If you suffer from a disability and live in the U.S. you may be entitled to Social Security Disability benefits. For this to happen the Social Security Administration must deem your disability severe enough that you cannot engage in “Substantial Gainful Activity”
The SSA evaluates your medical condition by looking at the “Listing of Impairments” and assessing your work-related limitations. The “Listings” outline each major body system, and provide requirements necessary for proving disability. Many of the listed impairments are permanent or likely to result in death.
For all other conditions, the SSA assesses your medical evidence which must demonstrate that your disorder will last at least 12 months and prevent you from working at any job.
What Are The Most Common Disabilities?
The list below will show you the type of medical conditions/disabilites that are the most common among SSD benefit applicants. (This list is based on the SSA’s Blue Book.)
Cancer
Cardiovascular Systems
Congenital Disorders That Affect Multiple Body Systems
Digestive System
Endocrine System Disorders
Hematological Disorders
Genitourinary Disorders
Immune System Disorders
Mental Disorders
Musculoskeletal System
Neurological Disorders
Respiratory Disorders
Skin Disorders
Special Senses and Speech
Get The Help You Need To Secure SSD Benefits
At Disability Help Group, we work hard to build a strong medical file to support your SSD claim. We will request your medical records and medical evaluations from your doctors and give you the best chance of receiving the benefits you deserve. Contact our team of experts today here or call us at 800-800-3332.
You probably know that a U.S. worker who is medically unable to work may be eligible for Social Security disability (SSD) benefits. If a worker meets the SSA’s definition of “disabled” and has accumulated sufficient work credits, they may receive a monthly benefit in the same amount they would have received in retirement benefits. After two years, a disabled worker on SSD is also eligible for Medicare coverage.
What you may not know is that certain family members of an SSD recipient may also be eligible for benefits. Here’s what you need to know about who qualifies and how benefits are determined.
Who Can Get SSD Family Benefits?
Under certain circumstances, the following family members of disabled workers may receive benefits:
A spouse who has been married to the SSD recipient for at least one year
A former spouse who was married to the SSD recipient for at least 10 years
An unmarried minor child of the SSD recipient
An unmarried child of the SSD recipient who is 18 or 19 years old but still in high school
An unmarried disabled adult child of the SSD recipient
Under certain limited circumstances, other family members may be eligible for benefits.
In the most recent year reported, the Social Security Administration (SSA) paid SSD family benefits to more than 90,000 spouses and former spouses and more than 1.1 million children of SSD recipients. The vast majority of those children were under the age of 18.
There are some additional requirements for a spouse or former spouse to be eligible for SSD family benefits. The spouse or former spouse must also either:
Be at least 62 years of age
Be disabled
Be caring for a child younger than 17, or
Be caring for a child 17 or older who is disabled
How are SSD Family Benefits Determined?
Unlike many other types of benefits, SSD benefits are determined based on the individual disabled workers’ past earnings and contributions. Since SSD family benefits are based on the disabled workers’ benefits, that means those benefits also vary based on the SSD recipient’s past earnings.
An eligible family member may receive up to 50% of the SSD recipient’s monthly benefit amount. However, total family benefits are capped. So, if there are multiple family members who qualify for benefits, the benefit amounts may be reduced so as not to exceed the cap. However, benefits paid to a former spouse don’t count toward the family maximum.
Disability Help Group is Here for You
The seasoned advocates at Disability Help Group work hard every day to make sure disabled workers and their families have access to the benefits they’ve earned. To learn more about how we can help your family, call 800-800-3332 or fill out our contact form here.
Better customer Service for SSD Benefit Applicants
If you’ve tried to apply for Social Security disability (SSD) or other benefits through the Social Security Administration (SSA), you might have been frustrated by the process and the customer service. If you felt like it took too long to process your claim or had trouble getting someone on the phone when you needed help, you’re not alone. Big changes may be on the horizon.
In the spring, SSA Commissioner Martin O’Malley appeared before a subcommittee of the U.S. House Ways & Means Committee to discuss a variety of issues, including “the efficiency and operation of the Administration itself.”
Understaffing and Other Hurdles Have Created Backlogs
O’Malley said that despite having more “customers” than ever before, SSA staffing was at a 27-year low. That reduced staff handled about 81 million calls last year–no surprise when you consider that more than 10,000 people become eligible for Social Security benefits every day. That’s created delays in getting customer service, delays in initial SSD determinations, and delays in SSD appeals.
Based on data shared at the hearing, the average wait time when someone called the SSA at the beginning of 2024 was 39 minutes, with some callers waiting more than an hour. While O’Malley said the average wait time was down to 31 minutes by spring, he called that figure “nothing to write home about” and said the SSA continued to work to get that time down.
He said the average SSD applicant was waiting nearly 8 months for an initial determination, and another seven months if they had to appeal. Now, the SSA is carving out time regularly to meet on several key performance areas, including:
Operations
Human resources
Initial disability determinations
ALJ hearings
Fraud
Notices
Overpayments
O’Malley Seeks to Change the Culture at the SSA
During the hearing, O’Malley was asked if he could change one thing that would last beyond his role at SSA, what it would be. He responded that he would like to change the culture at SSA to realize that all of the huge numbers they deal with are real people. He also said the agency is looking toward more sophisticated information-sharing processes to streamline procedures, reduce overpayments, and speed up processes. An improvement in the customer service at the SSA could make a big change in the experience each person has.
O’Malley is still relatively new in the role, and some changes to the system would be subject to formal rulemaking procedures or require Congressional approval. So, the exact nature and extent of the changes haven’t fully been determined. However, improved efficiency and customer service have the attention of the new Commissioner and others in government.
Delays Aren’t the Only Problem with the SSD Process
Improved customer service can make the SSD application and appeals process less frustrating, but it won’t necessarily improve outcomes. If you need help securing SSD benefits or fighting a denial, an experienced disability benefits advocate can be your best resource. To learn more, call Disability Help Group at 800-800-3332 right now or click here for a FREE consultation.
Will I Lose My SSD Benefits if I Move to a Different State?
Social Security disability (SSD) is a federal program based on your work history and contributions to the program through payroll taxes. Your eligibility for SSD won’t change if you move from one U.S. state to another. In fact, you can often continue to collect SSD benefits while living in a foreign country. However, Medicare benefits are generally only available to those in the United States.
While earned income is considered in determining SSD eligibility, other types of income and resources are not. So, if the SSD recipient is moving to another state because they inherited a $500,000 house or because they can live rent-free with a family member, that won’t have any impact on their benefits. However, there is one way a move–whether in-state or outside the state–can hurt the benefits you’re receiving from the Social Security Administration (SSA). That’s if you neglect to inform them. You must keep the SSA up to date on your whereabouts. Fortunately, the SSA makes it easy to update your contact information.
Supplemental Security Income (SSI) is Different from SSD
SSD and SSI are both administered by the SSA. However, the two programs are very different. While SSD benefits are based on the work credits you earned across your career, SSI is a need-based public benefit.
Like SSD, SSI is a federal program. However, some states offer supplemental payments to elderly and disabled residents who qualify for SSI. That means that the total amount of benefits an SSI recipient gets may change if they move from one state to another. It’s also worth noting that because SSI eligibility is based on income, certain changes in living arrangements may affect eligibility. For example, if an SSI recipient moves from one state to another to move in with a family member who will provide lodging and food at no cost, that may affect the SSI calculation.
Know Your SSD Rights
Whether you’re just applying for SSD benefits, are receiving benefits, and are concerned about how a change in your circumstances may affect your eligibility or are appealing a denial of SSD benefits, the process can be complicated and confusing. An experienced disability benefits advocate can be your guide. To learn more about how the knowledgeable advocates at Disability Help Group can assist with every stage of the SSD application and appeals process, call 800-800-3332 right away or click here to get a FREE evaluation of your case.
Unless there are special rules that apply, the VA will deny service connection for Traumatic Brain Injury (TBI) unless the Veteran can prove a:
Current diagnosis,
In-service event, disease or injury, and
Medical nexus between the first 2 elements.
Reason for TBI C&P Exam
It is the veteran’s burden to prove he deserves the VA benefits. In certain circumstances, the VA must help the veteran meet his burden. A compensation & pension (C&P) exam is one example of how the VA helps veterans develop evidence. In a C&P exam, the VA asks a qualified professional to answer medical questions related to your claim.
When Should I Expect a TBI C&P Exam?
If you file a claim for a Traumatic Brain Injury based on sudden head trauma during service, then you should expect the VA to schedule a C&P examination.
A C&P exam can help VA answer the following medical questions:
Does the veteran have a confirmed diagnosis of a Traumatic Brain Injury?
Is it at least as likely as not that the TBI was caused or aggravated during active duty service?
How severe are the residuals of the Traumatic Brain Injury?
Who Can Conduct a TBI C&P Exam:
Neurologist,
Neurosurgeon,
Physiatrists, or
Psychiatrist.
Diagnosis of A Traumatic Brain Injury
A Traumatic brain injury occurs when a sudden trauma causes damage to the brain. According to the Department of Defense, more than 313,816 service members have sustained a Traumatic Brain Injury in training or combat. Common causes of this kind of head trauma include blast-related concussion events resulting from training or combat. A Traumatic Brain Injury is known as a signature injury of the Iraq and Afghanistan wars due to the frequency of IED attacks. However, a simple fall down a 10-foot ladder could also damage the brain.
Always Document Your Injuries
If you cannot prove that your that your Traumatic Brain Injury is related to service, then the VA may assume that it happened after discharge. For this reason, it is critical that service members document any and all head injuries. Your case is much easier to win if head trauma is clearly documented in your service medical records. In the absence of official records, statements from witnesses would be helpful. If you file a claim for Traumatic Brain Injury without a confirmed diagnosis, then VA may refer you for a C&P exam.
Medical Nexus for TBI
After a TBI C&P exam confirms a diagnosis, the next question is: what caused it? Is it at least a 50/50 chance that the TBI was caused by in-service head trauma? If your doctor’s answer is “Yes” and he provides a reasonable explanation, then you have your medical nexus. If the doctor answers “No”, then you should consider a second opinion from a private doctor.
What Are Residuals Of A Traumatic Brain Injury?
Veterans with a Traumatic Brain Injury may experience problems long after the initial head trauma. These problems are known as residuals. During a TBI C&P exam, the doctor will determine which TBI residuals are present.
Traumatic Brain Injuryresiduals are broken down into the following 10 categories:
Memory, attention, concentration, and executive functions–
Judgment
Social interaction
Orientation
Motor functions
Visual-spatial orientation
Subjective symptoms
Neurobehavioral effects
Ability to communicate
Consciousness
TBI Rating, TBI C&P Exam
After the TBI C&P exam, the doctor will send a written report to the VA. The report will include how severe your residuals are. If the VA approves your claim, it will likely use this report to assign a percentage rating. VA rates TBI residuals on a scale of 0, 1, 2, 3, or total.
0 = 0% (normal functioning)
1 = 10% (mild)
2 = 40% (moderate)
3 = 70% (severe)
Total = 100%
Every C&P exam involves the doctor asking questions of the veteran. The doctor relies on the veteran to explain his symptoms, some of which may not be present or observable on the day of the exam. Because memory deficits are common TBI residuals, a veteran should attend C&P exams with a spouse, family member, or friend who knows them well. They can fill in the blanks if the veteran is unable to either remember or communicate certain residuals during the exam.
A Veterans Disability Advocate Can Help You!
Working with the VA as a disabled veteran can be frustrating. Our expert Veterans Disability Advocates are here to help you through your VA Disability benefits process. Call us today at 800-800-3332 or click here to get in touch with a disability expert NOW.
