Social Security / Disability

We have handled social security disability and SSI cases since 1978.

In 1935 Congress passed the Social Security Act which provided retirement benefits to working Americans. Since that time the vast majority of Americans have relied upon these benefits either in whole or part to fund their retirement.

In 1956 Congress added Title II benefits to the Social Security Act. These benefits are known as social security disability benefits, or SSDI. The idea behind this provision of the law was that for the workers in our country who can’t make it to the finish line of full retirement age (66 years and 10 months) because of a disabling injury or illness, benefits should be available to them earlier than at full retirement age. In 1972 Congress added Title XVI, which provided SSI benefits to Americans who are poor and disabled.

There are other provisions that have been added to the Social Security Act to provide benefits to widows, visually impaired citizens and children, but the vast majority of these claims are made for either social security disability or SSI. In order to qualify for social security disability benefits a person must have worked 20 of the 40 quarters preceding their date of disability and they must be “disabled.” There are 4 quarters in a year, so if a person becomes disabled on January 1, 2024 that person must have worked in at least 20 of the 40 quarters between January 1, 2014 and January 1, 2024 to qualify.

To prove you are “disabled” the burden of proof varies dramatically with your age. For anyone under the age of 50, you must prove you cannot perform full-time “sedentary work”. This would be a job with no lifting where you have a sit or stand option all day. Very difficult. After the age of 50, social security looks at what you did for a living. If you had a sedentary job, you need to prove you can no longer do your job.

However, if you did “light work” or something even heavier, from 50-54 you usually have to prove that you cannot do full-time “light” work. This is work where you must stand all day, but only do light lifting, something like being a cashier at Walmart. Once you reach 55 if you did medium work or heavy work, you only need to prove you can’t do “medium” work, which involves standing all day and lifting 25 pounds throughout the day. For SSI benefits, the burden of proving you are disabled is the same as that for social security disability. However, there is no requirement that you ever worked.

For SSI, you need to be poor, which means no income for you or your spouse, you don’t own more than one automobile, you don’t own real estate you don’t live in and you don’t have more than $2,000.00 in the bank. The definition of “disability” is the same as for social security disability, so it is much easier to get an SSI application as the client gets older. Some other important aspects of social security disability benefits are that they are paid at the “full” rate, or the rate you would receive if you retired at the age of 66 years and 10 months. Second, there is a 6 month waiting period, so if you became disabled January 1, 2024 your first check would be for July 1, 2024.

Third, you get a Medicare card two years after your first disability payment (July 1, 2026 in this example). Fourth, you are allowed to work part-time without losing benefits—for 2024 the limit for part-time income is $1,550.00. For SSI the monthly payment for 2024 is $914.00 per month. If you work part-time, there is a dollar-for-dollar credit against your SSI payment. If you get free rent, that is credited against your SSI. If you inherit money or marry someone with a job you can lose your SSI benefits. If you receive SSI benefits, you also qualify for the Medicaid health insurance program.

To qualify for social security disability or SSI benefits you are not required to prove that you are permanently disabled. You only need to prove that you have an illness or injury that either has disabled you for at least 12 months or is expected to disable you for 12 months. For example, it is common for a younger person who is seriously injured in an accident to have a “closed period” for social security disability until they return to work. There is one aspect of social security disability that people commonly miss. Many times, people retire at age 62 because they can’t work any more.

There is an 8% increase for every year a person waits to retire until the age of 70. This means that if you retire at age 62 instead of the full retirement age of 66 years and 10 months, you lose 38.66% of your monthly social security check by retiring early. The solution is that if you are applying for social security retirement benefits before the age of 66 years and 10 months, at the same time apply for social security disability benefits. If you win the disability benefits, your rate is kicked up to the 66 year and 10 month rate, and that lasts your entire life. How do you apply for these benefits? Since the Covid virus pandemic, most Americans apply for these benefits on-line. You can do this yourself, but our recommendation is to have us help you with the application. The application process takes about two hours and requires a lot of information, is arduous and can be technically challenging.

We have found that in many instances clients who started the process on their own make mistakes that can’t always be remedied on appeal. Attorney’s fees are set by statute, and that fee is 25% of your past-due benefits with a ceiling of $6,000.00. It is our experience that benefits are awarded upon application in a high percentage of claims where we help the client from the beginning, but if the client begins the process on their own there are often a series of appeals required, can require attending a hearing and sometimes benefits are denied. Finally, a social security disability application is a very smart thing to do if you have a serious work or other type of injury.

In Pennsylvania, unless the claim involves an extremely serious injury, workers compensation benefits can only be extended for eleven and one half years. For this reason, and the way the system is structured, most people settle their benefits for one lump sum. The sum of money can be substantial, but you give up all your future wage loss and medical benefits to get it. If you don’t have any income, you can rapidly spend the money on living expenses. That is where social security disability comes in.

While you are receiving weekly workers compensation benefits, your social security disability check may be affected by the “80% rule”. The 80% rule states that the combination of workers compensation plus social security disability benefits can never exceed the average month’s wages that you received during the best earning five years of your life. If you were well-paid during those five best years, you may be able to get your full social security disability check while getting workers compensation benefits.

However, if your best five years aren’t that great, you might get a partial social security check or no benefits at all while you are receiving weekly workers compensation checks. That is where the settlement of workers compensation comes in. When you settle your case, your social security check bounces up to the full amount, so you can replace a substantial amount of the income you lose from settling your workers compensation case and preserve your lump sum instead of spending it on living expenses.