SSI Disability Qualifications for Adults and Children | Disability Advisor
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What medical conditions are required to meet SSI disability qualifications and to get an SSI approval?

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Find out how disability is defined for SSI and what SSI disability qualifications adults and children must meet to get SSI.

ssi-disability-qualifications

The SSI Definition of Disability for Adults

Any medical or psychiatric condition can be the basis for meeting the SSI disability qualifications if you are limited in the manner described in the SSI definitions of disability.

SSI disability qualifications are different for adults and children. Adults who apply for SSI benefits are evaluated using the same definition of disability that is used for Social Security Disability applicants. According to Social Security and SSI disability laws, disability is an adult’s “the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted, or can be expected to last, for a continuous period of not less than twelve months. Our article “What Is Disability According to Social Security Disability Laws?” explains the definition and our article “How Does the Social Security Administration Apply Social Security Disability Laws to Determine If I Am Disabled?” includes a step-by-step explanation of how Social Security applies adult disability laws to your situation to determine if you are disabled.

When a child who is eligible for SSI turns eighteen, his or her eligibility for SSI has to be re-reviewed. The former child’s medical condition will undergo a new disability review to determine whether he or she meets the adult definition of disability. Additionally, his financial eligibility and potential benefit amount will be re-determined without consideration to his or her parents’ income and resources.

The SSI Definition of Disability for Children

A child is disabled for SSI purposes if he or she has “a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than twelve months.”

Determining a Child’s SSI Disability Status

If a child who is under age eighteen applies for SSI benefit and it is determined that he or she meets the non-medical eligibility requirements, the local Social Security office determines whether the child is performing work that is Substantial Gainful Activity, which is called SGA for short. Usually, gross work earnings as an employee or net income from self-employment is considered to be SGA if the earnings reach $1,800 for a blind person or $1,070 for a non-blind person. If the child is performing SGA is performing SGA, then the child is not disabled. As mentioned, a more complete discussion of SGA can be found in the article “What Is Disability According to Social Security Disability Laws?

If the child is not performing Substantial Gainful Activity, then the claim will be sent to the Disability Determining Services, which is called DDS for short. To conduct a medical review of your child’s claim, the DDS will review the medical and other information you provide on the SSI application form. The DDS may also ask you for additional information, contact your child’s medical providers and educators, or ask that your child to attend a Consultative Examination. The examination, if requested, will be for evaluation purposes only and will not include any treatment. For more information about Consultative Examinations and about who decides if your child is disabled, see our articles “When Applying for Disability Benefits Will I Have to See a Social Security Doctor?” and “Who Decides If I Am Disabled? If Both My Doctor and the Social Security Disability Doctors Say I Am Unable to Work, Will I Be Approved?

In its first step, the DDS evaluates whether your child has a physical or mental impairment that is medically determinable and whether it is severe enough to cause more than minimal functional limitations. If no impairment is supported or functional limitations are only minor, the claim will be denied. On the other hand, if your child has a severe impairment, then the review proceeds to the next step.

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67 Comments

  1. Karl says:

    Kay,

    You have to be one of the busiest people I have ever seen. I have several questions but I will try to narrow them down.. I became unable to work January 8th 2013. I started my application the same month by the discretion of my physician which is also the Dr. that SS uses for my area. That being said.. I have been turned down twice and am now waiting for my interview with the ALJ. I have Diabetes Diabetic Neuropathy , Dystaloic Heart Failure , High Blood Pressure, a-fib, Edema and a host of other illnesses. And what my illnesses doesnt effect my dearn medicine does. Several of these are on the Blue Book for SSDI. Yet I have been denied 2x.. I am only 33 years old and look healthy as a horse other than I can barely walk. I am 6’2 and 325lbs.. I have had Diabetes for over 20 years and I am insulin Dependent. There has been several people that has stated the only reason that I have been denied was because of my age.. Even though my illnesses are listed on the blue book. Is this True?? If so it is a cryin shame that someone that is legitimately sick that has hard medical evidence is having to go through this when others who can work get it right away. (I’m sure you’ve heard that before)

    And I have been contemplating getting my congressman here in Arkansas involved in my case. I have a very reputable lawyer but she stated that it was still going to take several more months. My appeal is at the “judges office” in my words but they have not looked at it. Would it be more of an advantage to have my congressman look into it or verses my attorney. Just looking for your opinion??

    And the last question and I know that this is alot. I was the only income in the home and it abruptly stopped. My wife doesnt work. I was told that I could reicive SSI for the months that I was waiting for SSDI but when my SSD kicked in I would make to much then it would stop. That being said… I have seen several post’s that were statign a hold up on benefits because of SSI and SSDI. Is this going to be the same in my case. My quoted monthly benefits were 1479.00 fir SSD. If so should I go ahead and cancel that SSI app.. Just and opinion as stated before.. Thanks in advance !! Have a great day

    • Kay Derochie says:

      Dear Karl,

      You raise several issues, which I will try to address. First, because you are under age fifty, you must be disabled from all occupations that you could perform given your limitations, education, and experience. This would include jobs you could perform seated. The Blue Book does list medical conditions that are considered disabling, but only if they also have certain laboratory or clinical findings accompanying them. Those required findings are also listed. You might ask your attorney whether any of your conditions actually meet the findings.

      With regard to the status of your hearing, it can take a year or more to get a hearing date. The appeal isn’t actually looked at until around the time the date is set. You, of course, have the right to request your congressman to look into the claim, but it will not necessarily speed anything up. Whether or not you contact the congressman, you need your attorney to present your case in court. A congressperson will not go to court with you and will have less knowledge of Social Security law than your attorney.

      You have to be medically approved for Supplemental Security Income (SSI) the same as for Social Security Disability (SSD). You cannot get SSI until you are approved at the hearing. I recommend not withdrawing your SSI claim. Social Security has a five-month unpaid waiting period, so if your are approved your SSD will not start until July 2013, whereas SSI would begin February 2013. It is true that it can take a bit longer for both claims to be processed to payment after an approval, but it could result in more overall income and possibly payment of recent unpaid medical bills as Medicaid eligibility often accompanies SSI eligibility with limited retroactivity.

      For interim assistance, try contacting your state’s department of human services to see if they offer temporary cash payments to disabled individuals who are awaiting a decision from Social Security. If so, this would be repaid from any SSI you received. You might also apply for food stamps and energy assistance for help with heating bills.

      Sincerely,

      Kay

  2. Alicia says:

    Hi Kay,
    I have asked you for advice before. I applied for S.S.D.I.and S.S.I. in August 2013.i said on my initial claim i had depression, generalized anxiety disorder,panic disorder, bipolar(that decision was ruled out in my discharge paperwork after completion of a behavior health program) when I initially applied I did not know that bipolar was ruled out until after I received my discharge paper work) .Also,I put I have scoliosis,arthritis and G.E.R.D.i also did not know I did not have arthritis my hands and wrists hurt, burn,and I get a numbness, tingling feeling when I try to use a can opener and sometimes I can not get my fingers to work,I wake up every morning with swollen fingers and stiffness and pain throughout my body,but the S.S.D.I. Doctor that I was sent to said I did not have arthritis in my hands.He wrote chronic pain on my x-ray sheet and I was sent to x-ray.I have had depression since 1999, Generalized Anxiety Disorder 2005,Scoliosis 2007,(which my chiropractor put me on a 10 lb. lift restriction in 2012 for the rest of my life)Degenerative Disc Disease L4,L5-S1 2012,Panic Disorder with Agoraphobia2013, Major Depressive affective Disorder2013 and G.E.R.D. Since 2009 & Lung fibrosis 2013. Kay, I was denied because they feel I can do light unskilled work.My mental condition has gotten worse and I am still in physical pain on a daily basis.How do they expect me to go get a light unskilled job when I go for days without going outside due to my mental issues?My body hurts everyday! I have already received my paperwork for reconsideration and have contacted an attorney to file the reconsideration paperwork.i will be 49 years old in March and I read somewhere if Chronic pain is an issue with psychological disorders at any age, and can not due simple unskilled work the S.S.A. Will reach a decision of Chronic pain disabled. So, why did I get denied?

    • Kay Derochie says:

      Dear Alicia,

      When the Social Security Administration reviews your claim, it looks at more than your diagnosis or diagnoses. They look for evidence of how severe your condition or conditions are and how much they limit you. Apparently, based on the information they had, they determined that you were not limited enough to preclude all work. Because you have several different conditions, it is good that you got an attorney to help with your appeal.

      Best regards,

      Kay

  3. Jessica says:

    Hello, just have a quick question. I have been going through this process for a little over two years now and I’m still waiting g on a decision. I went to my hearing in May of 2013 and its February 2014 every time I call I’m told that its in the writing process what could be making it keep going back and forth to the writer?

    • Kay Derochie says:

      Dear Jessica,

      If you have been told it was in writing, then on the judge’s desk, and then back in writing, it could be that when the judge looked the letter over to be sure it was correct before it was sent out, he or she found an error or omission and requested that it be revised. The good news is that it appears the decision has been made and notification is in process.

      Sincerely,

      Kay

  4. j.lee says:

    I have been going through this process for 3 yrs and like so many others do not know how I can wait much longer with no way to live. I have 3 kids who have all become very depressed and have lost hope, it breaks my heart. I have type 2 diabetes and on insulin but still uncontrolled, peripheral neuropathy and severe vein disease in legs so have constant pain and wide spread edema. I also have COPD,sleep apnea and obesity. I have DDD and herniated discs in cervical and lumbar spine that push into the thecal sac with narrowing of spine and bone spurs and have fibromyalgia too. Theres more…Depression and anxiety. I take a lot of pain meds that of course have many side affects. My case has just been remanded back to LJ from appeals council, the VE testified there is no work I could do but it did not help as I was still denied. My question is the LJ did not feel my depression was signifigant enough to interfere with life but I have since been diagnosed with PTSD and bipolar depression, will the LJ look at the new info since it does prove a signifigant mental impairment??

    • Kay Derochie says:

      Dear J.

      In most instances additional evidence can be filed for a second hearing when a claim is remanded to the judge. However, the reasons for the remand can govern whether or not additional evidence will be considered. What reasons were given for the remand? If you submit evidence, it should be directed to a specific point and if possible to one of the reasons that the claim was remanded to the judge. Also, any evidence (such as new diagnoses) that came into being after the date you were last insured (the date you last had enough work credits) will probably not help you win Social Security Disability Benefits, though it could help with a Supplemental Security Income (SSI) claim. Other determining factors are why evidence that existed prior to the hearing date wasn’t it filed prior to the original hearing? If you do not have an attorney to help you analyze the remand order and assist you regarding possible submission of evidence, it could be a good idea to get one.

      Sincerely,

      Kay

  5. j.lee says:

    I forgot to mention the LJ had denied me for several reasons, she said although I had the above severe impairments she felt the COPD and sleep apnea were under control, felt my pain was also under control with meds and it appeared to her I was not following treatment orders with diabetes (not true) and I had failed to lose any weight which were all contributing to worsening of symptoms. The psych Dr she sent me to diagnosed me with major depressive disorder but only had minimum affect on my life. She said I should be able to return to light work and could stand or sit 8 hrs a day, even after the VE testified I could not. So, I do have more medical records to prove otherwise but wondering if the new diagnosis of PTSD and bipolar will be looked at too….?

  6. Hello Kay, my name is cynthia, good to meet you. You are very knowledged in this SSI and SSDI. I have been denied 3X’s and the 4th appeal I finnaly made it too the Judge. I didn’t know where to start, had no legal advice, and under so much pressure I thought I was going pop!Seconds before going in this guy told me to only speak when I’m given a question-and never call him sir, he hates that, only address him as ‘your honor’.Great!
    I had my ssi and ssdi from 1987 until 2001. Some terrible trouble happened and I lost it. Lost my housing {hud} my 2-checks and my daughter ran away with her boyfriend. I just could not even to go into that apt. by myself.Started to stay up all night-having been arested 7x’s for really stupid reasons. Jay-walking, be in fights, drunken disorder, never paid the fines, had to work off my fines at 10 cents an hour, you got it, prison for not paying my fines and 1 time such a tiny roach-it was considered “un-determend amount,” My public pretender told the judge I was a danger to myself!That she {me}should get max time. Ended doing 7 months, and only chiped off 1/2 of one huge fine. Got accepted to a half way house. A dear friend paid off my fines, and thought I could get the charge expunged. Making my appearence better. I lived on the streets for almost 4 years, so I made a claim for my social benifits. That “felony”charge {I feel} led to the denial of my benifits. Disability is corneal dystrophy-with corneal erosions, I currently and will probably never be off the anti-depressents, or the anxiety pills. Had a stroke in Sept. and my comprehention {and spelling} has gone back to the beginning of time. It is very hard to remember what I did last week, I have no short memory, but some past from years ago.What would you do? Or what do you and others think I should do.?When I talked to Bender&Bender, they had to fly out from New York, so I said no because that was part of their cut. Do you know a winning advocate that speakes for us in the court room? I only heard of it, that I wouldn’t have to go to court at all, could this be right? Thank you, Sincerely, Cynthia

    • Kay Derochie says:

      Dear Cynthia,

      It does sound as if you need an attorney to represent you. I do not know where you live. If you do not live in a fairly large urban area there may not be experienced Social Security/SSI disability attorneys in your area. You can start by looking in the yellow pages of your phone book or in the phone book of an urban area near you. And, of course, the internet is a source. These resources should be available in a public library. If you can not locate an attorney locally as you wish, you might talk with your local social services office to see if they know of any volunteer advocates who are knowledgeable.

      Sincerely,

      Kay

      A few hearing appeals are decided favorably without a hearing, but the overwhelming majority require appearance at a hearing.

  7. Cindy says:

    I have metastatic Neuroendocrine stage 3 Cancer, along with several other conditions, I am a nurse, and have not been able to work since diagnosed, initially the CTC had treated me for the wrong cancer and given me the wrong chemo, then following the PETSCAN no improvement because I had received the wrong treatment, was sent a letter from the oncologist that was treating me no longer took my insurance, but come to find out that was not true, I think he realized he had made a mistake, had gone to Mayo and found out that Cancer I had needed surgery as the tumors were wrapped around my jugular, carotid artery and cervical area, had I stayed with them according to the new radiation Dr I would have been dead within months had I stayed, so surgery , radiation, and chemo were started immediately. My question is I have since been accepted for disability but what is SSI for and can you collect both, also the amount of disabilty I will collect how is it calculated, as I find it hard to believe that they expect a person to live on it, my husband has left me I have used up my savings and was living on credit cards, I refinanced my home to lower the payments, but have no other income, what does one do when speaking with the Social Security Dept, they told me I had to sell my belongings to qualify for SSI benefits, I declined as I need what little I do have, and what exactly is it they want you to sell and what is it they you can have, I find it hard to believe that the many years that one has worked and payed all the Govt taxes and retirements, that to live you give up all you have to receive assistance, and not only that but to have to fight to get what one rightfully deserves they have no problem taking their taxes without asking or getting a lawyer to get them from me but I have to wait years to get a response and fight to get assistance, this a sick and undeserving position they put you in, especially when you are sick and to have to go through their expectations without regard to situation, when you can’t buy food pay rent or have medical bills coming at you left and right and the threatening phone calls from bill collectors, I think someone in the Government has really lost priorities, bailing out banks, wars, helping Wall street, with billions of our dollars and I’m trying to get a disability check and FIGHT I might say to get it. So anyway sorry back to question can you get both, and how do they decide on the amount you should get?

    • Kay Derochie says:

      Dear Cindy,

      Your Social Security benefit is calculated related on your earnings under Social Security. You can request an earnings statement of your taxed earnings from your work and look it over to be sure that all your earnings are listed. If they are all listed, then the calculation is highly likely to be correct because it is performed by a computer program.

      Supplemental Security Income (SSI) can be paid to disabled individuals who have countable income and assets below a certain limit. If your Social Security (or your Social Security and other income together) is $741 or over, you are not eligible for SSI. The resource (asset) limit for an individual is $2,000. Your home, usually one vehicle, and normal household and personal items are not counted. Countable assets usually include investments of most kinds, including 401ks and IRAs, second vehicles, boats, valuable collections of art,some insurance policies, etc. If a representative of Social Security suggested selling items, I would think that it would not refer to the essential excludable items such as home or vehicle.

      I hope this information is helpful.

      Sincerely,

      Kay

      • Kay Derochie says:

        Kristina,

        I think that you intended to address your post to someone who has visited the site. Instead it was sent to me, so I am not posting it. If you wish to repost a comment directed to the right person, I will post it on the site.

        Sincerely,
        Kay

  8. Cindy says:

    Please let me know also what is Medicaid and how do you get that? And why can’t you leave the country for more than 30 days, what does that have to do with getting disability?

    • Kay Derochie says:

      Dear Cindy,

      If you are a U.S. citizen, you can live abroad in many countries and still receive Social Security benefits without restriction. The thirty-day restriction for being out of the country applies to individuals who receive Supplemental Security Income (SSI). The reason behind the law is that the program is a public assistance welfare program for residents of the U.S. who are citizens or meet certain limited legal alien qualifications.

      Sincerely,

      Kay

      • Jolee says:

        One would think that if you are requesting Medicaid that you cannot afford to provide for yourself in day to day living much less travel abroad.

        • Kay Derochie says:

          Dear Jolee,

          A third party may have paid for the transportation to go abroad. A plane ticket is not countable income for Supplemental Security Income because it does not provide housing or food.

          Sincerely,

          Kay

  9. Amanda says:

    Dear Kay,

    I have was at home mom for 13 years then I had to have back surgery, the Dr. told me he would fill out the disability papers for me and I told him no way because I hadn’t had a chane to prove myself in to the working world and contribut to society. Since my surgery I have been in and out of the hospital numerous times I have had so many problems and have missed so much work I dont know what to do. And now I have had a migrainge since August 7th 2013 and the Dr’s are telling me that it is chronic and there is no cure I should just go on disability. I am so torn. I have 4 kids and I want to work to make our life better. But when I work that is all I do, I work and sleep and I do not see my family. I wish the was a perfect equal medium. sigh…

    Amanda

    • Kay Derochie says:

      Dear Amanda,

      If you are disabled and do not have enough work to be insured for Social Security Disability (also called SSD or SSDI), you may qualify for Supplemental Security Income (SSI). I suggest that you make an appointment to apply by calling Social Security at 1-800-772-1213. They will first screen you to determine whether your family’s income and assets are low enough for you to be eligible. Even if you are married and your spouse works, with four children, your spouse’s income may not disqualify you. You expressed a desire for an equal medium. If you are not eligible for either SSD or SSI, perhaps you can find a job that you can do working just a few hours a week.

      Sincerely,

      Kay

      Sincerely,

      Kay

  10. sue says:

    Hello, I applied for SSDI on line and had my appointment at the local SS office here in California where I gave a completed Residual Functional Capacity form from my doctor including a MRI report. The doctor wrote that my condition will last more that 12 months and that I can not sit, stand for more that 10 minutes. My condition is Lumbar Stenosis, I also am a Diabetic and have been taking anxiety and pain medications. I am turning 55 years old in June I have an established earnings report and have earned enough credits from working all my life. On the RFD my doctor wrote I was going to be referred to a back specialist.A week after my SSS appointment i received a call from a SSA Medical Evaluator asking if I had seen the back specialist I told her that I am still waiting for the referral to see the specialist and that I am on State of CA Medical which may take some time for the approval. My question is What happens if the back doctor wants to do surgery? Do I have to have surgery at 55 years old to get approval for SSDI?
    Thank You

    • Kay Derochie says:

      Dear Sue,

      Social Security does not have the authority to require you to obtain any particular medical treatment. The claims examiner was probably inquiring about the appointment to find out whether there was additional medical information from a specialist that was not available when you filed the claim.

      Sincerely,

      Kay

  11. Donna says:

    I just received my second denial from SSDI. I just don’t understand. They ask for letters from all of your doctors, and I got them. My neurologist put me out of work on July 15, 2013. He’s been treating me for 15 years and knows me better than any doctor in SSDI. He has literally diagnosed me with conditions before specialists have. I have epilepsy, Hashimoto’s thyroiditis, migraines, sixth nerve ocular palsy, which causes double vision, chronic fatigue syndrome, hypertension, arthritis, narcolepsy, irritable bowel syndrome, and diplopia. That’s all they took into account. I also have fibromyalgia, osteoporosis, muscle atrophy that started in my hands while I was working and is getting worse, a lipoma (tumor) lying on my spine that needs surgery, balance problems that are so bad that I would fall into the walls at work. I also fell asleep at work because of the narcolepsy and chronic fatigue syndrome. I also have two forms of arthritis: psoriatic arthritis and osteoarthritis. Psoriatic makes your joints well and become inflamed, and it has now spread to both my hands, back, hips and knees.

    I was denied because my blood pressure is higher than normal. However, it has not damaged any vital body organs, and is not causing any problems which would prevent you from working.

    You do have arthritis. However, it does not limit your ability to move about and use your limbs.

    And the kicker, The evidence shows no other condition which significantly limits your ability to work.

    I honestly don’t know if it’s their job to put people on the street, and make them homeless. I am 60 years old, and since July, my credit has been ruined and I am on the verge of being homeless. Who decides that epilepsy is easy to work with? Did they ever have a seizure and wake up with a migraine that lasts for 7-9 days? They are debilitating. And arthritis. They should experience getting up in the morning and almost collapsing b/c your knee and hip just aren’t cooperating, especially during wet or bad weather. I can’t open a jar or open a bottle. The palsy in my eye? It’s horrible seeing double all the time. And since it’s now lasted over a year, I have the choice of living with it forever, or waiting until July, getting another MRI to see if there’s a lesion causing this, and either way, getting surgery. I was sleeping in work b/c of the narcolepsy and chronic fatigue syndrome. Diplopia is my eyelids closing on their own, which is also caused by the palsy. I would LOVE to know the physicians who make these decisions for SSDI because I sincerely doubt they are qualified to make decisions that impact people’s live so much.

    • Kay Derochie says:

      Dear Donna,

      I recommend that you file a request for hearing and hire a Social Security attorney. Multiple conditions combining to cause disability need to be presented in a manner that makes it clear your conditions together meet the definition of disability in Social Security law. I suggest that you call Disability Advisor to discuss your case with one of their knowledgeable attorneys. They can be reached at 1-888-393-1010. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from your retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,

      Kay

  12. Mary says:

    Ok here’s my question I am wanting to sign up for ssdi but I am the payee for someone else can I be there payee and still be approved for ssdi,I have been sick for several years but have not applied hoping to get the help I needed so now it’s been several years since I last worked and I have no other choice but try and get ssdi/ssi can you tell me if I can still be there payee and get help myself,,,thank you

    • Kay Derochie says:

      Dear Mary,

      Your being representative payee for someone else’s Social Security or SSI benefit will have no impact on a claim for yourself. Be sure to claim the first date that you became disabled, that is, when you initially ceased work so that there will be a possibility of being found insured for Social Security.

      Sincerely,

      Kay

  13. michael says:

    kay I have a couple of questions i was denied ssi and have appealed.And that was due to them receiving maybe a 10th of my medical reports.anyway i have been receiving general relief for about 3yrs now through social services and for me to receive benefits without going to one of there work programs i have to see one of there doctors for a medical assessment and have them declare to be temporary disabled. i suffer from chronic venous insufficiency thrombosis phlebitis in both legs and feet. and every medical assessment for G.R. they see my condition and declare me TEMP DISABLED.and the first 2 times it was for 3-months and 3-months then it was for 6-months twice.and last assessment there doctor put me down as temp disabled for 12 months and that i was potentially SSI eligible. My question is does ssi consider my medical assessments i have to go to to receive G.R. in there decision on my claim? sincerely M.W.M.

    • Kay Derochie says:

      Dear Michael,

      Social Security will not adopt the social services’ doctors’ opinions, but they will consider them. I suggest that you have a copy of the records from those examinations and reports sent to the Social Security Administration for your appeal. Also, it could be a good idea to have an attorney who is well-versed in Social Security disability law help you with your appeal. You can obtain an excellent Social Security attorney by calling Disability Advisor at 1-888-393-1010. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from your retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,

      Kay

  14. Teri Baiocchi says:

    Hi Kay,

    I filed for disability February 13th of this year. I have been working very hard since I was 12 years old, 42 years straight (very hard work) with hardly any breaks. I am now 54. I had a great little job working at Sam’s Club as a cashier. I came home the day of the 13th and told my roommate “The gig is up, I can no longer work.”

    I have been diagnosed with osteoarthritis and osteophytes.

    I went to my Dr. yesterday to get my prescriptions refilled and he told me everyone gets denied at least twice. He said he has never known anyone to get their disability benefits at the first try.

    I put together a 200 page binder with my medical history, work history, pictures, faxes – all by category and every page with a sheet protector. I don’t feel I need an attorney, as I have kept accurate records and have plenty of evidence.

    My question to you is that true about everyone being denied at least 2 times?

    • Kay Derochie says:

      Dear Teri,

      No, it is not true that everyone gets denied twice. Many people are approved on first application. that said, I suggest that you keep a copy of everything you submit to the Social Security Administration, just in case you have to appeal. When submitting your claim, explain why you can no longer to jobs you have done in the past. Also, check with your employer to see if you are covered by short-term or long-term disability policies that they sponsor.

      Sincerely,

      Kay

  15. wendy nelson says:

    After the hearing my lawyer decided to file an appeal of review, sending it to the Appeals Council. My denial letter stated that while it agreed with all the findings, and that I was likely not finding gainful employment due to 5 medical conditions/illnesses I have, it was denying me. During the questioning, the judge asked my age. my lawyer said that age cannot be biased, however she said the judge typically denies anyone under 50. I am 45. If this should have no bearing on my case, why ask my age, why agree with findings, but still have been denied? I am still very confused on how else a denial could be determined, but hope the Appeals Council will reverse the decision.

    • Kay Derochie says:

      Dear Wendy,

      Social Security Disability law says that a person age fifty or over is disabled if he or she is unable to perform any occupation that he or she has done in the past. If you are under age fifty, you also have to be unable to perform other occupations that are new to you and that you could otherwise do based on your education, training, and transferable skills. The idea behind the two different standards is that younger people are more likely to be able to start and become successful in a new occupation than older people. I cannot explain what the judge might have been thinking when he or she mentioned your medical conditions as related to the ability to find work.

      Sincerely,

      Kay

  16. kliana says:

    Hi my name is kliana and im currently receiving ssi for my premature baby. He was born weighing 2lbs 1ounce low birth weight and also a IUGR baby,.anywho I was wondering can some one tell me when do they stop payments he’s current 9 months and only weighs 11.4 and not doing things thats he should be doing at his age. Answers please thanks

    • Kay Derochie says:

      Dear Kliana,

      The Social Security Administration is likely to do a medical review when your son turns age one to see if he is still disabled, but your son will continue to receive benefits as long as he is disabled and family income and assets are below the Supplemental Security Income (SSI) limits.

      Sincerely,

      Kay

  17. Kaly says:

    Dear Wendy,

    My son is age 18 and was just approved for SSI. He will be entering college in August. His mailing address will remain the same, while his physical address will change to the college where he will be living. Does he need to report that he has started attending college? He has scholarships that will cover his classes, but he and we, his parents, will have to take out loans to cover his room and board costs. Does he need to report his responsibility to pay room and board while in college? How does that work?

    Thanks for all your help,
    Kaly

    • Kay Derochie says:

      Dear Kaly,

      Yes, the change needs to be reported. Now that your son is age eighteen, your income and assets are not considered in determining his payment amount. However, you will be paying his room and board, which counts as income to him. If you pay it directly to the college, the amount of in-kind support and maintenance charged against his SSI will be limited to $240, which is most likely less than the actual amount you pay. If his living arrangement changes in the summer (comes home, gets an apartment), he needs to report that also.

      Sincerely,

      Kay

  18. lachonnie says:

    I had my hearing on April 9 2014 I have not heard from them now I get a letter saying I got to go for second hearing on sept 29 . Can u tell me what are my chances.

    • Kay Derochie says:

      Dear Lachonnie,

      Did you get an explanation of why you are having a second hearing? It could be that the judge decided he or she needed more information to make a decision.The other possibility is that the original judge has become ill and can’t complete the review, which means that the judge taking over for him or her must hold a hearing. Either way, your claim is still under consideration for possible approval.

      Sincerely,
      Kay

  19. Gina says:

    Dear Kay,

    Six months ago I had brain surgery(craniotomy) to remove a benign tumor (acoustic neuroma/vestibular schwannoma). My vestibular nerve has been compromised and I have balance problems, hearing loss and debilitating headaches. Despite vestibular therapy and a trial and error with several kinds of medication, I have not been able to find relief. I am a teacher and I have been receiving sick pay, but it will soon be exhausted. My doctors will not approve me going back to work at this time, but cannot predict if these symptoms will last twelve or more months. Not receiving any kind of income will create hardship and I’m not sure what my next move should be. Also, if I apply and am approved for SSDI and disability insurance through the NYS Teachers’ Retirement System, would one affect the other? I am 55 years old. Thank you in advance for your advice.

    • Kay Derochie says:

      Dear Gina,

      I recommend that you apply for Social Security Disability. It will take two to five months for the claim to be processed, which will put you closer to twelve months. If you are denied just because they think your disability will not last twelve months and you are still disabled when you receive the denial, you can appeal towards the end of the appeal period and that will put you very close to twelve months at that time.

      If you were paying into Social Security at the same time as getting credit for the Teachers’ Retirement System (TRS) benefits, then the TRS will not affect your Social Security. Check with the TRS office to find out if Social Security affects the TRS benefits.

      Sincerely,
      Kay

  20. judy c says:

    Hello. I recently applied for disability benefits but was denied. First, a little about my medical history. I was officially diagnosed at the age of 4 with Systemic Onset Juvenile Rheumatoid Arthritis and this condition has caused a great deal of pain in all my joints and health. In the past few years, my left shoulder and left elbow has been affected greatly by pain and limited mobility. I applied for the SSI application with disability benefits and was denied right away, after seeing one of the Social Security medical doctors. On the denial letter, it says I am sufficient to work because my right arm is able to perform duties, I have a 12 year education, etc. Is there a way to reverse the disapproved claim?

    • Kay Derochie says:

      Dear Judy,

      I suggest that you request a copy of your claim file so that you can see the medical information used and also the reasons for the denial listed in the determination memo. If you still think the decision is wrong, file and appeal and hire an attorney to assist you. (Be sure that you don’t miss the deadline for appealing while waiting for the claim file.) You can obtain an excellent Social Security attorney by calling Disability Advisor at 1-888-393-1010. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from your retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,
      Kay

  21. Gloria Howell says:

    I applied for SSDI in May 2014. At that time I declined application for SSI. Was that a mistake? I didn’t want to ask for more than I need, but now I suspect SSI would have been approved already. Can I go back and add SSI to my application?

    • Kay Derochie says:

      Dear Gloria,

      Social Security Disability (SSDI) and Supplemental Security Income (SSI) disability for adults have the same medical requirements. The only difference in the disability decision is that you must have become disabled while you were insured for Social Security Disability. To be eligible for SSI, your income and assets have to be below a certain limit. (Not all assets are counted. For example, a house you own or are buying and live in is not a countable asset.) If you think you might qualify financially for SSI, you can apply for SSI now; SSI benefits, if you are approved, will not be retroactive prior to the SSI application.

      Sincerely,
      Kay

  22. L. Andersen says:

    My adult child was attempting college while we awaited the appeals on her child to adult redet. It had been denied at age 18, because she was no longer a child and had enrolled for 12 credit hours at school. Half of those credits had only a single exam requirement, no homework, and were independent study. Ssi denied based on the number of credits. Now, two years later, and several relapses of her conditions, she is now diagnosed with additional physical developments. And she is withdrawing from school. Do i just report the withdrawal to the ssi office to add to her appeal folder, or do i need to get official letters or transcripts or anything from the college? Her diagnoses are auto immune inflammatory asthma, which flares severely about every two to three months, and auto immune cardio-pulmonary inflammatory disease, which flares when her lungs also inflame, and allergies to dust and grass pollen, and tachycardia that has become permanent, from all the asthma medications she has taken since birth. She had been taking 40 mg of medrol then step down over a period of three weeks to treat the flare ups, and now was told she will need to increase the amount for flare ups, and will need to take double doses, every other day, permanently. She takes advair 500/50, two prescription anti allergy medications, levalbuterol nebulizer four times a day, and a rescue inhaler. She has never been able to participate in anything normal during her childhood nor in her early adulthood. She has had pneumonia eight times since birth, and last years bout left her hospitalized, and needing xrays and antibiotics for three fill months following. It took her until this fall to get back some weight and look healthier again. She has no physical endurance. We walk every evening, as she needs to have some activity. She is degrading every year though. This will never even stabilize. She is maxed out on everything. Stress, emotions, laughter, cold or hot foods, a sinus or head cold, or not a good nights rest all set her off. She has never been higher than fair to poorly controlled. Her claim is up for an alj sometime this year. I was the one who kept the payments going as we appealed and as a result, i can not get any attorney to assist me. They will only take a case if there will be retroactive payment. Believe me, i have called them ALL. I do not feel qualified to explain my daughters multiple complex auto immune disorders as a qualifying disability. I dont know what terminology or legalese is correct for this. Help?

    • Kay Derochie says:

      Dear L.,

      I suggest that if you cannot get legal assistance that you

      1. Write up a chronological timeline of the different medical events your daughter has experienced since she turned age seventeen.
      2. At each point in the timeline when there was a change in her condition, a flare up, a change in treatment, or new diagnoses, state what happened, the problems she was having, including why she couldn’t work at that point in time, and the names of the medical providers who treated her at that time.
      3. At the end of the statement, write up the full contact information for each medical provider.
      4. Point out the frequency of the severe flareups and point out that she would not be able to keep a job with such frequent absences.
      5. Get all the medical records from the flare-ups or other important information that you can afford to. At least try to get the admission medical history and summary and the discharge summary from each hospitalization.
      6. Write up a statement about your daughter’s school attendance. Include a description of any problems she had doing the work.
      If she still has a copy of the syllabus (plan for the course) for the classes she took, submit a copy of those to show the classes were not demanding. If they are not available, try to get them or something comparable from the professors. If she missed a lot of classes, a prof might either have a record or remember and be willing to make a statement. Note if she took any of the courses online from home.
      7. Anything else you think shows disability.
      8. Indicate that you, her mother, did most of the work of gathering and preparing the statement the information.
      9. Be as streamlined as you can about providing the inforamtion.

      Send the statement, keeping a copy, to the hearing office and request that it be put in the claim file for the judge’s review. Also, in order for you to speak at the hearing, you may need to have your daughter appoint you as her representative for pursuing the appeal. Social Security has a special form for this, called Appointment of Representative, which you can get from her local Social Security office.

      Sincerely,
      Kay

      • L. Andersen says:

        Excellent advice. I am very grateful! I will get to work on this summary and submit it for her folder. I had already submitted her previous quarters’ schedules and syllabi, showing her actual physical and class requirements including homework have never equalled even 14 or 15 total hours per week. And those hours i described with brief outlines of exactly what the requirements consisted of. After reading the rest of your suggestions, i feel maybe i can do this. I will have my daughter appoint me as her rep, and i will include a statement that i have gathered and prepared her informations. Thank you, so much!

  23. Dallas Bergmann says:

    I have looked at tons of questions to you and haven’t really seen an answer to mine, so here I am. I have been on SSDI for a few years now. I’m struggling to get by. Can I get SSI? Do I have to go through everything I went through to get SSDI?

    • Kay Derochie says:

      Dear Dallas,

      If your gross Social Security before withholding for taxes or Medicare premiums is less than $741, you may be eligible for some federal Supplemental Security Income (SSI). Depending on the state you live in, your income could be somewhat more and you could be eligible for the state’s SSI supplement even if you are not eligible for a federal benefit. If your income is low enough for you to apply for SSI, you will only have to submit financial information; a new medical review is not needed. Other sources of income include food stamps, energy assistance for heating bills (usually available through your power company or local non-profit agency), telephone reduced rates through your phone company. If you do not own your own home, you might also try to get on a waiting list for government-subsidized housing.

      Sincerely,
      Kay

  24. Ty says:

    Kay, is drug addiction considered a disability along with severe social anxiety and depression?

    • Kay Derochie says:

      Dear Ty,

      Neither Social Security or Supplemental Security Income pays benefits for drug addiction. If an addict is disabled due to mental illness alone, irrespective of the addiction, benefits could be paid. It is difficult to get approved in such a situation because it is hard to separate the disability caused by mental illness from the disability caused by addiction. If you apply and are denied, you will probably need an attorney to assist with an appeal.

      Sincerely,
      Kay

  25. Stacy says:

    MY FIANCÉE HAD APPLIED FOR DISABILITY MAY 2013 AND WAS DENIED AROUND AUGUST 2013. HE HAVENT WORKED SINCE 2002 HE’S ALWAYS IN CONSTANT PAIN HE HAVE A HERINATED DISC AND SEVERE MIGRAINES. HE HAD MRIS,CATSCANS ON HEAD AND NEUROLOGISTS CAN NOT FIGURE OUT WHATS CAUSING THESE THROBBING,PAINFUL MIGRAINES. HE SEEKED ATTORNEY OCTOBER 2013 SO HE BEEN WORKING WITH SS ATTORNEY AND OVER THESE PAST 6 MONTHS HE WAS RECOMMENDED TO SEE PHYSCIATRIST DO TO SUICIDAL THOUGHTS,ANXIETY,DEPRESSION. HIS PHYSCIATRIST DIAGNOSED HIM BD DO HE NEED TO REAPPLY FOR SSI OR NOT? WILL THE BIPOLAR DISORDER COUNT AS ANOTHER DISABLITIY (MENTAL) HIS ATTORNEY SAID THEIR IS A HEARING SET FOR JANUARY 2015 FOR PHYSICAL DISABILITY WE ARE LOST AND NEED HELP????

    • Kay Derochie says:

      Dear Stacy,

      Your fiance can check with his attorney, but my understanding is that new medical information can be submitted at any time and that the new psychiatric information can be submitted to supplement the appeal before the hearing so that mental limitations can be considered together with the physical limitations at the hearing.

      Sincerely,
      Kay

  26. Anna Latric says:

    Hi,

    Thank you for writing this. I have a question to ask.

    Two days ago I had a hearing with the Judge for my five year old daughter. After reviewing the paperwork and asking me quite a lot of questions she said to me: “We agree that her ability to learn is extremely limited, however the way SSI works is that there needs to be two marked limitations. For example if she was destructive in the school environment and unable to get along with other children that could be a second mark. But since she gets along fine with other children we will be looking into her speech area to see if that effects her ability to interaction with other children.”

    She then told me that they would send a teacher questionnaire to my daughters school and if I had anymore information to send it to them right away.

    Today I received a educational record from my daughters teacher stating that my child’s speech was unintelligible, even more so when the conversation was out of context and as a result she is unable to get many of her needs met. The teacher needed me to sign these papers which stated my child was eligible as speech and language impaired so that they could put her in speech therapy asap.

    I signed these papers, and then forwarded them to the SSI office so the judge could see them.

    My main question is, based on that what is the likelihood of her being approved? The teacher hasn’t yet filled out the questionnaire as far as I know but the educational papers I sent in today seemed to make it clear that my child has serious speech issues on top of her learning disability.

    It seems like this would be all they need and would count as the second marked limitation but I’m not quite sure how this process really works.

    Thank you,
    Anna

    • Kay Derochie says:

      Dear Anna,

      The teacher needs to complete the forms the judge requested as soon as possible especially if only your signature was on the papers making it your statement, not the teacher’s statement. Even if you both signed, the judge may require Social Security’s form. Be in touch with the teacher, thank her for getting therapy started for your daughter, and emphasize how important it is that she complete the Social Security requested forms this week.

      Sincerely,
      Kay

      • Anna Latric says:

        Hello Kay,

        Thank you for replying.

        My signature is not the only only on the education form I signed.

        The paper, which is called “REED” has statements from the teacher stating my daughter is difficult to understand, and shows 4-5 words sentences with continued unintelligible speech. The REED has the signature of the District Representative, Special Education Teacher and the Speech Therapist Teacher and makes it very clear that there are intelligibility issues in the ‘Language Samples issued by the teacher’.

        It says a few other things all of which point to Speech and Language Impairment and a need of therapy added to her already Special Educational class asap. :(

        I was curious to know if that paper work I sent in would be enough for a approval but according to your statement it seems it would be best to also have the teacher fill out that form as well.

        I don’t want to constantly bother the teacher to finish the forms but if needed I will.

        Thank you for your reply,
        Anna

        • Kay Derochie says:

          Dear Anna,

          As you describe the statement that the school provided, I would think it would be adequate. I suggest that you review the form the judge sent to see if any questions on it are unanswered and, if so, ask the teacher to complete that portion of the form and write “see statement of such-in-such date” in all the other sections.

          Sincerely,
          Kay

          • Anna Latric says:

            Hi Kay,

            I wanted to thank you for all of your replies. I really appreciate this and you’ve taken a lot of stress off my back. If I ever have anymore questions I know who to turn to.

            Thank you

          • Kay Derochie says:

            You are welcome, Anna.

      • Anna Latric says:

        Hi Kay,

        I have another question!

        I was reading over this: https://secure.ssa.gov/poms.nsf/lnx/0424599001

        And noticed the section where they go over the “Guidelines for Evaluating Severity of Speech Impairments”

        My daughter turned five two days ago. Would she be classified in the 3 1/2 to attainment of 5 years, or in the ’5 years and older’?

        Perhaps I’m over thinking this all a bit but I’ve been unable to take my mind off of it since the hearing.

        Thank you again Kay.

  27. Kelly Rii says:

    Hello Kay Im kelly I have a 2 year old daughter hear lately I do a lot of walking with her becus ahe hate the bus everytime it stop or make a loud noise she cries well she has been approved for 6 months in those 6 months I received her regular check an I got back pay will 1installment I got her cloths shoes electronics her hair done lots of toys drawing boards an kids drum sets tv her all the dvds she likes to watch over an over a bed covers sheets ok I got her comfii a an the mane things needed I wen an requested a 2 installment for furniture I stay in an apartment so I wanted rugs cus she clumsy I want to keep apartment rug clean I went an bought all the safety kits for my bathroom cabinets cabinets in kitchen that she can reach got her a vicks vapor rub vaporizer for her astma then with the last couple hundreds went on books cable bill for her to have access to cartoons now its november she is due another installment an I’m needing a car to get her to doc apps an get her hair done take her to activitys we go to classes to help me on understanding this disability some time when u have a disable child u wanna keep them in a safe around were she happy but we have to break it just wanna know if they take to long to deposit can’t I request the deposit cus its really need the older she gets seem the worser it gets just want her in a great school

    • Kay Derochie says:

      Dear Kelly,

      The Supplemental Security Income (SSI) back pay installments are typically paid six months apart. If you have not gotten the check by the end of the sixth month from the last installment, contact the office and ask the status of the payment and when it will be released.

      Sincerely,
      Kay

  28. val says:

    Hi kay
    My son is 3 years old he has been denied disability .He started out by having random seizures and they couldn’t figure out why.I filed disability in august 2014 it wasn’t tell November that we found out the has epilepsy and severe sleep apnea. The denial letter said because it doesn’t affect his seeing or hearing nor day to day activities. Which is not truth .there’s a lot of things he can’t do that he would love to doas a child.he has mood swings and he complains and cries about bad headaches. Im wondering why was he denied where both of these conditions are very serious

    • Kay Derochie says:

      Dear Val,

      I suggest that you appeal the denial and submit all recent medical information. It would be best to have an attorney to help you present the best possible appeal at this first appeals level. You can obtain an excellent Social Security attorney by calling Disability Advisor at 1-888-393-1010. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from the retroactive award at the time it sends your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,
      Kay

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