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The Judge Approved my Case–What is Next?

November 5, 2015 by Guide1963


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You just received a written decision from the Social Security Administrative [“SSA”] Law Judge which APPROVED your application for Social Security Disability [“SSD”] benefits. We will address some “Frequently Asked Questions” about what will happen next:

Q.  Do I have to do anything (e.g., visit the SSA Local Office) to get paid?
A.  No. You will be paid automatically if you gave SSA your bank account information.  If you do NOT have a bank account, or have a new bank account since you applied, contact SSA to determine how you will be paid.  Call SSA at 1-800-772-1213 if this applies to you.

Q. How long will it take for SSA to pay me?
A.  As a general rule, it usually takes about 1-2 months for the back SSD benefits to be paid.

Q.  If I am not paid within 90 days, is there anything that can be done?
A.  We might be able to help. Please contact us.

Q.  How far back will my benefits go?
A.  You are not entitled to collect SSD benefits for the first five (full) months that you were disabled. Moreover, you cannot be paid for a time earlier than 12 months from the date that you first applied for SSD benefits.

Q.  The Judge indicated that I am “last insured” for SSD purposes on a date in the future.  Will my benefits stop then?
A.  No.  The Judge decided that you became disabled under the law before that date “last insured.”  Thus, your benefits will continue indefinitely into the future.

Q. Will I receive a notice from SSA explaining my benefits?
A.  Yes. That notice is called the “Notice of Award.” It shows the month you first are eligible to collect benefits, how much “back” benefits you will receive, how much you will be paid monthly, when you will be paid each month, whether our fee was withheld and, if so, the amount of our fee. It may show when you will be eligible for Medicare and how much it will cost you to participate in Medicare.  As a general rule, you will be able to participate in Medicare 24 months from the month you first are eligible to collect SSD benefits.  To learn more about Medicare, visit: www.medicare.gov This notice should arrive around the time that you receive your first payment.

Q.  I have received a payment but no Notice of Award. What Should I do?
A.  We recommend that you set aside 25% of the amount of the lump sum payment in case SSA failed to withhold our fee.  In most cases, SSA withholds our fee from your lump sum and pays it directly to us.  There are times, however, when SSA makes an error and fails to withhold our fee. You are responsible for paying our fee regardless of whether SSA withholds it from the lump sum.  Once you get the Notice of Award, you will know whether SSA withheld our fee.  If they did so, you are free to spend the entire amount of the money you received from SSA.  If SSA did not withhold our fee, we will arrange payment with you directly.  We recommend that you keep documentation of the lump sum payment you received and retain it for your records.

Q.  Will I have to pay taxes on my SSD benefits?
A.  It depends upon the amount of your total family income.  To our knowledge, part of your SSD will be taxed if: (1) you are single, and your total income is more than $25,000; or (2) you are married, and you and your spouse have total income of more than $32,000.  We are not qualified to give you tax advice. SSA publishes a booklet about the taxation of SSD benefits.  You can get one at the closest SSA Local Office or by visiting the SSA web site at http://www.socialsecurity.gov.  We recommend that you consult with a tax advisor about this complex issue.

Q. Am I entitled to other benefits because I will be receiving SSD?
A. By virtue of your receipt of SSD benefits, you may be eligible for other benefits from your union, former employer or from other sources (e.g., waiver of your obligation to make student loan, mortgage, credit card or car payments).  You also may be eligible to draw pension funds early and without penalty.  Contact the appropriate people and find out. Communicate with us if we can help.

Q. Will my receipt of Workers’ Compensation benefits affect my SSD benefit?
A. You cannot collect more than 80% of your pre-disability income when you add together your SSD and Workers’ Compensation [“WC”] benefits.  SSA has three different ways to calculate the amount of your pre-disability income. In fact, they allow you to use the way that produces the HIGHEST amount of pre-disability income.  For most people, the highest amount of pre-disability income is determined by calculating your average monthly (gross) earnings during the five consecutive years that you earned the most money.  The combined amount of your SSD and WC benefits CANNOT exceed eighty percent (80%) of that amount.  If it does, SSA reduces your SSD benefit and NOT your WC benefit. If you have not done so already, please provide us with information about your receipt of WC benefits since the date that we alleged that you became disabled.

Q.  Can I work and collect SSD?
A.  To be eligible to collect SSD benefits, you must be unable to work due to disability for a continuous period of 365 days or more.  If you work (even ONE day) before 365 days or more have passed, your SSD application may be denied even if you are “medically” disabled.  Thus, we do NOT recommend that you perform ANY work for money until at least one year AFTER the date that SSA found that you first became disabled.

Once you have been unable to work due to disability for 365 days or more, the law encourages you to work and gives you a financial incentive to do so.  You can work, earn an UNLIMITED amount of money, and still receive SSD benefits for a period of up to 12 months from the date that you start working.  This incentive is commonly known as a “Trial Work Period” [“TWP”]. Effective January 1, 2018, when you work and earn at least $850/month (gross), you have used one of the available TWP months. The 2017 amount was $840/month.

If your goal is to work but keep collecting SSD indefinitely into the future, keep your earnings BELOW $850/month (gross). Gross means before taxes.

Keep in mind that there are ~4.3 weeks in a month. Thus, to stay UNDER $850/month (gross), your weekly earnings before taxes must be LESS THAN $196/week ($850/month x 12 months/year = $10,200 divided by 52 weeks/year = $196.15/week).

The “working while disabled” rules are tricky. PLEASE CONTACT US BEFORE YOU PERFORM ANY WORK FOR MONEY.  While we encourage you to work, we urge you to contact us BEFORE you commit to any work activity. We want you to understand clearly the risks and rewards of working.

Q.  What are my obligations to the Long Term Disability [“LTD”] Insurance Carrier?
A.  It is likely that you will owe to the LTD carrier some or all of the lump sum that you received from SSA.  PLEASE SEND A COPY OF THE DECISION TO THE LTD CARRIER.  We will work with you to be sure that the amount that you pay back to them is correct.

Q.    Can I continue to receive Unemployment Benefits while collecting SSD?
A.    You are only entitled to collect Unemployment Benefits so long as you remain “ready, willing and able” to work.  Once you have been approved for SSD benefits, it is generally accepted that you are no longer “able” to work.  Therefore, we advise that you stop certifying for continued unemployment benefits once you have been found disabled by Social Security.

Q.  The Judge recommended that my case be reviewed in 24 months.  Does this mean that my benefits will stop then?
A.  NO.  This is just a recommendation.  SSA can review your case at any time.  For SSD benefits to stop, SSA has to prove that you have improved medically.

Q.  Social Security asked me to withdraw my SSI claim.  What should I do?
A.   Many times a Claimant’s entire SSI benefit will be completely offset by the amount of their SSD benefit.  If this occurs, SSA generally requests that the Claimant withdraw the SSI claim to expedite payment of their SSD benefits.  You are not required to withdraw your SSI claim, however, your SSD payment may be delayed if you do not.  In most cases, withdrawing your SSI claim in this situation is to your benefit.  Withdrawing your SSI claim generally makes you ineligible for Medicaid, however, you may remain entitled to it under other programs or circumstances.  We suggest you contact your Social Services caseworker to discuss how your SSD benefit may impact your Medicaid coverage.

Q.  Can unpaid child support or federal income taxes affect my SSD benefit?
A.   Yes.  If you have unpaid child support or federal income taxes, SSA may withhold some or all of your back SSD benefit to pay these debts.  If you still owe child support or federal income taxes after your back benefit has been seized, SSA may continue to withhold benefits until these debts have been paid in full.  Once your unpaid child support or federal income taxes have been paid, your SSD benefit should resume.

Q.  SSA assigned a representative payee to my case.  What does that mean?
A.  When SSA considers it appropriate, they will assign a representative payee to manage your benefits and ensure they are used in your best interest.  The benefits paid to a representative payee remain your personal benefits and cannot be used for the payee’s personal expenses.

ONE FINAL NOTE.  IF YOU HAVE NOT DONE SO ALREADY, CALL SSA AT (800) 772-1213 AND START A CLAIM FOR YOUR MINOR CHILD(REN).  SSA WILL DETERMINE WHETHER YOUR CHILD(REN) ARE ENTITLED TO A BENEFIT AS AN EXTENSION OF YOUR OWN SSD BENEFIT. 

We hope that we have answered some of your questions. If you have other questions, do not hesitate to contact us.

 

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