Frequently Asked Questions

The Social Security Administration has a disability program which helps disabled people. It is designed to replace part of the income you and your family lose if you become severely disabled. There are two parts to this program. Many times a person qualifies to apply for both parts of the program.

The first part of this program is Social Security Disability Insurance (SSDI). It is related to work. A person earns coverage for themselves and family members by paying Social Security tax. The program covers workers who are disabled, disabled widows/widowers and disabled adult children of workers.

The second part of the disability program is Supplemental Security Income (SSI). IT is related to means -- what you have or own. If you do not own much or have much income, you may be able to qualify for this part. Income and resources possessed are considered. This program covers adults and children who are eligible.

Federal law and the Social Security Administration provide the instructions used to determine whether a person is disabled. Therefore, a person filing for disability in Iowa is evaluated using the same guidelines as a person filing in any other state.

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"What is a disability?"

The Social Security Administration uses a specific definition of disability which is related to the ability to work. This definition is not the same one used by other agencies. It requires total disability and is somewhat stricter than definitions of other programs. For example the Veterans Administration uses a different definition, which includes partial disability.

For Social Security purposes, disability means:

• A person cannot be working.
• A person must be unable to do any work, or for a child, be unable to engage in age-appropriate activities.
• A medical condition must be the reason why a person cannot work.
• The mental or physical condition must be documented by objective medical evidence.
•  The condition must be so severe that it will last at least 12 months or result in death.

Here are some examples of conditions which ordinarily are severe enough to be considered disabling:

• Severe arthritis with inflammation, pain, swelling, and joint deformity which severely limits ability to move about or use your hands;
• cancer which is progressive and has not been controlled or cured;
• total inability to speak;
• serious loss of function of kidneys;
• loss of major function (such as amputation or paralysis) of both arms, both legs, or an arm and a leg;
• mental incapacity evidenced by dependence upon others for personal needs (e.g., eating, dressing, or bathing) and inability to follow directions;
• motor development generally acquired by children no more than one-half the child's chronological age, documented by appropriate medical findings.

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"How do I apply for Social Security disability benefits?"

Iowans with disabilities contact the Social Security Teleservice Center (1-800-772-1213) or the local Social Security field office. The field office phone number can be found in the blue pages under "Government Offices - United States - Social Security Administration." You will be asked to complete forms about your condition. Persons at the Social Security office will be able to help you with these. The forms will ask you to:

• describe your condition;
• tell hw it prevents you from working;
• list doctors who have treated you - name, address, telephone number, dates of treatment;
• explain past work activity;
• authorize release of medical information to Social Security and its agent, Disability Determination Services.

Then Social Security office personnel mail these completed forms to Disability Determination Services. For more detailed information on how to apply go to http://www.ssa.gov/pubs/10029.html .

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"How is my application processed?"

When your application is received, it is assigned to a trained Disability Examiner. The examiner reviews the forms and writes your medical sources to obtain medical evidence. Your doctors are asked:

• When did the condition begin?
•  How does the condition limited your activities?
•  What have medical examinations and tests shown?
•  What treatment has been provided?

Your doctor is not asked to decide whether you are disabled. The decision is made by a state agency team which includes a disability examiner and a medical consultant.

Usually the examiner receives enough evidence from your sources to make a decision. If more evidence is needed, a special examination is arranged and paid for by the Disability Determination Services with funds from the Social Security Administration. In many cases, you will be asked if you want your doctor to do the examination.

After all the needed evidence is obtained, the examiner and medical consultant consider all the facts in the case:

• how severe the condition is
• when it began
• how long it has lasted
• how it affect your ability to work
• your age, education, and work experience

They decide whether you are disabled, as defined by the Social Security Administration. Your case may then be randomly selected for a quality review by Social Security staff in Kansas City or Baltimore. After completion of the review process, the case is sent to your Social Security office. You will receive a letter about the decision from Social Security.

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"How long does it take to make a decision?"

It usually takes several months to make a decision. The time frame varies a great deal, depending on how quickly your medical sources respond to requests for records and the need for special examinations.

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"What benefits do I receive if I'm found to be disabled?"

Social Security pays monthly checks to qualified people with disabilities. If you applied under the work-related program (SSDI), monthly checks begin after a five-month waiting period for disabled workers and disabled widows/widowers. (There is no waiting period for disabled adult children.) You will receive Medicare benefits after receiving checks for two years.

If you applied under the means-related program (SSI), there is no waiting period before you start receiving monthly checks. You will usually receive Medicaid as soon as the application is approved.

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"What can I do if I disagree with the decision?"

The Social Security Administration has a specific appeals process. That means if you disagree with the decision, you can ask us to look at your case again. If our decision was wrong, we will change it. When we look at your case again, we look at all parts of it including those which were favorable to you.

Contact the Social Security Administration when you receive the letter about your decision. Ask that your case be reconsidered. You must appeal the decision within 60 days from the day you receive the letter. You will be asked to fill out some more forms, telling us about any changes in your condition and any new medical treatment.

The reconsideration case is then returned to Disability Determination Services where it is handled by a different examiner and medical consultant. Once again medical evidence is obtained. All evidence from the original decision and any new evidence is considered. An independent decision is made.

Some of the reasons to request reconsideration are:

• The condition is more severe than determined.
• The condition has lated longer than expected.
• The condition has worsened since the decision.
• The condition became disabling earlier than determined.
• Another condition developed which complicates the first condition.

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"If I'm found to be disabled, how long do I receive benefits?"

Once benefits begin, they will continue as long as you are still disabled and not working.

The Social Security Administration reviews all allowed cases on a schedule to see whether disability continues. The time of the review depends on these aspects of the condition:

• Is it expected to improve? Review in 6-30 months
• Is it possible that it will improve? Review in 3 years
• Is the condition permanent? Review in 5-7 years

When is it time for the review, your case is sent to the local Social Security office. You will be asked to come in for an interview. The office personnel will help you complete forms asking about:

• your original condition
• any changes in the original condition
• new conditions since you were allowed
• recent medical treatment
• ability to work because of the condition
• work activity since you were allowed benefits

You case is then sent to Disability Determination Services. An examiner will obtain medical evidence to see whether your condition has improved. The examiner and a medical consultant will decide whether you are still disabled, as defined by the Social Security Administration. If your condition has not improved or if the improvement does not enable you to work, your benefits will continue. If improvement has occurred and you are able to work, benefits will stop.

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"Will I be told when my checks will stop?"

Yes. If you are found to be no longer disabled, Social Security will send you a letter. That letter will tell you when you will stop receiving checks. You wil receive a check for the month we find that you are no longer disabled. You will also receive checks for two additional months. For example, if you are no longer disabled in January, you will receive checks for January, February and March.

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"If I believe that I am still disabled, can I appeal?"

Yes. There is an appeal process which you can use. By contacting the Social Security Administration (1-800-772-1213), you can ask that your case be reconsidered. After  completing necessary forms, the case is sent to Disability Determination Services for a decision. Medical evidence is obtained. If it is proposed that benefits should stop, you will be offered a face-to-face hearing with a Disability Hearings Officer. Once a reconsideration decision is made, there are three more steps you can pursue if you disagree with the decision:

• a hearing before an administrative law judge
• review by Appeals Council
• lawsuit filed in federal district court

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"If I feel able to return to work while I am receiving benefits, what should I do?"

If you feel able to return to work, you should contact the Social Security Administration. Also contact the Social Security Administration if you actually return to work while receiving benefits.

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