Benefits Eligibility in Sherman Oaks, CA


What If You Have Been Denied Benefits?

If you have been denied benefits, our office can help you.  Only about one third (1/3) of Social Security disability claims are approved at the initial level.  Read the denial notice that you receive carefully.   It will tell you what to need to do.   There are timelines so do not delay.

If you are denied benefits, our office will immediately file an appeal.   This must be done within sixty (60) days of the date on the notice of denial.   If necessary, our office will file a Request for Hearing before an Administrative Law Judge.      After the hearing, if the Administrative Law Judge denies your claim, we can file a request for review by the Appeals Counsel.  If the Appeals Counsel declines to “remand” or send the case back to the Judge, we can also file an appeal in Federal Court.

Some general information regarding a claim:

If your initial application is denied, our office can file a request for reconsideration.  This is the next step after the initial filing for a disability claim.  This is a request that your disability claim be review a second time and a new decision made.    The request for reconsideration usually takes anywhere from 3 – 6 months and unfortunately, approximately 90% of these requests are denied.    If there is a second denial, we can file a request for hearing.   Depending on the location, it can take up to 500 days to get a hearing by a judge.  

The definition by the Social Security Administration of disability is different and often much stricter that other agencies, such as the Workers Compensation Board or the Veteran’s Administration.  While Social Security will consider your treating doctor’s opinions or decisions made by other agencies, Social Security is not bound by these decisions and must make its own decision as to whether or not you meet the standard for disability.

While millions of Americans live with disabilities, Social Security disability benefits are restricted to individuals with the most severe disabilities and illnesses.  Individuals who are unable to do “substantial gainful activity” due to one or more severe mental and/or physical impairments may be eligible for benefits.  Benefits are not given freely and everyone who receives benefits must meet the definition that Social Security has given to disability.   This process typically requires a review of extensive medical and expert evidence.  

Benefits Eligibility

Benefits Eligibility

While millions of Americans live with disabilities, Social Security disability benefits are restricted to individuals with the most severe disabilities and illnesses.  Individuals who are unable to do “substantial gainful activity” due to one or more severe mental and/or physical impairments may be eligible for benefits.  Benefits are not given freely and everyone who receives benefits must meet the definition that Social Security has given to disability.   This process typically requires a review of extensive medical and expert evidence.  

Social Security has a very strict definition of disability, for both adults and children.  In order to qualify for disability benefits, you must be found “disabled” under this definition.   You must have a severe impairment or a combination of impairments, you must be unable to do substantial work because of your medical condition and your medical condition must have lasted, or be expected to last, at least one year or be expected to result in death.

For a child to be found disabled, the child must have a physical or mental condition or multiple conditions, that seriously limits his or her activities and must have lasted or be expected to last at least one year or be expected to result in death.

Along with these impairments, Social Security also takes into consideration, age, education and work experience.    There are no percentages with the disability determination.  You are either entirely disabled or not.  There are not benefits that are payable for partial or short-term disability.

Congress prohibits Social Security from paying disability benefits on the basis of alcoholism or drug addiction alone.    However, so long as the alcoholism or drug addiction does is not a material factor that contributes to the disability and you are disabled in other ways, you may be eligible for Social Security disability benefits.

If you have worked five (5) out of the last ten (10) years before becoming disabled, you may have enough earnings to qualify for Social Security Benefits.  A homemaker, depending on his or her financial situation, may quality or Social Disability benefits regardless of work history.  If you have very limited income and resources, you may qualify for benefits even if you have never worked before.  It is also possible to qualify for disabled adult child benefits on a parent’s work history if you became disabled before age 22 or for disabled widow or widower’s benefits on the earnings record of a late husband or wife.    Call our office, (818)377-2200,  for a free consultation regarding your eligibility.  

If you are collecting worker’s compensation benefits, you can receive both at the same time.  However, your benefits will be reduced so the total amount of the combined benefits do not exceed eighty (80) percent of you average earnings before you became disabled.    If you believe that you will be out of work for more than one (1) year, you could file for Social Security benefits while your worker’s compensation matter is pending.

Everyone found disabled under the Social Security program is eligible for Medicare after being disabled for at least 29 months no matter what your age is at the time of disability.   If you are qualified for disability and either have not worked or have enough “credits”, you can be eligible for Medi-Cal benefits.  These programs are based on income and assets as well as a medical or mental disability. 

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