Unless you’re an experienced Houston Social Security disability lawyer, you probably aren’t too familiar with the unique terminology used by the Social Security Administration. To help our clients understand the language of the SSA, here’s a short glossary of common terms they’ll hear during the SSDI benefits application and appeal process:
Administrative Law Judge
Administrative Law Judges (ALJs) settle disputes between government agencies, such as the Social Security Administration (SSA), and the people affected by the decisions these agencies make. If your SSDI claim has been denied, you can request a hearing before an ALJ to appeal the SSA’s decision.
If your claim for SSDI benefits has been denied, you have a right to appeal that decision. You must always appeal to the next level. The levels in the appeal process are:
- Reconsideration of your initial application for benefits. The SSA will review your case to determine if they were in error when they denied your claim.
- Requesting a hearing before an ALJ to rule on your claim
- Appealing the ALJ’s decision with the Social Security Appeals Council
- Filing a lawsuit in Federal Court to review your claim
If your SSDI claim was denied again after reconsideration, you have the option of requesting a hearing before an ALJ. You have 60 days after receiving the reconsideration denial letter to file a request for an appeals hearing. Being represented by an experienced SSDI claims lawyer at this stage in the appeals process can significantly improve your chances of obtaining benefits.
The award letter confirms that your SSDI claim has been approved and that you are qualified to receive Social Security disability benefits. The usual time between filing a claim and receiving an award letter is about three months.
When your SSDI claim has been approved, you will receive back payment for the benefits you were owed while your claim was being processed, starting from the date you became disabled.
Benefits Eligibility Screening Tool (BEST)
Posted on the Social Security Administration’s website, the Benefits Eligibility Screening Tool (BEST) can help you determine if you qualify for SSDI benefits as well as providing information on how to apply for benefits. You can find BEST here.
Benefit Verification Letter
The benefit verification letter is an official letter from the SSA that lists your monthly Social Security Disability and Supplementary Income earnings. The letter is of use in situations where proof of income is needed, such as applying for loans or mortgages or other benefits such as Medicare and assisted housing.
(Social Security) Blue Book
Officially known as the “Disability Evaluation under Social Security,” the Social Security Administration’s Blue Book contains a listing of what the SSA considers to be disabling impairments and the specific criteria under which claimants who suffer from a disabling condition can qualify for Social Security disability benefits.
Continuing Disability Review (CDR)
At some point, a Social Security disability benefits recipient will be subjected to a Continuing Disability Review (CDR). This is a periodic review to determine if you are still eligible for Social Security disability benefits. There are two types of CDRs: medical CDRs and work CDRs.
Cost Of Living Adjustment (COLA)
An increase in the amount benefits to match inflation.
Date of Filing
The date you file for Social Security disability benefits.
Date Last Insured (DLI)
The last date you are eligible to receive Social Security disability benefits. This date is based on when you last worked.
Disability Benefits, Qualifications
You may qualify for SSDI benefits if you:
- Haven’t reached full retirement age
- Have worked long enough to earn sufficient Social Security credits
- Have a severe medical or physical impairment that will prevent you from doing substantial work for a year or more
- Have a condition that is expected to result in death
A claim to obtain disability benefits from the Social Security Administration.
After the SSA has made their decision about your claim, you will receive a decision note (either an Award Letter or Denial Letter) explaining the decision, what benefits are available and the amount of benefits you will receive each month.
The Social Security Administration defines disability as “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
Disability Determination Process (SSA)
The Disability Determination Process is an evaluation process used by the Social Security Administration (SSA) to determine whether a person’s disability meets the SSA’s disability criteria for disability-based benefits.
An official chronological history of the amount of money you earned each year during your working lifetime and your contributions to the Social Security Fund.
Federal Benefit Rate (FBR)
Also known as the SSI Standard Benefit Amount or the Federal Payment Standard, the Federal Benefit Rate is the maximum dollar figure of Supplemental Security Income (SSI) benefits paid to a disabled individual under the Social Security Disability (SSD) program.
Federal Court Review
If your disability claim has been denied through the Social Security Administration Appeals Council process, you can appeal their decision by filing a civil suit in Federal District Court. You have 60 days from the date an Appeals Council denial is received to file for a Federal Court Review.
An individual’s earned income (before taxes and other deductions are made) plus their unearned income.
Gross Monthly Earnings
An individual’s total earned income for the month before taxes and other deductions are made.
You have insured status if you worked and earned enough Social Security credits to be eligible for retirement benefits, disability benefits or to enable your dependents to be eligible for benefits due to your retirement, disability, or death.
Maximum Sustained Work Capability
You might not be able to qualify for Social Security disability benefits unless you can prove that you are unable to keep a job or make at least $900 a month in income. While determining your claim, the SSA will assess your maximum sustained work capability to determine what type of work, if any, you are still able to perform. There are four categories of maximum sustained work capability: sedentary work, light work, medium work and heavy work.
Non-Medical Disability Criteria
In addition to medical criteria, the SSA also takes into account several non-medical criteria when making their decision, including proof of age, employment records, marital status, etc.
Office of Disability Adjudication and Review (ODAR)
The Office of Disability Adjudication and Review (ODAR) reviews Social Security Disability claims which have been denied.
Request for Hearing
See Administrative Law Judge
Request for Reconsideration
The next step in the appeals process after your initial application for SSDI benefits has been denied.
Social Security Administration (SSA)
The Social Security Administration is the federal government agency that oversees the social insurance programs for retirement, disability, SSI, Medicare, and survivors’ benefits.
Social Security Disability Insurance (SSDI)
Social Security Disability Insurance is a federal insurance program managed by the Social Security Administration. It provides benefits to American workers who have paid into the Social Security fund and have become unable to work due to a mental or physical disability.
Supplemental Security Income (SSI)
Supplemental Security Income is a federal program that provides monthly cash benefits to individuals who are 65 and older, blind or disabled and have limited income. Beneficiaries must meet the income-based qualifications of the program and, unlike Social Security Disability Insurance, are not required to have a certain number of work credits to be eligible.
Substantial Gainful Activity
You must be unable to engage in substantial gainful activity (SGA) in order to be eligible for SSDI benefits.
Urgent Case Request
In certain situations, an application for SSDI benefits will be marked as an “Urgent Care Request.” The claim qualifies for expedited processing and can provide immediate benefits to the applicant while their application is being processed.
Veteran Disability Benefits
Veterans who have become disabled due to physical or mental injuries while serving in the military may qualify for veteran disability benefits. Veterans can receive Social Security disability benefits while receiving VA disability benefits.
In some instances, an applicant for SSDI benefits may recover and be able to return to work after their application has been approved. The SSA imposes a five month waiting period during which the applicant receives no SSDI benefits to ensure they are not paying benefits to a person who does not have a long-term disability.
(SSDI) Work Credits
As you work and pay Social Security taxes, you earn credits (a maximum of four each year) that count toward your eligibility for future Social Security benefits. Most people need at least 40 credits to qualify for disability and other benefits.
Help with Social Security Disability Denials
Applying for SSDI benefits can be challenging when you aren’t familiar with the process, and a large percentage of applications are denied with the initial application. When this happens, board certified Houston SSDI lawyer M. Stanley Whitehead is here to help.
It’s a fact that an experienced Social Security disability benefits lawyer can greatly improve the chances of a successful appeal to an SSDI denial. Contact the Law offices of M. Stanley Whitehead to schedule a free consultation to discuss your case.