James H. Greeman and Patrick A. Toomey have over 15 years of combined experience representing claimants before the Social Security Administration. We will work closely with you and your doctors to fully and properly develop your claim and obtain all relevant supporting medical documentation. Whether filing a claim for Disability Insurance Benefits, Supplemental Security Income benefits, Children's Disability benefits, Disabled Adult Child benefits, or Disabled Widow's/Widower's benefits, we have the experience you can trust. James H. Greeman and Patrick A. Toomey have represented over 20,000 clients before the Social Security Administration and continue to build on their knowledge and experience.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security disability insurance program (Title II of the Social Security Act (the Act) and the Supplemental Security Income (SSI) program (title XVI of the Act).
Title II provides for payment of disability benefits to individuals who are "insured" under the Act by virtue of their contributions to the Social Security trust fund through the Social Security tax on their earnings, as well as to certain disabled dependents of insured individuals. Title XVI provides for SSI payments to individuals (including children under age 18) who are disabled and have limited income and resources.
Disability is a subject you may be familiar with, but not think of as something that would actually happen to you. But your chances of becoming disabled are probably greater than you realize. Studies show that a 20-year-old worker has a 3-in-10 chance of becoming disabled before reaching retirement age.
Definition of Disability: For all individuals applying for disability benefits under Title II, and for adults applying under Title XVI, the definition of disability is the same. The law 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 in Children: Under Title XVI, a child under age 18 will be considered disabled if he or she has a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months.
Making an Application: The first step in applying for Social Security disability benefits is to complete an interview with the Social Security Administration ("SSA"). You can schedule an interview with SSA by calling them at 1-800-772-1213. You will have the option of completing your interview in person at your local Social Security office or requesting that a telephone interview be conducted by SSA. The process is generally faster and more convenient if you request that a telephone interview be scheduled. If requesting a telephone interview, SSA will schedule a time and date for one of their representatives to contact you at home, via the telephone. Upon completing the interview, SSA will send you a number of forms for your review and signature.
Initial Decision: Once you have completed the initial application, it may take SSA up to 120 days to process your claim and make its initial decision. Please note most claims, approximately 75 percent, are denied at the initial level. If your claim is denied our office will complete the appeal form (Request for Reconsideration). As there is only a 60 day time period in which to appeal an unfavorable initial decision, it is important that you contact an attorney right away once you receive an unfavorable initial decision.
Request for Reconsideration: If your claim has been denied, you have 60 days from the date of the initial decision to file an appeal. The first appeal is called a "Request for Reconsideration" and involves submitting an appeal form and ensuring SSA is apprised of any updated medical information. Once SSA has obtained any updated medical information, your claim will be reviewed and a new decision will be made. It typically takes SSA four-to-six months to make a decision at the Reconsideration level, and approximately 95 percent of all cases are denied at this step. If your claim is denied at the Reconsideration level, the next step is to request a hearing before an Administrative Law Judge. You have only 60 days from the date of the Reconsideration decision to file an appeal; therefore, it is important if you do not already have a representative that you contact an attorney right away once you receive an unfavorable Reconsideration decision.
Request for Hearing: If your initial claim and Reconsideration appeal were denied, the next step is to request a hearing before an Administrative Law Judge. Most claims for Social Security disability benefits - over 70 percent - are approved at the hearing level. To ensure your claim has the best chance of success, it is in your best interest to at least speak with an attorney regarding your claim before your hearing. As most attorneys will require several weeks or months to review your file, make certain all relevant medical information is up-to-date and obtain supportive evidence, it is important to contact an attorney as soon as possible. We offer free telephone consultations and would be happy to discuss your particular case.
The hearing process is very informal. The judge and your attorney will ask you questions about your daily activities and how your disability limits you. These questions will be very simple and similar to the questions our office has already asked you about your disability. A medical expert and vocational expert hired by Social Security may also be called to testify at your hearing. These experts are not there to testify for or against you, but to give their opinion about your disability and how it would impact your ability to work. The hearing will be very short. Typically, a hearing lasts 30-60 minutes. Most of the talking will be between the judge, the attorney, and the experts. You may be answering some questions for 10-20 minutes during the hearing. The hearing will likely be far less frightening than you will imagine it to be. Any questions the judge asks you will be about you and what you can and cannot do because of your disability; there are no right or wrong answers. As I often tell my clients, there is no better witness about how your disability limits what you can do than you.
Appeals Council Review: If your claim is denied at the hearing level, the next step is to request administrative review by filing an appeal with the Appeals Council. This involves filing another appeal and submitting written arguments as to why the judge's decision is not supported by substantial evidence. The Appeals Council deals with paper or written appeals only, and does not involve a personal appearance by the attorney or claimant. The Appeals Council will either deny the appeal, remand the case back to the judge for a new hearing, or if warranted by the record, reverse the judge's decision and award benefits. Cases on appeal at the Appeals Council typically take 1-2 years before a decision is made. While your claim is pending review at the Appeals Council, I always instruct my clients to file a new claim during this period as sometimes benefits are approved on this second claim before a decision is made on the appeal.
Federal Court/Civil Action: If your claim is denied by the Appeals Council, the next step is to file a Civil Action in the Federal Court. As with other appeals, you have only 60 days from the date of the Appeals Council decision to request Federal review. As the issues and procedures for filing in Federal Court are complex, it is best to contact an attorney for legal advice on filing a Civil Action.
