Initial Level:

You apply for SSD and/or SSI or for your child for child’s SSI, and it generally takes on average four (4) months to receive a decision in the mail. It can be a lot less or possibly more time to wait for the decision. You will receive the decision in the mail. If you are denied, you have sixty (60) days from the date of the denial to appeal the decision and file a Request for Reconsideration and other paperwork. You can file the appeal at your local SSA office or online at www.socialsecurity.gov.

Reconsideration Level:

This stage again takes on average four (4) months, but it can take less or more time. If you are denied at this stage, you will again have sixty (60) days to appeal the decision from the date of the denial, and you’ll need to file a Request For Hearing and other paperwork. You can file the appeal at your local SSA office or online at www.socialsecurity.gov.

Hearing Level:

A hearing is generally scheduled within 10-12 months from the date your Request for Hearing is processed by SSA; you will have received a notice from SSA when your Request for Hearing has been processed. During this time, it is extremely important for you to receive medical treatment for your health conditions and honestly explain to the doctor’s how you are feeling, including pain levels and limitations you have, if any, at your appointments.

Following the hearing, if you receive an unfavorable decision from the Administrative Law Judge, you will have two choices. First, you have sixty (60) days to file an appeal to the Appeals Council, or your second choice is to file a new application and begin again. There are factors to consider when deciding. You do not get to file an appeal and file a new application; it is an either or decision since the law changed on this issue.

Appeals Council:

This is all done in writing, and they are not in the State of Florida; however, since it is all in writing, you and an attorney, if you hire one, do not go to discuss the case with the Appeals Council. It takes on average 1.5 years to receive a decision from them.

Federal Court:

If denied at the Appeals Council, you have sixty (60) days to file suit in Federal District Court. This is essentially a paper appeal, as you will not have a hearing in federal court. You will also need the In Forma Pauperis application (to request that the filing fee be waived because you are indigent), if don’t have an attorney.

Filling out the appeal paperwork can feel like a complex and tedious task to anyone. Yet, it can feel extremely overwhelming and difficult to complete if you are in severe pain, have fatigue or have difficulty concentrating or memory problems related to your health condition(s).

After you have been denied, you have sixty (60) days plus five (5) days for mailing from the date you were denied (located in the upper right-hand corner of the denial letter) to file your appeal. A lot of people do not file the appeal in a timely manner, and your case will be dismissed if you do not file your appeal within the requisite timeline, unless good cause is requested and approved. Most people are so discouraged after they have been denied, and they take it so personally. However, please do not get discouraged or give up from continuing with your Social Security Disability Insurance Benefits and/or SSI case(s). There are so many factors that the Social Security Administration considers at the initial and reconsideration levels (i.e., age, education, work experience and health conditions and limitations associated with them based on medical records and your statements in filling out SSA’s many and various forms), and the Administration Law Judge reviews and considers many factors at the Hearing Level. Thus, it is extremely important to file your appeal within the time deadline to continue your Social Security Disability and/or SSI case(s), and you should not give up. To file the appeal, you can do so by going to your local SSA office (can locate the closest office by going to www.socialsecurity.gov and typing in your zip code into the SSA office locater), going online to www.socialsecurity.gov, or calling SSA’s national phone number 800.772.1213.

After you have been denied, you have sixty (60) days plus five (5) days for mailing from the date you were denied (located in the upper right-hand corner of the denial letter) to file your appeal. A lot of people do not file the appeal in a timely manner, and your case will be dismissed if you do not file your appeal within the requisite timeline, unless good cause is requested and approved. Most people are so discouraged after they have been denied, and they take it so personally. However, please do not get discouraged or give up from continuing with your Social Security Disability Insurance Benefits and/or SSI case(s). There are so many factors that the Social Security Administration considers at the initial and reconsideration levels (i.e., age, education, work experience and health conditions and limitations associated with them based on medical records and your statements in filling out SSA’s many and various forms), and the Administration Law Judge reviews and considers many factors at the Hearing Level. Thus, it is extremely important to file your appeal within the time deadline to continue your Social Security Disability and/or SSI case(s), and you should not give up. To file the appeal, you can do so by going to your local SSA office (can locate the closest office by going to www.socialsecurity.gov and typing in your zip code into the SSA office locater), going online to www.socialsecurity.gov, or calling SSA’s national phone number 800.772.1213.

It is a complicated process that the SSA follows for determining whether you are disabled under the Social Security rules. It is basically a five-step process which is followed.

STEP ONE:

SSA must first determine whether the claimant is engaging in substantial gainful activity (SGA). SGA is defined as work activity that is both substantial and gainful. Generally, they are defined by the amount of money a person earns in a month and the kind of work they are doing. Generally, if an individual has earnings from employment above a specified level set out in the Social Security Regulations, it is presumed that the claimant has the ability to engage in SGA. If the claimant engaged in SGA no matter how severe their health conditions are, they will NOT be disabled. However, if the claimant is not currently engaging in SGA, then proceed to step two.

STEP TWO:

SSA must determine whether the claimant has a medically determinable impairment that is “severe” or a combination of impairments that are “severe.” An impairment is severe or a combination of impairments are severe under the Federal Regulations if it significantly limits an individuals ability to perform basic work activities. If the claimant does not have a severe impairment or combination of impairments, they are NOT disabled; if so, the process continues to step three.

STEP THREE:

SSA must determine whether the claimant’s impairment or combination of impairments meets or medically equals a listing in the Federal Regulations. If the claimant meets or medically equals a listing, the claimant is found disabled. If not, then proceed to step four.

STEP FOUR:

It is assessed whether the claimant has the residual functional capacity to perform the requirements of their past relevant work (work over the past 15 years). The SSA uses the Dictionary of Occupational Titles to assess and classify the type of work the person did at the following levels: sedentary, light, medium, heavy and very heavy.

STEP FIVE:

Generally, the Administrative Law Judge at this step will assess whether the claimant is able to do any other work, and they will consider the following to do so: residual functional capacity, age, education and work experience. If they are found to be able to do other work, they are NOT disabled. If they are found to not be able to do any other work and meet the year requirement (part of definition for disability), they will be found disabled. The burden of proof shifts a bit during this stage from the claimant to SSA.

It is important at steps three to five to have all updated medical records and medical statements from your treating physicians submitted to the Administrative Law Judge at the hearing level so they’ll be able to make a decision based on all the medical records and the claimant’s testimony

Generally if you received a fully favorable decision at the hearing level for a SSD case, you’ll receive your first check within sixty (60) days from the date of the decision. However, it’ll take longer if you have a SSI case because the local SSA office will need to have an interview with you to determine if you meet the non-medical eligibility requirements.

If you are approved for SSI, you will be entitled to Medicaid. If you are approved for SSD, you will be entitled to Medicare, after a waiting period is completed.

You have to be a U.S. citizen or national, or in one of certain categories of aliens. In general, however, an alien who is subject to an active warrant for deportation or removal does not meet the citizenship/alien requirement.

We do not fill out all of the forms for clients. We do review them and check the answers, depending upon which form or questionnaire. The general rule is that the forms will not win a case, and the medical proof is what does. However, the forms can be a basis for denial, and we help to limit that risk.

You do not have to be represented by an attorney on your case; it can be a non-attorney representative. However, it can matter if you are represented by an attorney or not. SSA’s own statistics show that claimants with lawyers win more often than those who do not have an attorney. Unlike a non-attorney representative, an attorney representative will have formal educational and legal training, probably have legal malpractice insurance and be aware of deadlines for appeals to federal court and may be admitted to federal court. The fee is the same whether you retain an attorney or non-attorney representative.

• Request medical records to support your case.
• Send your treating physicians medical statements that are based on your individual health conditions and limitations associated with them.
• Become familiar, if not already, with your health conditions.
• Attend a hearing with you and argue your case before an Administrative Law Judge.
• Correspond and assist in communication and appeals, with your approval and permission, to the SSA.
• Cross examine the vocational expert and medical experts at the hearing.
• Prepare a pre-hearing brief, post-hearing brief or other memorandum, as needed.
• An experienced attorney will know what has to be proven to win your case.
• Prepare you for your hearing and explain to you what types of questions may be asked of you and what takes place during the hearing.
• Familiar with the procedures at all levels of the process and familiarize you with them.
• For Child’s SSI cases, review the medical records and send needed medical statements to treating physicians and may suggest seeking other types of medical treatment given the health conditions, obtain school records, discuss the behavior of the child with teachers and others, obtain updated medical records to prove the health conditions, including testing if has an IEP or other accommodations with the school system. Prepare the parent and child, depending upon their age, for the hearing.
• Answer your questions during the process, after denials and if approved, and we’ll overall explain things to you throughout the process.

If you’d like to have a FREE consultation, please feel free to fill out our online form or you may contact us at (727) 822-7121.

In these types of cases, the income of the parents who reside with the child is deemed to be available to the child. Generally, if the child’s parents are among the working poor, the child will be able to obtain benefits. However no matter how disabled the child, if the parents may be described as being among the middle class, he or she will receive little or no benefits paid no matter the severity of their health conditions.

No, it is a bit different, and the standard for childhood disability was heightened considerably as part of “welfare reform” in 1996. It is very important to receive medical treatment for all of the child’s health conditions like on Adult SSI and DIB cases. To qualify for SSI, a child must have a medically determinable impairment resulting in “marked and severe” functional limitations. Yet, the domains of functioning are extremely important to try to prove that the child functionally equals a listing, especially if the child’s physical or mental impairment does not meet or medically equal a listing. As a result, it is very important to have all of the school records, medical statements from treating physicians and specialists to prove if the child has an extreme limitation in one domain of functioning or two marked limitations in the domains of functioning. Under that definition of disability, SSA consistently denied a majority of all child applicants as shown in a GAO study from 2000-2011. See The GAO report, Better Management Oversight Needed for Children’s Benefits, GAO-12-497 (June 26, 2012), and it is available at http://www.gao.gov/products/GAO-12-497.

A child must prove that he or she meets a Listing or medically equals or functionally equals a Listing . A child claimant can “functionally” equal a Listing if they have marked limitations in two (2) domains of functioning or one (1) extreme limitation in a domain of functioning. There are six (6) domains of functioning in total, and they are the following: Acquiring and Using Information, Attending and Completing Tasks, Interacting and Relating with Others, Moving About and Manipulating Objects, Caring for Self, and Health and Physical Well Being.

Mental impairments are the leading cause, and overall approximately 65% of all cases were approved overall from 2000-2011. Yet, those that were approved had multiple impairments. For example, 74% of children with ADHD found eligible for SSI had at least one other impairment, i.e., oppositional defiant disorder or a physical health condition. See The GAO report, Better Management Oversight Needed for Children’s Benefits, GAO-12-497 (June 26, 2012), and it is available at http://www.gao.gov/products/GAO-12-497.

It has been shown statistically that a person who is represented by a Social Security attorney has a higher percentage of being approved for benefits. Attorney Amy Bellhorn represents Social Security Disability (SSD), Supplemental Security Income (SSI) and Child’s SSI clients at the following levels: initial, reconsideration, hearing before an Administrative Law Judge, Appeals Council and Federal Court. Attorney Amy Bellhorn is only one of a few attorneys in the Tampa Bay Area that practices Child’s SSI. Should you decide to hire our law firm who represents people in Tampa and Clearwater/St. Petersburg and surrounding cities, you will have a licensed attorney, not a non-attorney representative, attend your child’s hearing with you and handling their case. We also represent client’s throughout the State of Florida and the country, depending upon the stage of the case and if a video hearing can be done if approved by the Office of Disability Adjudication and Review that has the case. If you believe we may be able to assist your child, you may contact us for a FREE consultation by filling out our online form or call us at (727) 822-7121, and attorney fees are paid only if your child’s case is won; there is no up front cost to you, if past-due benefits are involved (i.e., cessation cases do not have past-due benefits and a small up front cost is involved).