Social Security Disability is a Federal benefit program, separate from Workers Compensation, which provides a monthly benefit to people who are unable to work due to a medical condition (whether related to a work injury or not) that has lasted or is expected to last at least a year. Unlike workers compensation, Social Security Disability is available to you even if your medical condition was not caused by work. Social Security Disability has a very strict definition of disability: you must be found unable to engage in any substantial gainful employment in order to qualify. There is no partial benefit available. In addition to having a medical condition that prevents you from working, you must also have put in enough years of work to qualify as insured under the Social Security Disability program. There is also a program called Supplemental Security Income, which has the same disability requirement, but which doesn’t require that you be insured under the Social Security Disability program so long as your household meets certain income requirements.
If you have a work injury that leaves you with permanent injuries that make you unable to work anymore, Attorney John Jokela is a Wausau denied social security benefits lawyer that can often maximize your potential recovery by representing you for both Workers Compensation and also Social Security Disability.
To meet the federal requirements for Social Security Disability eligibility, you must be able to prove the following:
Social Security Disability payments are provided monthly for individuals who are unable to work for more than an entire year, or who are expected to be unable to work for a year. If combined with state worker’s compensation claims, the state claim in Wisconsin may be reduced somewhat, depending on the circumstances and timing of the claims.
Compared to the Wisconsin Worker’s Compensation Act, Social Security Disability benefits do not cover temporary or partial periods of disability. Social Security is best understood as an all or nothing type of benefit program. Although, you may be able to recover Social Security Disability benefits for a limited period of time if you are temporarily disabled for a year or more, and then make a good recovery that would allow you to return to work.
Given the strict definition of “disability,” many claims are denied. To qualify for Social Security Disability payments, there must be a finding that your disability is either permanent or expected to last at least a year or longer. During this time, the medical bills will continue to pile up, and you may continue to be unable to work.
If your Social Security Disability claim has been denied, you can appeal the decision within 60 days of the denial and provide additional medical support or other documentation to support your claim. The Social Security Administration will then reconsider your claim and review any new information you provide, and make a new decision. If the decision is still a denial, you are entitled, within 60 days, to request a formal hearing, conducted by an administrative law judge. The administrative law judge will take a new and fresh look at your case, and give no deference to the prior decisions on your file. I consider the administrative law judge hearing, which is the third step in the appeal process, to be the first real chance to completely present and argue your claim. If you believe you are disabled and unable to work, you can continue to appeal until you can present your case to the administrative law judge. An attorney can also represent you at an administrative law judge hearing, present evidence on your behalf, and cross exam expert witnesses who may appear at the hearing. At the administrative law judge hearing, the experts may present technical evidence critical to winning or losing your case, and it may be hard to understand or follow this testimony if you do not normally deal with Social Security Disability claims. An attorney skilled at Social Security Disability can counter unfavorable statements, raise questions, and point out inconsistencies in expert testimony that may otherwise be harmful to your claim.
If your hearing before the administrative law judge is unsuccessful, then you may appeal your case to the Social Security’s Appeals Council within 60 days. This is a paper only appeal, there normally will not be a hearing. However, you or your lawyer can submit a letter or legal brief explaining why you believe your claim should have been accepted by the administrative law judge. The Appeals Council will consider your case and all documentation supporting your claim, and issue a new decision. If your claim is still denied, you may then file a lawsuit in federal district court, but the deadlines for filing such an appeal are shorter. It is important to consult with an experienced attorney throughout this process to understand your rights, the timeline, and your potential for success.
If you or a loved one have received a Social Security Disability claim denial, do not hesitate to contact the John Jokela Law Firm. John Jokela has years of experience in handling appeals for Social Security Disability claims and will work closely with you throughout the appeals process. Contact our Wausau office today and we will begin answering your questions, examining the facts of your claim, and then take action to get you the benefits to which you are entitled.