FREQUENTLY ASKED QUESTIONS

+ How does the Social Security Administration define "disability"?

Social Security defines "disability" as "the inability to engage in any substantial gainful activity by reason of any medically determinable physical and/or mental impairment that is expected to result in death, or has lasted or is expected to last, for a continuous period of not less than twelve months."

+ How can I apply for Social Security Benefits?

Please visit our Application Process page for more information on how to apply for benefits.

+ How long until I get a decision?

Processing times vary greatly depending on the region in which you reside.

  • Initial claims – generally 4-6 months
  • Appeal/Request for Hearing – generally 12-14 months
  • Appeals Council – generally 14-18 months

We recommend that you contact us for processing times in your region if you have reached the appeal level. There are, however, circumstances in which your claim may be eligible for expedited handling and a much quicker decision. Contact us to determine if your case meets the Social Security criteria for expedited handling.

+ What should I do while I wait for a decision?

Because the disability process can take a while, we advise our client's to pursue all avenues of financial assistance that are possible, such as State Disability Assistance through the Department of Health and Human Services.

+ Social Security has denied my claim, what should I do now?

Depending on the state in which you live, you will need to file for either reconsideration, or a hearing before an Administrative Law Judge. Most importantly, the appeal must be filed within 60 days from receipt of your denial notice. You should contact Health Claims Advocates immediately to speak with a qualified representative regarding your case. Let us handle the complex policy and procedures of your appeal.

Please note that if you live in one of the following ten states, reconsideration does not apply and you may file your appeal for a hearing directly to an Administrative Law Judge: Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New Hampshire, Pennsylvania, and parts of California and New York.

+ What are the fees that HCA charges?

Typically, Health Claims Advocates enters into a fee agreement with the claimants for a fee that is paid only after the case is won. There are no upfront fees or costs to you as the fee is paid through direct withholding from the Federal Government for 25% of past due benefits capped at $6,000.

+ What if I don’t have health insurance?

Please visit our Insurance Questions page for information on obtaining health insurance.

+ What does SGA mean?

To be eligible for disability benefits, a person must be unable to engage in substantial gainful activity (SGA). A person who is earning more than a certain monthly amount (net of impairment-related work expenses) is ordinarily considered to be engaging in SGA. The amount of monthly earnings considered as SGA depends on the nature of a person's disability. The Social Security Act specifies a higher SGA amount for statutorily blind individuals; Federal regulations specify a lower SGA amount for non-blind individuals.

+ What are work credits?

Social Security bases credits on the amount of your earnings, they use your earnings and work history to determine your eligibility for retirement or disability benefits ir your family’s eligibility for survivors benefits when you die.

In 2015, you receive one credit for each $1,220 of earnings, up to the maximum of four credits per year. Each year the amount of the earnings needed for credits goes up slightly as average earnings levels increase. The credits you earn remain on your Social Security record even if you changes jobs or are unemployed for a period of time. However after a period of about 5 years disability insurance under Social Security is no longer active.

What are considered assets?

  • Checking, Savings, CD Accounts, Savings bonds, money market funds
  • Stocks or Mutual funds
  • IRA, KEOGH, 401K, or deferred compensation accounts
  • Trust funds
  • Life insurace that money may be withdrawn at any time
  • Anuties
  • Multiple cars, trucks, boats, motorcycles, atvs and any other vehicle
  • Farming tools and equipment, Livestock or Crops
  • Funeral contracts, Burial plots, caskets
  • Cash on hand

+ If I win my claim, how much will I receive and for what period of time?

A claimant's monthly benefit amount depends on multiple factors. For RSDI, also known at Title II benefits, your monthly benefit amount is based upon a complex calculation using your lifetime earnings record. A claimant's dependents may also be eligible for auxiliary benefits once the claim has been approved. There is also a five month waiting period from the date your disability is established before benefits are payable to you. In addition, retroactive benefits can only be paid for twelve months prior to the date of your application.

For individual who do not qualify for RSDI or Title II benefits, because of a limited earnings history and insufficient quarters of coverage, SSI benefits are examined. SSI benefits, also known as Title XVI benefits, are payable beginning the calendar month following the month in which you applied, with a monthly maximum in 2017 of $735.00 per individual, and $1,103.00 for an eligible couple.

+ I have been receiving disability benefits and have recently received a notice that Social Security is conducting a Continuing Disability Review (CDR) on my claim. Are my benefits going to be terminated, what do I do?

This is a very common practice with the Social Security Administration and does not mean they are going to end your benefits. Whether you are receiving SSDI or SSI, your medical records will be reviewed periodically to determine if your disabling condition(s) has changed. You should comply with any request from Social Security in a timely fashion and contact a qualified representative immediately if you are informed that your benefits will be terminated. Most importantly, if a denial is received after a Continuing Disability Review, you must file an appeal within 10 days for your benefits to continue while the appeal is pending.

+ Can I get Social Security disability benefits if my condition has improved, or I have returned to work?

Social Security has a durational requirement of twelve consecutive months. If your condition has lasted for at least one year, but has improved, you may be eligible for a limited time for disability benefits. If the durational requirement of 12 months has been satisfied, even if your condition has improved and/or you have returned to work, you should consider filing an application for Social Security disability benefits. (referred as a closed period of disability).

The Social Security offers a program called Ticket to Work for individuals attempting to return to work. Please visit SSA.Gov for more information.

+ Do I have to pay income taxes on the benefits that I receive?

You will have to pay federal taxes on your Social Security benefits if you file a federal tax return as an individual and your total income is more than $25,000.00. If you file a joint return, you will have to pay taxes if you and your spouse have a total income of more than $32,000.00 The Social Security Administration has no authority to withhold state or local taxes from your benefits. Many states and local authorities do not tax Social Security benefits. You may choose to contact your local taxing authority for more information depending on the region you reside in.