SSI Claims: Filing & Appeals

Supplemental Security Income is a disability program for individuals who have a clear financial need, as well as a disability which prevents them from engaging in substantial gainful activity. Individuals who are over the age of 65 could potentially qualify for Supplemental Security Income even if they are not totally disabled (according to SSA’s definition of a total disability). Those who are younger than 65 must establish they have no way to support themselves and they are totally disabled, therefore unable to engage in substantial gainful activity.

Supplemental Security Income prohibits you from owning more than $2,000 in countable assets, or, if married, $3,000 in countable assets jointly. A “countable asset” is anything of value other than your home and one vehicle. Money in checking accounts and savings accounts, retirement accounts, vehicles above and beyond the one allowed, jewelry, artwork, cash value in life insurance policies, and virtually anything else of significant value.

How Do I File a Supplemental Security Income Claim? Those individuals who have worked over the past ten years, should potentially look into applying for Social Security Disability while also applying for Supplemental Security Income as some people will qualify for both. SSDI is an insurance program designed for those who were working prior to becoming disabled, while SSI is also for the disabled, but for those with a demonstrable financial need.

Supplemental Security Income should be applied for as soon as you realize you have a disability which could potentially last for more than a year, or a disability which is expected to cause your death or expected to be terminal within the next twelve months. There are some instances where a child with a disability could qualify for Supplemental Security Income based on the child’s disability and the parents’ income and assets.

You can apply for Supplemental Security Income in person at your local Social Security office or online. A Social Security representative will interview you and complete forms with the information you provide. If you are a parent or a guardian of a child who is disabled, you can apply on behalf of the child who is under the age of 18. The date you apply for Supplemental Security Income or the date you initially made contact with your local Social Security office to apply for SSI is the earliest date the benefits can be paid.

You will be asked about your income, what you own, your living arrangements, and your citizenship status to determine your eligibility. You will also be asked about your specific health issues (or those of your child if you are applying on behalf of your child) and how those health issues your daily activities and your ability to engage in substantial, gainful employment.

You will need your bank account information for direct deposit, and will need to bring your Social Security card, your birth certificate, proof of citizenship (or alien status), information about your home (mortgage or lease information), proof of your income and proof of your resources (checking and savings accounts, insurance policies, CD’s, stocks or bonds). Finally, you will need the contact information of every doctor, clinic or hospital that has treated you, the dates of those treatments and any other information regarding your disability. 

How Do I Appeal a Supplemental Security Income Claim Denial? If your application for Supplemental Security Income is denied, you can appeal that decision—you can ask that a second look be taken at your application for SSI. You may be appealing a decision over whether you are eligible for Supplemental Security Income, the amount of your Supplemental Security Income, or you could be appealing an overpayment as far as whether you are required to repay the overpayment. Following receipt of your Supplemental Security Income written determination of denial, you must request an appeal in writing within 60 days. The notice of denial you receive will tell you how to proceed with an appeal. You are requesting reconsideration of the initial determination and can do so by writing a letter requesting an appeal.

If you are currently receiving Supplemental Security Income and are denied further benefits, if you ask for reconsideration in writing within 10 days from when you receive the notice of denial, you will continue receiving regular payments until a reconsideration determination is reached. There is a new service which allows you to check the status of your reconsideration appeal. This service provides detailed information regarding Supplemental Security Income appeals filed online or filed in person with a Social Security employee.

If your reconsideration for benefits is denied you have 60 days to ask for a Supplemental Security Income hearing before an administrative law judge. If you choose not to appear at the hearing in front of an ALJ, you can ask that a decision be made based on the evidence contained in your file. If the distance to the hearing before the ALJ is a significant distance from your home—more than 75 miles one way—you can request money for travel costs prior to the hearing. The ALJ could ask that you have additional medical exams or tests—which you do not have to pay for. Medical and vocational experts could be asked to testify at the hearing, and you are allowed to ask for your own witnesses to attend the hearing. You will receive a copy of the ALJ’s hearing decision.

Finally, if you disagree with the decision of the ALJ, you may request that an Appeals Council review the decision. You must request this appeal within 60 days of when you receive the ALJ’s hearing decision. Any new evidence must be submitted to the Appeals Council, which will only review a case based on additional evidence if it is new material, related to a period on or before the hearing decision, and there is a reasonable belief that the new evidence would change the outcome of the decision.

The Appeals Council will examine your case, then will deny your request for review, dismiss your request for review, or grant your request for review. If your request for review is granted, either the Appeals Council will make a determination or send the case back to the ALJ for further action. If the Appeals Council denies your appeal, you are allowed to file a civil action with the U.S. District Court in your area within 60 days, therefore you could benefit from contacting a disability lawyer Houston.

What is an ALJ Disability Hearing? A disability hearing in front of an Administrative Law Judge is the third step in the appeals process, after an initial denial of SSI benefits, then a denial on reconsideration of those SSI benefits. You have the right to appeal any decision made regarding Supplemental Security Income benefits or Social Security Disability benefits. By requesting an ALJ disability hearing, you are asking to receive a new decision from a judge who had no part in the first decision or the reconsideration. You have 60 days from the time of the reconsideration denial to ask for an appeal in front of an ALJ. It is presumed you received the notice five days after it is mailed unless you can show you received the letter later. If your appeal is not filed within the allowed time limit, your appeal may be dismissed, meaning you would no longer be eligible for the next step in the appeals process.

Having the Sullo & Sullo Disability lawyers in Houston, Texas assist you in determining whether you qualify for Supplemental Security Income, how to file for SSI and what benefits you might be entitled you can be invaluable. Our attorneys can guide you through the entire process, helping you with your appeals if your application is denied. Having help for the SSI process can result in a more favorable outcome with you getting the benefits you are entitled to.

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