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Disability Benefits Under Social Security

This is information on disability benefits under Social Security.

This basic idea of social security is a simple one: During working years, employees, their employers, and self-employed people pay benefits to cover the costs of the program. When a worker's earnings stop or are reduced because of retirement, death or disability, social security benefits will be paid to the worker or his family because of these prior contributions.

Social security provides benefits to employees and others who become disabled. This information deals only with the benefits which are payable because of disability and also with legal assistance available to help you claim such benefits.

Disabled people who receive monthly benefits come from all walks of life: the 40 year old salesman who has had a heart attack; the 23 year old secretary unable to work because of injuries she received in an auto accident; the 53 year old widow who is crippled with advanced arthritis; the retired or disabled worker's 25 year old son who has been mentally retarded from birth. These are only a few instances of people who are eligible to receive social security disability benefits.

Social security provides benefits to disabled persons under two programs. Benefits under the Title II program are payable to disabled individuals, or their families, who have made prior contributions. Benefits under the Title XVI program, Supplement Security Income(SSI), are payable to disabled individuals who are poor. Both of these programs have provisions which provide for benefits to a disabled widow or widower as well as to disabled children.

Under both programs, disability is defined as the inability to engage in any substantial gainful activity (work) due to a medically determinable physical or mental impairment that has lasted, or is expected to last 12 months or result in death. The medical determination is based on signs, symptoms, and laboratory findings. In addition to medical reasons, non-medical factors such as age, education, and prior work experience, are involved in determining eligibility for social security disability benefits. This means: you can not work because of a severe medical problem.

If you live in Illinois, when you apply for benefits, your local social security office will send your claim papers to Springfield for an evaluation. There is a state agency which has a contract with Social Security to make disability decisions. The state agency will make a decision whether you are disabled under the law.

A written notice is used to notify you of the determination made on your claim. If you believe the decision is not correct, you have the right to ask that your claim be re-examined. If you want to have the determination reviewed, you should contact the local Social Security District Office and do the following:

  1. Ask that the initial decision be reconsidered. Your request must be made within 60 days from the date of the notice of initial determination. This is called a request for reconsideration. If there is additional medical evidence available, submit that evidence to Social Security when you request reconsideration or advise Social Security where such medical information can be obtained.
  2. If you disagree with the results of that reconsideration, you may next ask for a hearing before an Administrative Law Judge. Your request must be made within 60 days from the date of the notice of the decision on reconsideration. A hearing is the most important stage of administrative appeal, because it is the claimant's first and only opportunity to explain his case directly to the person who will decide his claim. Therefore, it is also the point at which a lawyer will be most helpful to the claimant.
  3. If you disagree with a decision of the Administrative Law Judge, you may then ask for a review of that decision by an Appeals Council. This request must be made within 60 days from the date of the decision.
  4. If you disagree with the decision of the Appeals Council, you may file a suit in a Federal Court. Your complaint must be filed in the United States District Court for the district in which you reside within 60 days from the date of the decision of the Appeals Council.