The Roosevelt Administration enacted the Social Security Program in 1935 to provide financial protection for disabled workers and their families as well as retirement benefits. Social Security differs from other government aid programs such as welfare because benefits follow strict eligibility guidelines based on employment history and prior contributions to the Social Security system.
Every American worker pays a Social Security tax on his or her paycheck. The number of years a person is employed (workers earn credits for every year employed) and the amount one contributes determines the range of benefits a worker is entitled to. The longer one works and the more they contribute, the more they receive. The government does set a maximum benefit of around $1,750 a month for workers retiring at Social Security's full retirement age of 65 and 2 months.
There are several types of Social Security benefit programs available to the public. Normal full retirement benefits begin at age 65 (there are an estimated 36 million Americans age 65 or older) and are available to anyone who has worked long enough to meet the eligibility requirements. Seniors may collect reduced payments beginning at age 62 or may delay their Social Security until age 70 if they plan on working past age 65. Workers born after 1929 must have at least 40 earned work credits, the equivalent of working 10 years, to be eligible for Social Security retirement. Unmarried children, grandchildren and divorced spouses are also eligible for benefits.
Social Security will pay benefits to the spouse and children of a deceased worker if the deceased earned enough work credits while alive. Widows or widowers may collect full benefits at age 65 or older or reduced payments as early as age 60. If disabled, applicants may receive benefits at age 50. Widows or widowers caring for a child under the age of 16 may apply for payments at any time. Unmarried children under age 18 (or up to 19 if they are in high school) as well as grandchildren adopted by the deceased or living with the worker at the time of his or her death may also be eligible for benefits. Divorced spouses may collect if the marriage lasted 10 years and the divorce at least two years. Divorced spouses caring for the deceased worker's child (must be under 16 or disabled and is also receiving benefits) do not have to meet the 10-year marriage requirement.
Disability benefits involve the most controversy and are the main reason a person seeking financial aid would need an attorney. Social Security disability payments are available to persons who stop working due to a physical or mental impairment that prevents them from performing "gainful" work. The disability must last at least 12 months or be expected to result in death. To be eligible, an employee must have worked at least 5 years (depending on your age) within the last forty calendar quarters (10 years) before the disability began. Disability checks are based on the average earnings for all the years an employee worked before becoming disabled. Benefits last as long as the injured is unable to work. A disabled person can get benefits until age 65 when payments are converted into retirement benefits. The amount will stay the same. Children under 18 and some disabled adults may also collect benefits if their parent receives disability.
The Social Security Administration follows strict guidelines when determining if an applicant is eligible for disability. Several factors may significantly delay or void a person from collecting disability:
- If their earnings average more than Social Security's annual income cut-off (currently around $800 a month)
- If the injured can perform other types of duties
- The actual severity of the condition
- If the condition is found in the Social Security list of disabling injuries
After filing an application, a worker's claim will be reviewed by a state agency hired by the Social Security Administration. The agency will review all of a claimant's medical records and often send the person to a hired doctor. If the safety of your medical records
is a concern, it may be a good idea to review your privacy rights as outlined in the Health Insurance Portability and Accountability Act (HIPAA)
. Unfortunately, because of strict guidelines, 60 percent of initial Social Security disability claims are declined. If the claim is declined, the claimant has 60 days to appeal the decision.
The first step in the appeal process is known as reconsideration. When under reconsideration, a claim is sent to a disability examiner not involved in the initial review. The case is re-evaluated and all medical evidence is updated. About 80 percent of all reconsideration cases end in denial.
A claimant has 60 days to request a hearing before an administrative law judge if the reconsideration process ends in denial. Although it may take up to 10 months before a case is heard, a hearing presents the best chance for victory during the appeals process and is also the most important time to have an attorney present. During a hearing, further evidence is often presented and new testimony is offered. If hired, a lawyer may cross-examine witnesses and raise objections. After 1 to 3 months, the judge will mail the claimant his decision. Over half of all hearings are successful.
If the claimant disagrees with the outcome of the hearing, he or she may ask for a review by the Social Security Appeals Council. The Appeals Council will only review the administrative law judge's decision to ensure the judgment was correct. The Appeals Council, which can take up to three years to hear a case, may uphold the judge's decision, reverse it or send the case back to the judge for further review. Around 80 percent of Appeals Council decisions are denials.
If denied by the Appeals Council, the last resort for a claimant is to file a lawsuit in federal district court requesting a review of Social Security's decision. At least once a year, a disability case reaches the Supreme Court. An attorney is not required for these proceedings but is highly recommended.
Social Security always seems to be a hot topic, especially among the elderly, many of whom rely on its benefits as their largest source of income. Unfortunately, because Social Security payments are taxed, there is a constant outcry for reform. Making matters worse, by 2018 the Social Security Administration is expected to begin paying more in benefits than it will collect in taxes. Without change, the Social Security Trust Fund will be exhausted by 2042.
To help protect your rights, plaintiff attorneys are taking more and more Social Security cases, mainly because of the high rate of denial seen with disability claims. The hiring of an experienced attorney familiar with Social Security legal issues will aid a plaintiff in his effort to achieve a fair result from the Social Security Administration.
If you feel you were wrongly denied Social Security benefits, it may be important to contact an attorney
who can help you protect your legal rights. Please keep in mind that there may be time limits
within which you must commence suit.Attorneys associated with InjuryBoard.com
will evaluate your case free of charge
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- Frequently Asked Questions: United States Social Security System