The social security program is run by the United States government and is the program that provides benefits to more brain injury survivors than any other. Almost all survivors of a moderate or severe brain injury, with the proper representation and case presentation, should eventually be found to be entitled to social security benefits. Many mild brain injury survivors will also qualify for social security disability.
The problem is that social security routinely turns down, or unnecessarily delays, acceptance of even severely injured survivors.
The basis for such denial is almost always the standard that in order to be eligible for social security, the survivor must be totally disabled for a period of one year.
Note:There are exceptions: Click here for Anne's Story.
Typically, at the time social security first evaluates the claim, it will not have been one year from the date of injury. If, at that time, the doctors are saying anything like: "We will just have to wait and see," social security may turn the application down with the following language:
"We have determined that your condition is not expected to remain severe enough for 12 months in a row to keep you from working."
The doctors won't say how fast the survivor will improve, which leaves social security with the opportunity to conclude that some work will be possible within a year. Thus, the initial application gets turned down.
The good news is that social security takes so long to process applications, that by the time a hearing is finally heard, there should be no question that the disability has lasted a full year because a full year will have lapsed.
Simple rule for social security: don't give up. It is a three step process to get a hearing, but chances of winning at a hearing are excellent. The process can be summarized as follows:
A survivor applies for benefits, after several months of form filling and waiting for medical reports, social security will make an initial determination. If the bureaucrat handling the file finds some theory as to a quick recovery, the application will be denied. However, the denial will clearly explain how to request a reconsideration. 60 days is allowed for asking for a reconsideration, but do it as fast as possible
On reconsideration, another bureaucrat will look at the initial medical evidence, as well as any new medical information. While in most cases, reconsideration doesn't result in reversal; with the increasingly clearer picture of the extent of recovery as time passes, it can make a difference with brain injuries. If the treating doctors are issuing clearer opinions, the application may be accepted at this point. Again, the delay increases the chance of success.
If the reconsideration results in another denial, then the survivor must again appeal. It is at this stage that the claimant gets a hearing. It is also at this point that it becomes compelling to consult with an attorney. Experienced social security attorneys have excellent track records of success at hearings.
Frankly, attorney fees in this area are a bargain. Fees are almost always done on a contingent fee basis and work out to be quite reasonable in amount. Most lawyers today are limiting their fees to 25%. At the hearing, an administrative law judge will re-examine the medical evidence, as well as hear testimony presented by the applicant. Such testimony may include first hand descriptions of the survivor's difficulties by family members, co-workers or employers. For additional questions http://www.nosscr.org/faqind.html.
Odds are that an administrative law judge, presented with the proper evidence, will find that the disability is severe enough to meet the social security standard. If you can get a neuropsychologist to testify, your chances go up considerably.
Eligibility for social security, whether it be through SSI or SSDI not only opens the door for monthly payments, it may also provide payment for medical bills and other benefits.
SSI is short for Supplemental Security Income. It pays monthly checks to people who are:
and who don't own much or have a loss of income.
SSI isn't just for adults. Monthly checks can go to disabled and blind children, too.
People who get SSI usually get food stamps and Medicaid, too. Medicaid helps pay doctor and hospital bills.
SSDI is short for Social Security Disability Income.
Disability under Social Security is based on your inability to work. You will be considered disabled if you are unable to do any kind of work for which you are suited and your disability is expected to last for at least a year or to result in death.
You can receive Social Security disability benefits at any age. If you are receiving disability benefits at age 65, they become retirement benefits, although the amount remains the same. Certain members of your family may also qualify for benefits on your record. They include:
The Social Security Administration has about 1,300 offices in cities and towns across America.
They may be reached at their toll-free number 1-800-772-1213. You can get recorded information 24 hours a day, including weekends and holidays. You can speak to a service representative between 7 a.m. and 7 p.m. on business days. Their lines are busiest early in the week and early in the month.
People who are deaf or hard of hearing may call their toll-free "TTY" number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days.
Below is the link for the United States Government Page on Social Security. Note: For new users; clicking below will exit this site, to return, hit back.
Further help can be found from HDI Publishers who publish a helpful brochure entitled Social Security Benefits for Persons with Traumatic Brain Injury.
Attorney Gordon S. Johnson, Jr.
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