Social Security Disability & SSI - Applying for Benefits
by: Oregon Law Center and Legal Aid Services of Oregon
1. Who Can Get Social Security Disability (SSD) Benefits?
SSD is for any disabled person who can no longer work, but who has the required history of working. The disabled person's spouse, dependent children and parents, and even a divorced spouse might also be able to get SSD.
This program is an insurance program. While a person works, he or she pays money to Social Security and is eligible to get this money if he or she becomes disabled and can no longer work.
2. Who Can Get Supplemental Security Income (SSI)?
SSI is for any person who is blind, disabled or elderly (65 or over) and who meets certain income and resource rules. You do not need to have a work history.
The income rules depend on your living arrangements and whether you apply as a single person or couple. Resources include cash, savings, investments and valuables. But they do not include a needed car, your home, ordinary belongings, or some life insurance policies.
3. Do I Have to be a Citizen to Get SSI?
Certain non-citizens may be eligible to receive SSI.
· People who were receiving SSI on August 22, 1996, may continue to receive SSI
· People who were lawfully residing in the U.S. on August 22, 1996 and who became disabled later, or who were at least 65 on August 22, 1996, can receive SSI if they are:
1. Legal permanent residents
2. Refugees
3. Asylees
4. Persons granted withholding of
4. deportation
5. People paroled into the U.S. for at least one year
6. Certain battered spouses
7. Cuban and Haitian entrants
8. Individuals admitted as Amerasian immigrants
9. Certain conditional entrants
· The following non-citizens who immigrated to the U.S. before or after August 22, 1996 can get SSI:
1. People who are lawfully admitted for permanent residence and have 40 qualifying quarters of work. The spouse and minor children may also qualify under that individual's work record
2. Active duty members of the U.S. armed Forces and veterans, and their spouses and dependent children, as long as they were lawfully admitted to the U.S. under one of the above categories
3. American Indians born in Canada, and members of an Indian tribe
· The following non-citizens who immigrated to the U.S. after August 22, 1996 can get SSI for only 7 years after entry unless they fit into one of the other categories listed above:
1. Refugees
2. Asylees
3. Aliens for whom deportation has been withheld
4. Cuban and Haitian entrants
5. Amerasian immigrants
6. American Indians born in Canada, and members of an Indian tribe.
· The rules are different for non-citizens who are not disabled but apply for SSI after August 22, 1996 because they turn 65. Those individuals can only get SSI for 7 years after they are admitted into the U.S. and they must be:
1. Refugees
2. Asylees
3. Persons for whom deportation is
3. withheld
4. Cuban and Haitian entrants
5. Amerasian immigrants
· There is an exception for lawful permanent residents who can be credited with 40 qualifying quarters of Social Security coverage, and for veterans and active duty service members and their spouses. Those individuals will be eligible for SSI on the basis of age without the time limits
· Individuals who are 65 and disabled may use the more favorable laws for disabled people in order to qualify
4. How Can I Get SSI if I'm Aged or Blind?
If you are applying for SSI as aged, you must show that you are 65 or over. If you are applying for SSI as blind, you must give evidence that you have corrected vision of 20/200 or worse in your better eye.
5. How Can I Get Benefits for a Disability?
To get benefits from the SSD or SSI disability programs you must show you are "disabled." "Disabled" means that a physical and/or mental handicap keeps you from having gainful employment. Your disability must have lasted or be expected to last for at least 12 months, or be expected to result in death.
It is not enough to show that you cannot do your old job. You must show that you cannot do any kind of full-time work taking into consideration your age, education and experience. You cannot get benefits if you are able to work even if you cannot get a job.
6. When Should I Apply for the SSD and SSI Programs?
Apply as soon as possible after disability occurs.
An application for SSD may also be filed after the death of a disabled worker. You must apply within three months of the worker's death. If the claim is approved, back payments may be made for some months before the worker died.
7. Where do I Apply for Social Security Programs?
You must make an appointment to apply. You can make this appointment at your local Social Security office or by calling 1-800-772-1213.
8. What Evidence Should I Include with My Application?
To get SSI or SSD, you must have medical evidence that shows you have some physical or mental problem(s) that makes you unable to work at any job.
Medical evidence includes:
· Doctor or hospital reports
· Chart notes
· Test results
· Letters
The more medical evidence you have, the better chance you will have of winning benefits.
You should try to get your doctor to write a specific letter that describes your condition(s) and how that condition(s) keeps you from being able to do any kind of work. See Section 12 below for more information on Medical Letters. Include all the medical evidence that you have when you apply, but don't delay your application. You can send in additional medical evidence later.
9. Are There Special Rules if my Disability is Based on Alcoholism or Drug Addiction?
Individuals are ineligible to receive Supplemental Security Income (SSI) or Social Security Disability benefits if drug addiction or alcoholism is a contributing factor to the determination of disability.
Individuals who abused drugs or alcohol in the past, but who no longer do, may still be eligible if they have other physical and/or mental impairments that are disabling.
People who currently use drugs or alcohol may be eligible for benefits if they can prove that they are disabled, based on other physical and/or mental impairments, without considering the substance abuse problem.
10. What Happens After I Apply?
Your application will be sent to the Oregon Disability Determination Service (DDS) in Salem for review. They will contact your doctors. They also may send you to another doctor. They will send you their decision in about 4 months (sometimes longer).
11. Can I Get Other Help While Waiting for Social Security Benefits?
While you are waiting for a decision by SSA, you may be able to get General Assistance from the State of Oregon. You will have to meet welfare's eligibility
requirements.
You must have medical evidence showing that you will be disabled for at least twelve months. You will also be asked to sign a statement saying you will pay back welfare for your General Assistance if you get SSI benefits. If you do not get those benefits, you do not have to repay welfare.
12. Medcal Letters for Disability Claims
A helpful medical letter will give the following information:
· A diagnosis and description of the condition(s). This should be detailed and include any condition for which the doctor has treated you
· Medical findings. Ask your doctor to attach any materials from your medical file (such as test results, x-rays, progress notes) that would support the opinions given in the letter
· The condition's effect upon you. A specific statement as to how each condition limits your ability to do various work and non-work activities. Does the doctor think you can return to any previous jobs, or do any other type of full-time work?
· Medication and treatment. List medications, their side effects and a statement as to whether the medication itself might affect your ability to work. What kind of treatment are you undergoing (surgery, physical therapy, etc.)?
· Prognosis. Will you get better? Stay the same? Get worse? How long will the condition last? (Only individuals who have been or will be unable to work for at least l2 months are eligible for disability benefits.)
· Consultant. Does your doctor believe you have any problem which should be evaluated by a specialist.
Show this list to your doctor to explain what you need.
13. What Happens if I'm Found to be Eligible for Benefits?
If you are eligible for SSD, you will get benefits back to five months after you became disabled, but only for a maximum of 12 months before you applied for benefits.
If you are eligible for SSI you will get benefits back to the first day of the month following the date you applied, or later if Social Security believes your disability began after you applied. If you were getting General Assistance you may have to pay back welfare out of your retroactive SSI check (if any).
14. How Can I Get More Information?
For more information, call the Public Benefits Hotline (1-800-520-5292) or your local Legal Aid Services Office for possible advice or representation. Go to www.oregonlawhelp.org for a directory of legal aid programs.
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