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Social Security and Disability Benefits

By: the National Alliance for the Mentally Ill

Are you or your relative entitled to Social Security Benefits?

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.

Who receives disability payments?

More than 8.6 million Americans receive disability benefits from Social Security programs each year. 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. Doctors and disability examiners at state agencies determine disability examiners based on clinical evidence and examinations.

What specific disability program might I be eligible for?

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. 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.

How do l apply for social security benefits?

Applicants must generally apply in person at their local Social Security Administration (SSA) field office. Family members or guardians may apply when the disability is so severe that it prevents the individual from applying. Family members or guardians should call SSA to find out what procedure they should follow.

If it's clear I have a disability, will I automatically receive benefits?

The Social Security Administration has four basic standards for determining disability.

  • Earnings - Generally, If you make $700 a month or more, you will not be considered disabled.
  • Severity - If your condition does not interfere with basic work-related activities, your claim will be denied.
  • Checklist - If your condition is not on a list of disabling impairments maintained by Social Security, SSA would have to decide if your condition has the same disabling effect as a condition on the list in terms of ability to perform work.
  • Type of work - If you cannot do the work you did previously, SSA looks to see if you can do any other kind of work taking into account your age, education, past experience and transferable skills. If you cannot work, you will be considered disabled.

What does the application involve?

A field representative will conduct an in-depth interview with the applicant and complete a variety of application forms. The SSA 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 to accompany you for support

After the Interview is complete, what's the next step?

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.

What are the chances of receiving benefits?

Good, if you are willing to be persistent. Two out of three persons who apply for disability benefits are initially rejected. These applications are often rejected for what appear to be arbitrary reasons. If you appeal an initial rejection, your chances of obtaining benefits improve. In 1999, over half of disability cases that were appealed to an administrative law judge were won by beneficiaries. Appeals must be filed within 60 days of receiving a notice of determination.

If the application for benefits is turned down, what can be done?

Four levels of appeal exist. You can:

1. Ask for reconsideration by another DDS caseworker to determine if the initial decision was proper. These reviews rarely result in overturning the initial decision.

2. Ask for an administrative hearing-a formal hearing before an administrative law judge. You may request a hearing before an Administrative Law Judge if you disagree with the reconsideration decision. Such judges try hard to remain objective. In 1999, 55% of disability cases appealed to these judges were decided in favor of beneficiaries.

3. Ask for a review by the SSA Appeals Council. This council reviews decisions by administrative law judges. The council usually leaves judges' decisions unchanged.

4. Appeal a denial of disability benefits to a U.S. Federal District Court. Relatively few claimants get their case heard at this level, and the chances of a favorable ruling are only slightly better than the previous level.

If I have other questions, where do I go for answers?

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.