Social Security Process
The social security program is run by the US federal government by the social security administation (SSA). The program provides benefits to more TBI survivors than any other. Almost all survivors of a moderate or severe brain injury should eventually be found to be entitled to social security benefits. However, the quality of the represenation before the SSA is imporant. Many mild TBI survivors will also qualify for social security disability as long as they follow the Social Security Process.
Practical Rule for Social Security Process and Award: Apply on day one.
The SSA routinely turns down, or delays, acceptance of even severely injured TBI survivors. This is just part of the social security process.
The basis for such denial usually some version of a finding that to be eligible for social security benefits, the survivor must be totally disabled for a period of one year.
At the time SSA first evaluates the claim, it may not have been one year from the time of injury. If doctors are saying anything like: “We will just have to wait and see,” SSA may turn down the applicant with the following language:
“We have determined that your condition (brain injury) is not expected to remain severe enough to keep you from working for 12 complete months.”
The good news is that SSA takes so long to process applicants, that by the time a hearing is heard, there often will be no question that the disability has lasted a full year.
Simple rule for social security applications: don’t give up. There is a three step process to get a hearing. Chances of winning at a hearing are excellent, especially if represented at the hearing.
The process consists of the following stages:
A TBI survivor applies for benefits. After months of form filling and waiting for medical reports, SSA will make an “initial determination.” If the SSA finds some theory as to a quick recovery from the brain injury, the application may be denied. The denial will detail the process to request a reconsideration. Do the reconsideration request ASAP.
On reconsideration during the Social Security process, a different SSA person will look at the medical evidence, as well as any additional medical documentation. While reconsideration doesn’t always result in reversal; with the increasingly clearer picture of the disability as time passes, it can make a have a positive result after a brain injury. If the treating providers are giving clearer opinions, the applicant may be accepted at this point. Again, the delay improves the chance of being accepted for benefits.
If there is another denial during the Social Security process, then the TBI survivor must again appeal. At this stage the claimant gets a hearing in front of an administrative law judge (ALJ). It is also at this point that it becomes important to consult with an attorney. Experienced social security attorneys and representatives have excellent track records of success at hearings.
Attorney fees in this area are a bargain. At the hearing, an ALJ will re-examine the medical evidence, as well as hear testimony presented by the survivor or his or her representative. Such testimony should include first hand testimony of the TBIs urvivor’s difficulties from family members, employers or co-workers.
Odds are that an ALJ, if presented with the sufficient evidence, will find that the disability meets the social security standard. Getting a neuropsychologist to testify, even by telephone, increases your chances go up considerably.
Eligibility for social security, not only opens the door for monthly benefits, it may also provide payment for medical bills and other benefits as long as you complete the entire Social Security process.
SSI is abbreviation for Supplemental Security Income. SSI pays monthly checks to people who are:
- 65 or older,
- or have a disability;
- or blind.
and who don’t have substantial assets or income.
Monthly benefit checks can go to disabled and blind children, as well.
People who get SSI may also be eligible for food stamps and Medicaid, as well. Medicaid provides health insurance coverage for eligible individuals. Medicaid eligibility is set to expand under Obama Care, depending on actions taken by states governments, which continues to controversial in January of 2013.
SSDI is the abbreviation for Social Security Disability Income benefits.
Disability for SSDI is based on the inability to work.
You can receive SSDI benefits at any age.
For further information to starting your Social Security process:
The SSA has offices in cities and towns across America. Click here for the llink for the United States Government Page on Social Security. http://www.ssa.gov/SSA_Home.html