Attorney Kimberly Bishop, of The Bishop Law Firm, is a NC Board Certified Social Security Disability Lawyer in Raleigh, NC who has practiced disability since 2009 in North Carolina. In addition, Chasity Everett, EDPNA, also represents disability clients for the firm.
This page discusses what qualifies as a disability, types of disability benefits available and the process under which one may be awarded benefits. If you are looking for a Social Security Disability Lawyer in Raleigh, NC and surrounding areas, give us a call today for a free case review, 919-615-3095.
Introduction to Social Security Disability
Social Security Disability Benefits came about in 1956, when President Dwight Eisenhower added a “disability” amendment to the Social Security Act. The Social Security Act was originally signed into law by President Franklin Roosevelt in 1935. At first the program provided monthly benefits only to disabled workers between the ages of 50 and 65 who met certain requirements for insured status (Via SSA). Even though the program has expanded to those under the age of 50, it is difficult for anyone, especially under the age of 50, to attain disability benefits.
Who should apply for Social Security Disability/SSI?
Those who are unable to work because of their health should apply for Social Security Disability Insurance or Supplemental Security Income (SSI). In theory, anyone can apply for Social Security Disability or SSI, but SSA may refuse to take your application if you are still working, making over SGA or have too many resources for SSI and are not otherwise eligible for Social Security Disability Benefits.
When should I apply for Social Security Disability?
You should apply for disability benefits as soon as possible. Unfortunately, I have had clients wait years after they stop working to apply for benefits. I tell my clients to apply for benefits as soon as they can because you do not know what the future will bring. If you are able to return to work, you can always withdraw your claim for benefits with the Social Security Administration, whereas if you never apply and are unable to return to work you may have just lost benefits you could have otherwise received.
Do I need an Social Security Disability Lawyer to apply for disability?
No, you do not need an attorney to apply for or be awarded Social Security Disability Insurance benefits or Supplemental Security Income. But having an attorney on your case can improve your chances of winning by knowing the process and what SSA is looking for to approve your claim.
How much are Social Security Disability Attorney Fees?
Attorney fees for disability cases are set by the Social Security Administration. The SSA only pays attorney fees if the client wins their case and there is backpay. If you do not win your case or if there is no backpay, no attorney fees are due.
Currently, SSA allows attorneys to charge 25% of the client’s backpay up to a maximum for $6,000. For example, if the client attains $10,000 in backpay the attorney will receive $2,500. If the client receives $100,000 in backpay, the attorney receives $6,000.
In addition to attorney fees, attorneys ask clients to reimburse them for the costs of getting medical records as SSA does not pay the attorney for this. At my firm, these costs can range from $30 to $150-ish depending on the volume of my client’s medical records.
Can I get disability if I have been diagnosed with ______?
What qualifies as a disability varies based on severity. Severity is key, not the name of your disease. I have had clients with asthma so severe that they could barely breathe with the help of 24-hr oxygen use. I have also had clients with cancer whose medical records described them as capable of running a marathon. You can visit our page, Disability and Diseases, to search for your specific impairment and how SSA will evaluate it.
Substance Abuse can stop you from receiving disability benefits if it is found to be a material factor to your disability.
How do I apply for Social Security Disability/SSI?
The first step to apply for Social Security Disability Benefits is to call your local Social Security Office and set up an appointment to file OR you can file an application here. For a list of what you need to apply, look here. There are two types of benefits that you may be eligible for, SSDI, SSI or both.
Types of Social Security Disability Benefits
Social Security Disability Insurance (SSDI)
SSDI (Social Security Disability Insurance) is based on the credits from the work you have done in your life. You must be found disabled before your date last insured (DLI) to be found eligible for SSDI. Your DLI is calculated by counting your “quarters of coverage” from your earnings record. You must have 20 “quarters of coverage” of the last 40 quarters. Simply put, you must have worked 5 years of the last ten years (in general). In addition, Adult Disabled Children can be eligible for benefits off their parent’s account.
Supplemental Security Income (SSI)
SSI (Supplemental Security Income) is a need-based program and you must meet income/asset standards in addition to being found disabled under the five steps above. In 2021, SSI is $794.00 per month for an individual and $1,191 for an eligible couple. SSI will be reduced by 1/3 if you are receiving financial help from others. In NC, SSI recipients are also entitled to Medicaid.
SSI is also available for disabled children and is evaluated under a different standard than adults. Children must have a medically determinable physical or mental impairment or impairments (including emotional or learning problems) which result in marked and severe functional limitations, and the impairment(s) has lasted or can be expected to last for a continuous period of at least 12 months or be expected to result in death. Child SSI terminates when the child turns 18. The claimant will then have to reapply and be evaluated under the above adult sequential evaluation.
Step 1 – Are You Working? The Social Security Administration defines work as “Substantial Gainful Activity” (SGA). SGA is roughly defined as work from earnings that average more than $1,310 (2021) a month. If you are making that amount you generally will not qualify for disability.
Step 2 – Is Your Condition “Severe”? Severity is key when it comes to what qualifies as a disability. Severe is defined by the Social Security Administration as: your condition must interfere with basic work-related activities for your claim to be considered.
Step 3 – Is Your Condition on the List of Disabling Conditions? The Listings are very hard to meet in most cases and not always interpreted as a common reading would suggest. If you meet a listing you are gravely ill. The listings are found here.
Step 4 – Can You Do the Work You Did Previously? The Social Security Administration will look at your past work and determine if it was sedentary, light, medium, or heavy. They also will evaluate the skill level: unskilled, semi-skilled and skilled. For instance, an attorney would be sedentary skilled work. The Dictionary of Occupational Titles is found here.
Step 5 – Can You Do Any Other Type of Work? If the Social Security Administration finds that you cannot do what you used to do, they then look to see if you can do anything else. This is where the “grids” come into play. The grids are the Medical-Vocational Guidelines. The grids are only for exertional impairments. Non-exertional impairments are not considered by the grids. If you are found to be capable of any other work, you will be found not disabled. Read The Grids and Your Social Security Disability Case.
Overview of the Disability Process
You are at the beginning of a process that could take over 2 years to complete. Step one is to call your local Social Security Office and set up an appointment to file your initial claim or you can start your application online here. For a list of what you will need to apply look here. Apply for benefits as soon as possible, delay may cause you to lose benefits!
After you apply at the local Social Security Office or online, your case will be sent to DDS(Disability Determination Services) in Raleigh, NC. At DDS, an examiner will review your file, send you forms (i.e. work history forms and 3rd party questionnaires for your family to complete) and order medical records on you. They also may send you to a Social Security doctor for an physical or mental consultative examination.
The three most important things you can do for your case at the initial (and reconsideration) level is to return the forms to DDS as soon as possible, go to any consultative examinations they schedule for you and also get regular medical treatment from your doctors. If you do not return the forms to DDS or go to the consultative examination they can deny you on a technicality.
The DDS Examiner will then make a decision. If you are denied, you have 60 days from the date of the denial to request a reconsideration. The Bishop Law Firm can help you request an appeal, communicate with DDS and make sure that your case keeps moving as quickly as possible.
You have received a denial on your initial application. The denial lists what medical records DDS considered and the Social Security Administration’s reason why they feel you are not disabled. The denial is upsetting, especially with being sick, having no health insurance and household income. You can file an appeal online or go to the local Social Security office and request an appeal, the reconsideration.
When you request a reconsideration, your case will again be sent to DDS. A different examiner will review your case, send more forms for you to complete and order more medical records if you have any. This examiner will then make a decision on your case. Statistically speaking, you have a far greater chance of being denied than you do being approved. If you receive a denial at the reconsideration level you have 60 days to request a hearing from the date of the reconsideration denial. A Social Security Disability Lawyer can help you request an appeal, communicate with DDS and make sure that your case keeps moving as quickly as possible.
You received your notice of reconsideration. This is your second denial. You are in shock at being denied twice by the Social Security Administration after they have requested so much information from you, your family and your doctor. You request the next level of appeal, a hearing before an Administrative Law Judge (ALJ). It usually takes 8-14 months before your hearing is scheduled and can be even longer if you live close to Greensboro and Fayetteville, NC.
The Bishop Law Firm has experience with hearings, what ALJs expect and what an ALJ needs to have in order to approve your disability case. Hiring a Social Security Disability Lawyer can help at all levels, but it is critical at the hearing level and beyond. The Bishop Law Firm will review your file to make sure DDS did not make errors, that your medical records are complete and that your doctor has been consulted for his/her medical opinion about your condition.
After the hearing, a decision is usually made by the ALJ within 60-90 days. If you lose at hearing, you can appeal to the Appeals Council (AC) OR open a new claim with the Social Security Administration if applicable. The Social Security Administration will not allow you to file an appeal and start a new claim. You have to choose which is the right one for your case. At the Bishop Law Firm, we have experience with these difficult choices and can advise you on the best choice for your case.
If you appeal the denial of the ALJ, your request will go to the Appeals Council. The Appeals Council will review your case to see if the ALJ made a legal error. The Appeals Council reviews the file and any arguments made by your Social Security Disability Lawyer. If the Appeals Council determines that a error was made they will send your case back to the hearing office for you to have another hearing. The Appeals Council does not evaluate your case to make sure the ALJ made the right decision. They only look for legal errors made by the ALJ.
The Appeals Council is slow and unresponsive. It may take 18 months for the Appeals Council to rule on your request for appeal. The Appeals Council can remand your case back to a ALJ or they may approve your case. Approvals are rare, but they do happen. If you are denied by the Appeals Council, you can file a case in District Court or start a new application.
If the Appeals Council denies review, you have three choices. You can file a claim in Federal Court or you can start over again with an initial application to the local Social Security Office (or online as discussed above) or do both.
Federal Court (District Court) cases do not involve hearings or any type of meeting that you have to attend. The government attorney assigned to your case will file a brief on behalf of the Social Security Administration. Your Social Security Disability Lawyer will file a brief on your behalf as well. The Federal Court judge will make a decision based on the briefs and records alone.
If the Federal Court judge agrees with you, he/she can approve your case or send your case back to the hearing office with instructions on how the ALJ can correct his/her error(s) of law. Approvals at the DC level are rare and remand is the usual remedy.
Applying for Social Security Disability and Supplemental Security Income can be a tough process but you have to stay determined. For my clients going through this process, Social Security Disability is their last resort. A Social Security Disability Lawyer can improve your chances of winning your case by knowing what the SSA needs to find you disabled. The Bishop Law Firm represents Social Security Disability clients in Raleigh, Durham, Fayetteville, Cary, Rocky Mount, Wilson, Smithfield, Louisburg, Chapel Hill, Roanoke Rapids and surrounding areas in North Carolina. Call us today for a free case review, (919) 615-3095.