Mental illness, like a physical illness, can be disabling. Persons with a serious mental illness are just as entitled to disability payments as persons with a serious physical illness. If you or your relative has a mental illness such as schizophrenia, obsessive-compulsive disorder, manic depression, or another disabling brain disorder (mental illness), you may be entitled to benefits from the Social Security Administration. For all inquiries, call the Social Security Administration at 1-800-772-1213 or visit their website at www.ssa.gov.
The benefits include cash payment that averages $900 per month. In most states, Social Security Disability Insurance comes with Medicare and Supplemental Security Income with Medicaid, although some states have different names or slightly different programs. Often the Social Security Disability benefit is the most important benefit because many states tie a Social Security Disability finding to eligibility for local programs.
Millions of Americans receive Social Security Disability benefits each year, and each year more that 2.5 million new applications are filed. The Social Security Administration defines disability in terms of ability to work. Persons who cannot work for a year or more, or whose condition is likely to result in death, may qualify for benefits. Disability examiners at state agencies, consulting with SSA doctors, determine disability based on clinical evidence and examinations. Unfortunately, these examiners do not meet the applicants.
You could be entitled to receive payments from one, or both, of two Social Security programs: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). SSI is for persons who are disabled, poor, and unable to work. SSDI is for persons who are disabled and unable to work, but who have worked in the past, or whose parents have worked and paid into the social security trust fund. The most SSI will pay for 2007 is $623 a month for an individual. About half the states supplement SSI, which increases cash benefits. The amount you may be entitled to from SSDI can be much larger, depending on work history, but the average payment is about $900 per month.
All disability claims start with an application to Social Security. This may be done in person, or electronically over the internet at www.ssa.gov. Or call any local Social Security office or the national toll free number: 1-800-772-1213. Family members or guardians should call SSA to find out what procedures they should follow.
No. The Social Security Administration has four basic standards for determining disability:
A claim representative will conduct an in-depth interview in person or over the telephone with the applicant and ask you to complete a variety of application forms. The representative will ask about the applicant's disability, medical history, leisure time activities, and financial status. This process can be difficult particularly if the applicant is experiencing symptoms or if the interviewer is not skilled. You may want a relative or friend, or a representative or lawyer, to accompany you to provide
A caseworker from SSA and a caseworker from the state Disability Determination Service (DDS) share responsibility for determining eligibility for disability programs. The SSA caseworker will focus on financial eligibility while the DDS caseworker will focus on medical and functional information. A decision should be reached within three months from the application date. This happens rarely, however. The process will more likely take six months. It's a good idea to call and check on the status of the application. The DDS caseworker will NOT meet with you.
Good, if you are willing to be persistent. Two out of three persons who apply for disability benefits are initially rejected, although the rejection rate varies widely from state to state. These applications are often rejected for what appear to be arbitrary reasons. If you appeal an initial rejection until you get a hearing with a judge – and most persons do not appeal – your chances of obtaining benefits improve. In 2004, over 60% of disability cases that were appealed to an administrative law judge were won by beneficiaries.
There are four levels of appeal. You can:
You can reapply. In some cases, you can reapply while an earlier unfavorable decision is on appeal. There may even be ways to “reopen” an old unfavorable decision; usually expert help is necessary to do this.
Call the Social Security Hotline at 1-800-772-1213 between 7 a.m. and 7 p.m. EST weekdays. The best times to call are early in the morning and early in the evening, in the middle of the week, and in the middle of the month. It may be worthwhile to call more than once and get a second opinion, or to consult with an attorney.
Allsup is a nationwide provider of specialized services for those with disabilities, including Social Security Disability Insurance representation and Medicare plan selection services. Allsup experts have helped more than 120,000 people receive SSDI and Medicare benefits. The company is headquartered in Belleville, Ill., and has approximately 600 employees located around the country. For more information, call (800) 279-4357, ext. 2020, or visit www.Allsup.com
Two other national groups have referral lists of representatives who can help you with your claim: The National Association of Disability Representatives (NADR) at 1-800-747-6131, or the National Organization of Social Security Claimants’ Representatives (NOSSCR), at 1-800-431-2804.
The Medicare Rights Center (MRC) publication, Your Guide through the Medicare Maze, also has been helpful for many seeking assistance. The MRC Consumer Hotline, 1(800) 333-4114, is available Monday-Friday, 9am-5pm ET.
Updated July 2009
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