Wettermark Keith stands as a towering presence in the Southeast, boasting one of the largest Social Security disability practices in the region. We've successfully navigated thousands of clients through the intricate labyrinth of the claims process, addressing their unique concerns and challenges arising from severe medical conditions that render them unable to work full-time. Despite the singularity of each case, we've noticed recurring statements that often don't hold water. This second installment in our three-part series tackles the most common myths and misconceptions surrounding Social Security benefits.

1. If I can longer do my previous job or jobs, I will qualify for disability benefits.  

Many applicants for disability benefits are under the impression that if they can no longer perform their current job, they will be approved for disability. That’s not always the case. When evaluating a claim for disability benefits, the Social Security Administration (SSA) will consider any work that you’ve had lasting three months or longer during the last fifteen years. SSA will determine if you are able to do any of this “past relevant work” (any job lasting three months or more, in which you earned an amount considered to be substantial gainful activity, and for which you had sufficient time to learn the duties of the job) considering your mental and physical limitations.  

Once SSA determines what your limitations are, they decide your “residual functional capacity” (RFC) - the physical and mental activities you are able to do when you consider the limitations of your conditions. SSA will use this “RFC” to make a decision whether you can perform a past relevant job. The evaluation is not finished even if SSA decides that you can no longer do your past jobs! They must now consider if you are able to do any other kind of work. At this step, SSA considers your age, education, residual functional capacity, and the job skills of your past work while making their disability determination. If the disability examiner finds you unable to perform any type of work, you will likely be approved for benefits.  

Overall, the work history analysis, along with job skill considerations, can be tedious and confusing. It is important to hire an experienced disability attorney to assist you with your claim. An experienced attorney is knowledgeable in these requirements and can help to ensure that your application is handled appropriately.  

2. It will only take a couple of months to be approved for disability. 

This is one of the most frustrating myths surrounding disability benefits! The exact time it takes to get a decision on your claim varies depending on several factors. Applying and qualifying for Social Security disability benefits is often a long and frustrating process. It generally takes four to six months to receive benefits if you are approved at the initial stage. However, if your initial claims are denied, you can expect the next step in the appeal, call “reconsideration”, to take an additional four to six months. If denied at this step, it takes an extra 6 to 8 months on average to get a hearing as part of the appeals process. Even if you win your appeal, two years may have passed since you first submitted your application. 

Why do the timeframes differ among applicants? SSA and your attorney will assist in getting medical records and any other evidence needed to make a decision, but providers all differ in their timeframe to provide records. Also, how quickly you complete and return required forms will affect the speed of the process. Where you live may also impact your decision wait time. Some states process claims faster than others.  

No matter how quickly you get the first decision, the truth is that most claims are denied at the application level, and so most people will need to file one or more appeals before they are finally approved. Again, most people get denied not once, but at least twice. So, even if it means a long wait for an administrative law judge hearing, we will keep pushing forward with your case in pursuit of the benefits you deserve.  

Overall, filing for Social Security disability benefits can take months or years. The biggest take-away is that you should be prepared for a long wait if you're applying for SSDI or SSI. As one of the largest disability practices in the Southeast, Wettermark Keith works hard to get our clients their benefits as quickly as possible. We know exactly what SSA looks for on applications and will give you the best possible chance of a successful claim. Reach out to us today for help!  

3. I will get Medicare immediately if I am found disabled.  

Everyone eligible for Social Security Disability Insurance (SSDI) benefits is also eligible for Medicare; however, many don’t realize that the first 24 months of disability benefit entitlement is the waiting period for Medicare coverage. 

Even though Medicare coverage for most SSDI recipients starts two years after the first month they are eligible for their monthly disability benefits, this doesn’t mean that every person must wait that long from the date their claim is approved. The two-year waiting period is generally calculated from the date of your SSDI entitlement (the date you are eligible to receive your monthly award). Normally, this is the date your disability began plus the five-month SSDI waiting period. 

Determining your disability onset date is further complicated by other SSA rules. Since Social Security only allows a maximum of 12 months of retroactive benefits, plus the 5-month waiting period for benefits, the earliest that you can become eligible for Medicare is one year after you apply for Social Security disability. So depending on which stage you are approved at, you may have met a good portion of the waiting period by the time you are approved for benefits. 

Again, each case is different and requires specific review and strategies. Call Wettermark Keith today for help with your Social Security disability and/or SSI claim!