain work expenses like a seeing-eye dog can be deducted, when calculating your earnings limit.

To find out more about rules for the blind, contact the social security office; ask for their publication titled, if you are blind - how we can help.

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Benefits for the Self-Employed
If you're self-employed, there are some rules you'll need to know, regarding social security benefits. As long as you make at least $400 net per year, report this income, and pay social security taxes on it, you can be eligible for all social security benefits. You'll receive work credits each year, just like a standard employee. What's more, you'll also retain any credits from previous jobs. A self-employed person who has worked long enough and recently enough will qualify for retirement benefits, survivor's benefits, disability, and Medicare hospital insurance.

However, your earnings must be reported on your federal income tax return, schedule se.
If you make less than $400, there are optional methods of reporting, that may allow you to receive social security credit. Ask the I-R-S for details. When you're self-employed, you must pay both the employer and employee share of social security tax, currently 15.3 percent of net profit.

Even if you don't owe any income tax, you still need to file a return. It's important that social security have a complete and accurate record of your work history: your future benefit amounts will be based on this record.

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Signing Up for Disability
As soon as you become disabled, you may apply for disability at any social security office. You may also apply by phone or mail. The claims process for disability usually takes longer than for other social security benefits. So the sooner you apply, the better. Here are some ways to speed up the process. Be sure you have the social security number and proof of age for each person who is applying. This includes your spouse and children, if they are also filing for benefits. You'll need the names, addresses and phone numbers of your doctors, hospitals and other health care providers, plus the dates of treatment. List the names of all medications you are taking. Obtain copies of medical records from your doctors, therapists and caseworkers, as well as lab or test results. You'll need to give a summary of where you worked in the last 15 years, and what type of job you did. Take a copy of your w-2 form, or your federal tax return, if you're self-employed.

The social security office will help you fill out all the necessary forms. They can also help you get the information you need, to process your claim.

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The Disability and Determination Service
Once your application is submitted to the social security office, it is first reviewed there, to see if you may qualify for disability benefits. Social security looks at factors like your age, how long you've worked, and how recently you worked. If you're a family member applying for benefits, they'll confirm your relationship to the worker. Next, your application is sent to the disability determination services, or dds, office in your state. The dds decides whether you are disabled under current social security law. Your case is examined by a dds team, consisting of a physician or psychologist, and a disability evaluation specialist. They will study the medical evidence from doctors, hospitals and other institutions where you've been treated. In some cases, the dds may request additional medical information. If it is not available, you may need to return to your doctor, for a special exam called a consultative examination.

Social security will pay for the exam and any other medical tests you may need.

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The Review Process
If you're unhappy with the social security administration's response to a claim for benefits, the administrative review process could help you. All requests for review must be submitted in writing, and time limits may apply. First you should request that the initial determination be reconsidered. This "de novo" review will include an inspection of the administrative records as well as supply you with the chance to give new information and evidence for your claim. If there is still conflict you can ask for a hearing before an administrative law judge of the office of hearings and appeals. If you oppose the administrative law judge's decision, you can get a review by the appeals council of the office of hearings and appeals. If you still don't get the results you wanted with the appeals council's action you can file a civil action in a federal district court. If your complaint concerns the constitutionality of the denial of your claim, you may be able to use the expedited appeals process. This will take you directly to a federal district court. Forms for review requests are available at any social security office and you should call your nearest social security office for further information.

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Work Incentives - Trial Work Period
Whether you're a disabled person entering the work force for the first time, or trying to get back to work, social security provides a number of incentives to help you. One such incentive is called the trial work period. For a total of nine months, you are allowed to earn as much as you can, without affecting your disability benefits. Though the nine months do not have to be consecutive, they must fall within the same five-year period. Any month in which you earn over $200 is counted as a trial work month. For those who are self-employed, a trial month is one with earnings over $200, or one in which you worked over 40 hours in your business. At the end of the trial work period, your work is evaluated to see if it is substantial. If your wages average less than $700 per month, benefits will usually continue. If you are earning more than $700 a month, generally, this is considered substantial work. In that case, your benefits would be paid for three more months, and then stop.

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You have hired a Household Worker
A household worker is someone you hire to work in or around your home: for example, a nanny, a maid, a cook, or a gardener. If you pay a household worker $1,100 or more in cash wages during a year, you are required to pay their social security and medicare taxes, and report the wages on your tax return. This includes any cash you pay for their transportation, meals, or lodging. In order for your household employee to be eligible for social security and medicare some day, you must have paid the necessary taxes to the irs. As their employer, you contribute half of the social security and medicare taxes, which is 7.65 percent of wages up to $68,400. The other half of these taxes is withheld from the employee's paycheck.

There are some exceptions to these rules. Household workers under age 18 are usually exempt from social security tax, unless household work is the employee's primary occupation. However, if you run a hotel, boarding or rooming house, all wages you pay to employees must be reported, even if they earn less than $1,100 a year.

For more details on your tax responsibilities when hiring a household worker, contact the social security office, or the I-R-S.

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