1.
What should I do if I'm involved in an auto accident?
First,
call and report the accident to the police no matter how minor
you think the accident is. Do not admit responsibility, and
do not discuss it with anyone other than your attorney. If
there are witnesses get their name, address and telephone
number immediately.
2.
How long will it take to get money in my case?
Settlement
negotiations for your personal injury generally do not begin
until you have completed all necessary medical treatment and
all the medical records and bills are submitted to the insurance
company. After your medical treatment is completed a settlement
letter will be prepared by your attorney and mailed to the
insurance company. After the settlement letter is sent to
the adjustor settlement negotiations will begin after the
adjustor has had time to review the case and get settlement
authority from his supervisor. The property damage portion
of your claim is frequently resolved very soon after your
accident.
3.
I didn't go to the doctor right away and now I have pain?
Always
see a doctor after an accident even if you're not feeling
pain right away. Be sure to document when you noticed the
pain and when you went to the doctor. Also, keep up with the
mileage that it takes to get back and forth to the doctor.
4.
Do I need an attorney?
It
is always in your best interest to consult an attorney. Be
mindful that the insurance company on the other side will
have a very experienced adjustor or lawyer negotiating for
them.
5.
The other driver doesn't have car insurance, how am I supposed
to collect money from him now?
If
a person is uninsured or underinsured in an accident in North
Carolina, their personal assets become at risk. If you have
uninsured motorist or underinsured motorist coverage on your
own policy, we may be able to proceed against that insurance
policy.
6.
Will my insurance company pay for my medical bills while I
wait to go to trial?
Often
times, yes, to a certain amount and then they are not required
to be reimbursed in North Carolina unless your employer is
self insured for health insurance purposes and if so, the
insurance company will get reimbursed once the case is complete.
We will review your medical coverage options with you.
7.
How am I supposed to get back and forth while my car is in
the shop?
If
you have rental insurance on your car then your insurance
company may provide a rental. Otherwise, the insurance company
will provide you with a rental after liability is accepted
and will pay a reasonable rental rate.
8.
I can't work; can I file for unemployment even though litigation
is pending?
No,
however, you may file for state disability benefits.
9.
How much money can I expect to get in a settlement?
There
are many factors considered in the amount of a settlement.
In North Carolina, loss of wages, pain and suffering, property
loss, etc. may all be considered. Your attorney must look
at the facts in your individual case to arrive at an amount
of reasonable settlement.
10.
Should I settle ahead of trial?
Most
cases in North Carolina are settled before trial. If you think
you deserve a larger settlement amount than what has been
offered then you must weigh the benefits and risks of trial
in making your decision.
11.
The other driver's insurance company offered me money. I haven't
even hired an attorney, but I could really use the cash. Should
I take it?
No.
Tell the insurance company that you'll get back to them. In
the meantime, contact an attorney immediately. Often times
and insurance company will offer a minimal amount of money
in return for your signature stating that you won't sue them.
Never take an insurance check without first consulting an
attorney.
12.
Can I afford an attorney?
Normally,
in cases such as these, you don't pay the money up front.
When we win your case, your lawyer will receive a percentage
of the settlement amount as payment in full. You and your
attorney will agree upon this percentage amount at the time
you retain your attorney. In addition to the attorney's fee
the attorney will be reimbursed expenses for prosecuting your
case.
Social
Security Disability Frequently Asked Questions
Courtesy and Copyright Charles T. Hall, Esq.
NOSSCR Sustaining Member and Past President
1.
What is the definition of disability used by Social Security?
Under the Social Security Act, "disability"
means "inability to engage in any substantial gainful
activity by reason of any 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 12 months."
2. How many different types of Social Security disability
benefits are there?
There are at least five major types of Social Security disability
benefits. Disability Insurance Benefits is the most important
type of Social Security disability benefits. It goes to individuals
who have worked in recent years (five out of the last 10 years
in most cases) who are now disabled. Disabled Widow's and
Widower's Benefits are paid to individuals who are at least
50 and become disabled within a certain amount of time after
the death of their husband or wife. The late husband or wife
must have worked enough under Social Security to be insured.
Disabled Adult Child Benefits go to the children of persons
who are deceased or who are drawing Social Security disability
or retirement benefits. The child must have become disabled
before age 22. For Disability Insurance Benefits, Disabled
Widow's or Widower's Benefits and Disabled Adult Child benefits,
it does not matter whether the disabled individual is rich
or poor. Benefits are paid based upon a Social Security earnings
record. Supplemental Security Income benefits, however, are
paid to individuals who are poor and who are disabled. It
does not matter for SSI whether an individual has worked in
the past or not. SSI child's disability benefits are a variety
of SSI benefits paid to children under the age of 18 who are
disabled. The way in which disability is determined is a bit
different for children.
3. How do I apply for Social Security disability benefits?
The best, surest way to file a Social
Security disability claim is to go to the nearest Social Security
office in person and wait (often for a few hours) to see someone
to file the claim in person. In the alternative, a person
may contact Social Security by telephone and arrange for a
telephone interview to file the claim.
4.
I am disabled, but I have plenty of money in the bank. Do
I have to wait until this money is gone before I apply for
Social Security disability benefits?
No. If you have worked in recent years or if you are applying
for Disabled Widow's or Widower's benefits or Disabled Adult
Child benefits, it does not matter how much money you have
in the bank. There is no reason to wait to file the claim.
5. I used to work but lately I have been staying home
taking care of the kids. I have now become sick. Can I get
Social Security disability benefits?
Possibly. If you have worked five out of the 10 years under
Social Security before becoming disabled, you will have enough
earnings in to potentially qualify for Social Security disability
benefits. For individuals 31 or less, the requirements are
a little different, since such individuals have not had such
a long time to work. Unless a person has been staying home
and taking care of their children for quite a long time, however,
it is very possible that they will qualify for Social Security
disability benefits based upon their own earnings. Also a
homemaker, if poor enough, can qualify for Supplemental Security
Income (SSI) whether he or she has worked in the past or not.
6. How long do I have to wait after becoming disabled
before I can file for Social Security disability benefits?
Not even one day. You can file for
Social Security disability benefits on the very same day that
you become disabled. Many individuals make the mistake of
waiting months and even years after becoming disabled before
filing a Social Security disability claim. There is no reason
to file a Social Security disability claim if one has only
a minor illness or one which is unlikely to last a year or
more. However, an individual who suffers serious illness or
injury and expects to be out of work for a year or more should
not delay in filing a claim for Social Security disability
benefits.
7. I am still on sick leave from my employer. Can
I file for Social Security disability now or do I have to
wait until the sick leave is exhausted?
No, you do not have to wait until the sick leave is exhausted.
You should file for Social Security disability benefits now,
if you believe that you will be out of work for a year or
more.
8.
I got hurt on the job. I am drawing worker's compensation
benefits. Can I file a claim for Social Security disability
benefits now or should I wait until the worker's compensation
ends?
You do not have to wait until the worker's
compensation ends and you should not wait that long. An individual
can file a claim for Social Security disability benefits while
receiving worker's compensation benefits. It is best to file
the Social Security disability claim as soon as possible because
otherwise there may be a gap between the time the worker's
compensation ends and the Social Security disability benefits
begin.
9. Can I get both worker's compensation and Social Security
disability benefits?
Yes. There is an offset, which reduces
Social Security disability benefits because of worker's compensation
benefits paid, but in virtually all cases, there is still
some Social Security disability benefits to be paid. In a
few states the offset works the other way - - worker's compensation
benefits are reduced because of Social Security disability
benefits.
10. How can I tell if I will be found disabled by Social Security?
Unless your disability is catastrophic (such as terminal cancer,
a heart condition so bad that you are on a heart transplant
waiting list, total paralysis of both legs, etc.), there is
no easy way for you to tell whether you will be found disabled
by Social Security. In the end, the decision of whether or
not to apply for Social Security disability benefits should
not be based upon whether or not the person feels that Social
Security will find them disabled. Attorneys familiar with
Social Security disability can make predictions about who
will win and who will lose, but even they can seldom be sure.
An individual should make the decision about whether or not
to file for Social Security disability based upon their own
belief about their condition. If the individual feels that
he or she is disabled and is not going to be able to return
to work in the near future, the individual should file for
Social Security disability benefits. If denied, the individual
should consult with an attorney familiar with Social Security
disability to get an opinion as to the chances of success
on appeal.
11.
Can you receive Social Security disability benefits for _________________
(insert the name of whatever disease you are interested in)?
In almost every case, no matter what the disease is, the answer
is the same - "Maybe, it just depends upon how badly
you are affected by the disease." One example might be
cancer. The word "cancer" is scary to anyone, but
there are many cancers which can be treated and cured very
quickly, with little or no lasting effect. On the other hand,
of course, there are cancers which cause great suffering and
ultimately death. The question in each individual case is
"How sick is this particular individual with cancer and
how long is this person going to remain sick?" Skin diseases
are another example. The vast majority of skin diseases, while
annoying, would not be considered to be disabling. On the
other hand, there are some uncommon, very severe skin problems
which are clearly disabling. In extreme cases, psoriasis,
which is not rare, may be disabling. Thus, almost without
exception, the mere fact that an individual has a disease
with a certain name does not guarantee that the individual
either will or will not be found disabled. It all depends
upon how sick the person is.
12. Do you have to be permanently disabled to get
Social Security disability benefits?
No. You have to have been disabled for at least a year or
be expected to be disabled for at least a year or have a condition
that can be expected to result in death within a year.
13. I have several health problems, but no one of
them disables me. It is the combination that disables me.
Can I get Social Security disability benefits?
Social Security is supposed to consider the combination of
impairments that an individual suffers in determining disability.
Many, perhaps most claimants for Social Security disability
benefits have more than one health problem and the combined
effects of all of the health problems must be considered.
14. I got hurt in an automobile accident. I am disabled
now, but I expect that I will be able to return to work after
I recover. Should I file for Social Security disability benefits?
If you expect to be out of work for a year or more on account
of illness or injury, you should file for Social Security
disability benefits.
15. How does Social Security determine if I am disabled?
Social Security is supposed to gather your medical records
and carefully consider all of your health problems, as well
as your age, education, and work experience. In general, Social
Security is supposed to decide whether you are able to do
your past work. If Social Security decides that you are unable
to do your past work, they are supposed to consider whether
there is any other work which you can do considering your
health problems and your age, education, and work experience.
16.
Who decides if I am disabled?
After an individual files a Social Security disability claim,
the case is sent to a disability examiner at the Disability
Determination agency in your state. This individual, working
with a doctor, makes the initial decision on the claim. If
the claim is denied and the individual requests reconsideration,
the case is then sent to another disability examiner at the
Disability Determination agency, where it goes through much
the same process. If a claim is denied at reconsideration,
the claimant may then request a hearing. At this point, the
case is sent to an Administrative Law Judge who works for
Social Security. The Administrative Law Judge makes an independent
decision upon the claim. This is the only level at which the
claimant and the decision maker get to see each other.
17. Why does Social Security consider my age in determining
whether I am disabled?
Social Security has to consider age, because that is what
the Social Security Act requires. As people get older, they
become less adaptable, less able to switch to different jobs
to cope with health problems. A severe foot injury which might
cause a 30- year- old to switch to a job in which he or she
can sit down most of the time, might disable a 60- year- old
person who could not make the adjustment to a different type
of work.
18. Is there a list of illnesses that Social Security
considers disabling?
Not really. Because most types of illness can vary from minor
to severe, there is no one simple list of illnesses which
Social Security considers to be disabling. However, if an
illness has reached a very severe level with certain medical
hallmarks, Social Security will award benefits on the basis
of medical considerations alone.
19. What can I do to improve my chances of winning
my Social Security disability claim?
Be honest and complete in giving information to Social Security
about what is disabling you. Many claimants, for instance,
fail to mention their psychiatric problems to Social Security
because they are embarrassed about them. In almost all cases,
individuals who were slow learners in school fail to mention
this fact to Social Security, even though it can have a good
deal to do with whether or not the Social Security disability
claim is approved. Beyond being honest and complete with Social
Security, the most important thing that you can do is just
keep appealing and hire an experienced person to represent
you. It is important to appeal because most claims are denied
at the initial level, but are approved at higher levels of
review. It is important to hire an experienced person to represent
you because you do not understand the way Social Security
works. Statistically, claimants who employ an attorney to
represent them are much more likely to win than those who
go unrepresented.
20.
How do I find an attorney to represent me before on my Social
Security disability claim?
The National Organization of Social
Security Claimants' Representatives (NOSSCR) offers a referral
service. You may call NOSSCR at 1-800-431-2804 during regular
Eastern Time business hours.
21.
If I am approved for Social Security disability benefits,
how much will I get?
For disability insurance benefits, it all depends upon how
much you have worked and earned in the past. For disabled
widow's or widower's benefits, it depends upon how much the
late husband or wife worked and earned. For disabled adult
child benefits, it all depends upon how much the parent worked
and earned. For all types of SSI benefits, there is a base
amount that an individual with no other income receives. Other
income that an individual has reduces the amount of SSI which
an individual can receive.
22. How far back will they pay benefits if I am found
disabled?
For Disability Insurance Benefits and for Disabled Widow's
and Widower's Benefits, the benefits cannot begin until five
months have passed after the person becomes disabled. In addition,
benefits cannot be paid more than one year prior to the date
of the claim. For a Disabled Adult Child, there is no five-month
waiting period before benefits begin, but benefits cannot
be paid more than six months prior to the date of the claim.
SSI benefits cannot be paid prior to the start of the month
following the date of the claim.
23. What do I do if Social Security denies my claim
for Social Security disability benefits?
First, do not be surprised. Only about 40% of Social Security
disability claims are approved at the initial level. If you
are denied at the initial level, unless you have already returned
to work or expect to return to work in the near future, you
should appeal, that is, file a request for reconsideration.
You should also consider employing an attorney to represent
you.
24. Why does Social Security turn down so many claims
for disability benefits?
There is no simple answer to this question. One reason is
that there is no simple way to determine whether an individual
is disabled. Most people who are disabled suffer from pain.
There is no way of determining whether or not another individual
is in pain, much less how much pain they are in. A second
reason is that Social Security over the years has been more
concerned with making sure that everyone who is receiving
Social Security disability benefits is "truly" disabled
than with making sure that everyone who is disabled receives
Social Security disability benefits. An underlying reason
is that Congress has always believed that, given a chance,
many people will "fake" disability in order to get
benefits.
25. I only want to get back the money I put in Social
Security. Why do they make it so hard for me to get my own
money back?
Actually, when you file a Social Security disability claim,
you are not trying to just get "your own money"
back. The money that an individual may have paid into Social
Security over the years would not last very long if that was
all that an individual could draw from Social Security.
26. What is "reconsideration"?
When a claim for Social Security disability benefits is denied
at the initial level, the claimant may then request "reconsideration"
of that decision. The case is then sent to a different disability
examiner for a new decision. Unfortunately, about 80% of the
time the reconsideration decision is the same as the initial
decision - a denial.
27. Who makes the reconsideration determination?
A disability examiner at the Disability Determination Section
makes the reconsideration determination. Most of the time,
the claimant does not see the disability examiner or even
know his or her name.
28. What are my chances of winning at reconsideration?
Statistically, about 20% of the time a claimant wins at reconsideration.
29. Do I have to go through reconsideration?
If you want to appeal a denial of Social Security disability
benefits, you have to go through reconsideration. There is
no way to avoid it.
30. How long does it take to get a hearing on a Social Security
disability claim?
There is much variation around the country. In a few areas
of the country the wait is only three months. In a few areas
of the country the wait is more than a year.
31. What is the Social Security hearing like?
The hearings are fairly informal. The only people likely to
be there are the judge, a secretary operating a tape recorder,
the claimant, the claimant's attorney, and anyone else the
claimant has brought with him or her. In some cases, the Administrative
Law Judge has a medical doctor or vocational expert present
to testify at the hearing. There is no jury nor are there
any spectators at the hearing. There is no attorney at the
hearing representing Social Security trying to get the judge
to deny the disability claim.
32. What are my chances of winning at a hearing?
Statistically, over half of the claimants who have a Social
Security disability hearing win.
33. If the Administrative Law Judge denies my claim, can I
appeal any more?
Yes. You can appeal to the Appeals Council which is still
within Social Security.
34. What is the Appeals Council?
The Appeals Council exists to review Administrative Law Judge
decisions. The Appeals Council is located in Falls Church,
Virginia, and neither the claimant nor the attorney sees the
people at the Appeals Council who are working on the case.
35. Can I appeal a case beyond Social Security to the Federal
Courts?
Yes. After being denied by the Appeals Council, it is possible
for a claimant to file a civil action in the United States
District Court, requesting review of Social Security's decision.
A Social Security disability claim can go all the way to the
Supreme Court. Perhaps once every year or two years, the United
States Supreme Court actually hears an appeal about a Social
Security disability case.
36. If I get on Social Security disability benefits
and get to feeling better and want to return to work, can
I return to work?
Certainly you can return to work. Social Security wants individuals
drawing disability benefits to return to work and gives them
every encouragement to do so. For persons receiving Disability
Insurance Benefits, Disabled Widow's and Widower's Benefits,
and Disabled Adult Child Benefits, full benefits may continue
for a year after an individual returns to work. Even thereafter,
an individual who has to stop work in the following three
years can get back on Social Security disability benefits
immediately without having to file a new claim. In SSI cases,
things work a differently, but there is still a strong encouragement
to return to work.
37. Where can I go to get help with my Social Security disability
claim?
For help, go to a lawyer or other person who represents Social
Security disability claimants on a regular basis. If you need
a referral to a lawyer who represents Social Security claimants,
call the referral service of the National Organization of
Social Security Claimants' Representatives (NOSSCR) at 1-800-431-2804.
To contact NOSSCR by e-mail, just Click Here.
38. Do I really have to hire a lawyer to represent
me in my Social Security disability claim?
No. You can go through all of the levels of review on your
own, if you wish, but statistically claimants who are represented
by an attorney win a good deal more often than those who are
not represented.
39 How do lawyers who represent Social Security disability
claimants get paid?
In almost all cases, the attorney receives one- quarter of
the back benefits if the claimant wins and no fee if the claimant
loses.
40. Can alcoholics and drug addicts really get Social Security
disability benefits?
Not anymore. There never were all that many people getting
Social Security disability benefits on account of alcoholism
or drug addiction, but Congress has now prohibited Social
Security from paying disability benefits on the basis of alcoholism
or drug addiction. However, alcoholics and drug addicts have
heart attacks, get cancer or get sick in other ways just like
everyone else. Alcoholics and drug addicts who become disabled
apart from their alcoholism or drug addiction can become eligible
for Social Security disability benefits.
41. I know someone who is on Social Security disability and
he does not look a bit disabled. Why do they put all of these
freeloaders on benefits?
When it comes to disability, looks can be very deceiving.
There are many people who look quite healthy but who are quite
disabled by anyone's standard. For instance, many individuals
who suffer from very severe psychiatric illness are physically
healthy and able to do things such as mow their yards.
42. I am disabled, but I have never worked at public
work. Can I get Social Security disability benefits?
If you are poor enough, you can qualify for Supplemental Security
Income (SSI) if you are disabled, even if you have never worked
in the past. It is also possible to qualify for Disabled Adult
Child Benefits on the account of a parent if you became disabled
before age 22 or for disabled widow's or widower's benefits
on the account of a late husband or wife.
43. I am a widow. I have not worked in public work
in many years. I am disabled. Can I get Social Security disability
benefits?
If you are over 50 and became disabled within seven years
after your husband or wife died or within seven years after
you last drew mother's or father's benefits from Social Security,
you can get Disabled Widow's or Widower's Benefits. Perhaps
more important, if you are poor, you can draw Supplemental
Security Income benefits no matter what age you are or when
you became disabled.
44. I have a daughter who has been disabled by cerebral palsy
since birth and has never been able to work. Can she get disability
benefits from Social Security?
Very possibly. If the child is under 18 and you are poor enough,
the child may be able to qualify for SSI child's disability
benefits. If the child is over 18, she may be able to qualify
for SSI disability benefits without regard to the income of
her parents. If her father or mother is drawing Social Security
benefits of some type or is deceased, the child may be eligible
for disabled adult child benefits.
45. I am already on Social Security disability benefits, but
I am worried that my benefits will be stopped in the future.
What are the chances of this happening?
Social Security is not supposed to cut off disability benefits
for an individual unless his or her medical condition has
improved. When Social Security reviews a case of someone already
on Social Security disability benefits, they continue benefits
in the vast majority of cases. In recent years, Social Security
has been doing few reviews to determine whether or not individuals
already on Social Security disability benefits are still disabled.
This is changing and Social Security should be doing far more
reviews in the next few years. However, the vast majority
of individuals who are reviewed will see their Social Security
disability benefits continued.
46. If Social Security tries to cut off my disability benefits,
what can I do?
You should appeal immediately. If you appeal within 10 days
after being notified that your disability benefits are being
ceased, you can ask that your disability benefits continue
while you appeal the decision cutting off your benefits. You
may also want to talk with an attorney about representation
on your case, but you should file the appeal immediately.
47. My doctor says I am disabled so why is Social Security
denying my Social Security disability claim?
Social Security's position is that it is not up to your doctor
to determine whether or not you are disabled. It is up to
them and they will make their own decision regardless of what
your doctor thinks.
48. VA says I am disabled, so why is Social Security
denying my Social Security disability claim?
It is Social Security's position that VA decisions are not
binding upon them. Social Security and VA have very different
standards for approving disability claims.
49. I am 60% disabled. Do I get 60% of my Social Security
disability benefits?
No. There are no percentages of disability in Social Security
disability determination. For purposes of Social Security
disability benefits, you are either disabled or not disabled.
There are no percentages of disability, nor any percentages
of disability benefits.
50. I am disabled by mental illness. Can mental illness
serve as the basis for a Social Security disability claim?
Yes. Mental illness is a frequent basis for awarding Social
Security disability benefits.
51. Will it help if I ask my Congressional Representative
to help me get Social Security disability benefits?
Many Social Security disability claimants
become frustrated with claim delays and eventually ask their
U.S. Representative or Senator to help. The local Congressional
office typically will have staffers who are experienced with
Social Security procedures and personnel. A “Congressional
Inquiry,” as it is called at Social Security, may help
to get a stalled process moving again. Note that the inquiry
will have no impact on how Social Security decides the outcome
of the case.
52.
How long does it take before Social Security makes a decision
once I file a claim for Social Security disability benefits?
In most cases Social Security makes
the first decision within four months.
53.
How long does it take for Social Security to make a reconsideration
determination on my Social Security disability claim?
In most case Social Security makes
the reconsideration determination within four months.
54.
How long does it take for Social Security to act upon a request
for Appeals Council review?
About a year, maybe longer.
55.
I am disabled. I need help with medical bills even more than
I need a cash income. How do I get help with medical bills?
Getting help with medical bills is
usually tied up with getting cash benefits, that is, you don't
start getting help with medical bills until after you start
getting the cash benefits, so you have to keep going with
the Social Security disability claim in order to get the help
with medical bills.
56.
What is the difference between Medicare and Medicaid?
The short answer is that Medicaid is
a poverty program and Medicare isn't. Many disabled people
who get Medicaid get it because they are on Supplemental Security
Income (SSI). This is called “categorical” Medicaid
eligibility. To get SSI and thereby get Medicaid you have
to be poor and disabled. Medicaid pays doctors at very low
rates. People who have only Medicaid can have a hard time
finding doctors willing to take them on as patients. Medicaid
does pay for prescription medications. Medicaid can go back
up to three months prior to the date of a Medicaid claim.
Note that it is possible to apply for Medicaid directly -
through a local Medicaid office - without having a companion
claim for SSI.
For
Medicare it does not matter whether you are rich or poor.
If you have been on Disability Insurance Benefits, Disabled
Widows or Widowers Benefits or Disabled Adult Child Benefits
for 24 months you qualify for Medicare. The good thing about
Medicare is that it pays doctors at a higher rate than Medicaid.
Almost all doctors are happy to take Medicare patients. The
bad things about Medicare are that it does not begin until
after a person has been on cash disability benefits for two
years and that it generally does not pay for prescription
medications.
57.
If I get Social Security disability benefits will I get Medicare?
If you are approved for any kind of
Social Security disability benefit other than SSI you will
get Medicare after you have been entitled to Social Security
disability benefits for two years.
58.
If I get Social Security disability benefits will I get Medicaid?
If you are approved for SSI you will
get Medicaid. It is possible to get both Medicare and Medicaid
if you are entitled to SSI and some other type of Social Security
disability benefit. Also see #56, above.
