Supplemental Security Income (SSI) Benefits Claims
Philadelphia Area SSI Lawyers
Do I qualify for Supplemental Security Income (SSI) benefits?
The Social Security Administration offers two different programs that may provide funding sources for you if you’re suffering from a disabling medical condition: the Social Security Disability (SSD) program and the Supplemental Security Income (SSI) program.
Both programs require you to establish, through competent medical evidence, that you are disabled. Disability is defined as:
The inability to engage in substantial gainful activity, by reason of medically determinable physical or mental impairment(s) which has lasted or can be expected to last for a continuous period of not less than 12 months.
In simple terms, this means that to be found disabled you must prove three elements:
- You can’t work
- Because of an accident or illness, and
- Your illness and/or disabling conditions have lasted, or are expected to last, for at least one year.
Generally, the older you are (especially over 50, 55 or 60) the less education you have, the more physical your work has been, and the less transferable your work skills, the easier it is to get benefits.
At times, however, age doesn’t matter at all. For example, if your disability is based on emotional problems, such as depression, then none of the above factors come into play. Bottom line – if you honestly believe you can’t do a full-time job and your doctor supports your application for disability, you should be successful.
SSI Eligibility: SSI eligibility is based on both disability and income/resources – meaning you are entitled to receive these benefits if your household income and assets fall below a certain level, regardless of whether you have ever worked. If eligibility for SSI is established, the program entitles you to Medicaid and other social services administered through the state’s Department of Public Welfare. SSI benefits are only available to the person bringing a claim and not to the claimant’s family members.
In general, you may not have more than $2,000 in resources individually ($3,000 if a couple), and the limit to household income varies by the size of your household. If you qualify for state welfare and/or medical assistance, you will most likely meet the income and resource requirements. For example, in Pennsylvania, if you have no children and your spouse earns less than $2285.00/month, you would most likely qualify for some type of benefit.
In some instances, you may be eligible for both SSD and SSI benefits. If your SSD benefits are less than the amount of the Federal SSI benefit amount, you can apply for SSI to increase your total benefits. In these instances, household income and resources will be taken into account in determining whether SSI is payable.
The decision about when and how to apply for these programs is important. Generally, if there is medical evidence that your disability will continue for at least 12 months, you can apply immediately. If the medical evidence about the length of disability is unclear, then it might make sense to apply as soon as the medical evidence indicating that you will be out of work for more than one year becomes available.
It is helpful to have an attorney prepare and review the application and medical documentation. It is important that your submitted medical information clearly indicates the medical condition that prevents you from working as well as your physical and mental limitations. Most claims, unfortunately, are still denied at the initial level. There is a lengthy administrative appeals process in the event of an initial denial and it is important to have an attorney who primarily deals with Social Security Disability law assist you.
There is no fee unless you are successful. Attorney fees for Social Security claims must be approved by Social Security and are calculated at 25% of back due benefits. In general, fees do not exceed $6,000 unless claims rise beyond the hearing level.
SSI for Children: Children with disabilities may be eligible for SSI. A child qualifies as disabled if the child has a medically determinable impairment (physical or mental) that causes marked or severe functional limitations for more than one year, or is likely to result in death. The Social Security Administration considers the overall effects of various impairments in making a determination of disability. Therefore, functional limitations in a few different areas will be considered cumulatively.
Whether or not benefits will be paid also depends upon household income. Generally speaking, the income level must be low enough to qualify for welfare and/or food stamps. Income eligibility is determined using a complex formula that accounts for many factors. Also, a parent’s assets can operate to make the child ineligible for payments if the child lives with the parent. For example, in Pennsylvania, if a two parent family has two children, one of whom is disabled, then the monthly earned household income cannot exceed $4,158 in order for the disabled child to receive some type of benefit.
If you think you may qualify for SSI, let us help you get the benefits you deserve! We’re with you at every step of the way, so contact us today.