Cindy Speaker: Welcome to our broadcast today. My name is Cindy Speaker, and I have with me today Attorney Laura Holland of Gardberg & Kemmerly. She’s a Social Security Disability attorney. Laura, welcome.
Laura Holland: Thank you. Good to be here.
Cindy Speaker: We’re going to talk today about SSI and SSDI. I think there is a lot of confusion over what the difference is. So why don’t you start off by telling us what is the difference between the two and what circumstances would you deal with either one of them.
Laura Holland: Okay. First I’ll start just by talking about the definitions of the acronym, the SSI and the SSDI. SSI is supplemental security income. SSDI is social security disability insurance. SSI is just basically what it says, a supplement to income. It is not based on anything you’ve ever paid in, it is not based on your work history. It is only based on your income and your assets at the current time that you file or at the time that you are approved.
SSDI, social security disability insurance, is based on what you have paid in while you’ve been working. When you work, you see social security being taken out of your account. That is for retirement, but then that is also a safety net for if you become disabled and are no longer able to work. While you’re working, you’re building up credits for SSDI. Usually those will expire after five or so years after you finish working.
Cindy Speaker: Is there an advantage in SSDI over SSI?
Laura Holland: The advantage when you are filing for SSDI, which social security calls DIB, just disability insurance, but the advantage to that is you’re eligible for more money, usually, when you apply for that. Because if you’ve been working for 20 years and you become disabled, usually you’ve built up quite a bit of income. Basically what SSDI is, is basically receiving your retirement early. If you get disabled and injured at, say, 55 and you apply for disability you’re going to get what you would be eligible for if you turned 65 that day, or 66 now, if you turned 66 that day and were applying for your retirement.
This is basically you just getting your retirement early. That would be the monthly amount you would get, would be that amount that you would receive at 66. You would also be eligible for the same Medicare that you would receive at 66 if you become disabled and are found disabled on the social security system at whatever age it is that you become disabled, as long as you’ve been working and have those credits built up.
Usually … Well, I don’t want to say usually, but in a lot of cases you are eligible for more money with disability than with SSI because SSI is a supplemental income, like I said. So it is capped at $735 a month. That is the maximum that you … They raised it. I don’t believe they did in 2016, but in 2017 they raised it a couple of dollars a month. It’s not always going to be $735, but it’s never going to increase. You may get a couple of dollar increase every year, but it’s never going to be based … I mean it’s never going to be as much as if you worked and paid in for 20 years.
A lot of times, that’s all people are eligible for, particularly if they’ve never worked, if they’re younger. If you’re 21, 22 and you don’t have that work history or if you’re a child, children are eligible for SSI. Children who have disabilities, children who require special treatments, children who require special therapies, things like that, parents can apply on behalf of their children for SSI to get assistance with those things.
SSI really is, like I said, just there as a supplement and it’s there as a safety net for people who have disabilities, who have never worked, or are children or are younger and just don’t have that work history. Medicaid goes along with SSI. You still get the insurance. You still get some sort of income, but SSI, like I said, is based on … Well, I guess I didn’t say this yet, but it’s based on your income and your assets.
Not everyone is eligible for SSI. If you make more than $735 a month, you’re not eligible for SSI. If you have assets over $2,500, you’re not eligible for SSI. You can own a piece of property that you live in, you can own a vehicle. But if you own things above that, that are worth $2,500 or more, you’re not eligible for SSI. It is a safety net for people who just don’t have a lot, really. But, on the other hand, sometimes people are eligible for both. Even if they have work, you can still be eligible for SSI.
Cindy Speaker: Okay, that’s interesting. You can be eligible for both.
Laura Holland: You can.
Cindy Speaker: Would you apply for both, or just the one that you said would potentially give you more benefits?
Laura Holland: Yes, you can apply for both. If you’re eligible for both, we absolutely encourage you to apply for both because you don’t … Well, let me give you an example. Say someone has been disabled, but they have thought that they could go back to work. They have been out of work for three years. A lot of times, when you’re out of work for three years you can’t keep up with car payments, you can’t keep up with a savings account, things like that.
In a case like that, a lot of times people are eligible for SSI because, due to them not being able to work and unfortunate circumstances, they’ve gotten to where they’re under that asset limit and under that income limit. So they’re eligible for SSI. Then, since they’ve worked in the past in the past five or so years, they still have those credits.
They would have a SSDI, a DIB claim, and an SSI claim. Always apply for both when you go in to apply, even if you think you’re not eligible for SSI. Always talk to them about that, because you want to make sure that you’re maximizing your benefits. You want to make sure that you’re getting everything you possibly can. Because with the disability, with the SSDI, there is a 24-month waiting period before your insurance kicks in.
Cindy Speaker: Oh, wow.
Laura Holland: From the time … Right. From the time that you’re found disabled … Well, actually from your onset date. Say you had an accident at work on May 1st of 2017 and you apply for disability. Another thing that I’m sure most people are familiar with, the disability process, the application process is a long process. You apply. Most people, about 70% of people, get denied at the initial level. Then you have to appeal to an administrative law judge. Because 70% of people are getting denied at the initial level-
Cindy Speaker: Wow. 70% get denied?
Laura Holland: Yes, at the initial level. That’s what we try to tell people when they first-
Cindy Speaker: At the initial level. Okay.
Laura Holland: At the initial level, right.
Cindy Speaker: It’s not a done deal yet.
Laura Holland: Not a done deal. You can-
Cindy Speaker: I see. Okay, that helps.
Laura Holland: Right, no. That’s what we tell people when they come in here the first time. Do not be discouraged because you’ve been denied at the initial level, because we appeal to the administrative law judges at that point. That’s where most cases go, is to the administrative law judge. That’s when you have a hearing. At the initial level, they’re just reviewing your medical records, reviewing the reports they have you fill out.
But at the next level, that’s when you get in front of a judge and that’s when you get a hearing. But that whole process can take up to two years, so it’s best to apply for everything at one time. A lot of people sometimes get to the point where they’ve been waiting a year. At that point, they may need to apply for SSI. They may become eligible for SSI while they’re in the process of applying.
We try to ask people about that as we have our appointments with them and see where they are, see where they are financially, see if they need to apply for SSI at that point. Because that’s still something that you can ask them to attach that to your claim that you’ve appealed, and a lot of times they will. You’ll still potentially have that eligibility for both, even after you’ve applied for disability.
Cindy Speaker: Let me ask you this, Laura. Is it possible to get approved for both, and also is it possible to collect from both? Or is it one or the other?
Laura Holland: You can get approved for both and collect for both.
Cindy Speaker: Oh, interesting.
Laura Holland: Yes. A lot of times, when people have, say, lower income entry-level jobs, they are paying into social security but when they become disabled or when they become unable to work, maybe their disability benefits are only going to be $600 a month. They’ll still be eligible for that $600 a month, but if they’ve applied for SSI as well, they’ll be bumped up that extra $135 up to that $735 a month. Because SSI can’t go above $735 a month and you can’t be receiving over $735 a month.
But, like I said, if you’re getting that $600 from disability you would still be eligible to be bumped up to $735 through SSI and you would also have your Medicaid and your Medicare. Medicaid with SSI comes into effect the month after you apply. Going back to that person I was talking about who became disabled on May 1st of 2017, say they applied June 1st. They apply for disability and SSI. They get their hearing in June of 2019 and they’re approved, and they’re approved back to May 1st of 2017. I know I’m throwing a lot of numbers and dates at you-
Cindy Speaker: No, this is great.
Laura Holland: … and this may be confusing. When they are approved in June of 2019 their Medicare, through their disability, they start counting at the time you get paid. Your first payment goes back to on your disability. You’re disabled May 1st. There’s a six-month waiting period before your disability payment starts, so June, July, August, September, October of 2017 would be when their payments would start. That’s when their 24-month waiting period for Medicare would start. They would be eligible for Medicare as of October of 2019. That’s a long time to wait for your Medicare-
Cindy Speaker: Yeah, sure is.
Laura Holland: … but if you have those SSI benefits you’re eligible for Medicaid the month after you filed. You filed in June of 2017, so you’re eligible for Medicare going back to July of 2017. You’ve got all of that, so if you have outstanding hospital bills, outstanding medical bills, you can use your Medicare as if you’ve had it the whole time and go back and make those payments. That why it’s very beneficial to apply for both. Because if you are eligible for a dollar of SSI, you still get that Medicaid.
Cindy Speaker: Okay, that’s big.
Laura Holland: Yes. That’s why it’s so important for people to know what they’re going to the social security office for, know what to ask for, know to say, “I want to see if I’m eligible for SSI. I want to see if I’m eligible for SSDI. I want to see if I can apply for both.” Because you need to maximize all the benefits that you can potentially get.
Cindy Speaker: Yeah. Let’s talk about the application process. Is that something that they do online? How is that done?
Laura Holland: Disability, you can do the SSDI application online, the DIB application. That’s the one that, if you’ve worked and paid into, that’s the one you’re applying for. That one can be done online. SSI can only be done in your local office. You have to physically go down there and apply for it. I think a lot of times it’s better to go down there and apply for it anyway because you know that you’re talking to them about what you’re eligible for with everything. Even if you get-
Cindy Speaker: Okay, that’s … Yeah.
Laura Holland: Sorry. I was going to say even if you get an attorney to help with your claim, you still have to make the initial application on your own. The attorney can never go down and file that application for you. You have to do that on your own.
Cindy Speaker: I see. Then, at what point would you get involved?
Laura Holland: Usually people come to us either after they have filed that initial application. People will come to us and say, “Here’s my application. Here’s what I’ve done. What’s the next step?” At that point, we make sure they’ve told social security all the doctors they’re seeing, all the hospitals they’ve been to, make sure social security is collecting all of their information to make a decision at that initial level. That’s what we do if people come to us after they apply. Other times, people will come to us after they have appealed or after they’ve been denied and then we’ll file their appeal for them. Those are kind of-
Cindy Speaker: Oh, so you can actually file the appeal.
Laura Holland: Yes. We can file the appeal for them. People, a lot of times, and that’s what happens in most cases, is people will come to us once they’ve been denied and say, “What now? What can I do? What are my options?” Then we will talk them through the process and let them know that we can file that appeal for them and that it’s not done once you’re denied at the initial level. That’s just the first step. Either of those times. Really any time up to a hearing. We’ve had people come to us a month before their hearing and say, “Can you help me?” If it’s something that we’re able to do, of course. But most people will come to us either after they’ve filed their initial application or after they’ve been denied at the initial level.
Cindy Speaker: Okay. Is that what you recommend?
Laura Holland: Yes. The earlier you can get to an attorney, the better they can help you develop your case. Because you want the judge to have all the information they can possibly have in front of them at the time that they are meeting with you in your hearing.
Cindy Speaker: Well, what you’re talking about sounds like a big part of the process that I’m sure an attorney could be very helpful with, is getting all this documentation. Medical records, all that. A lot of people wouldn’t really know how to go about all that. So I think getting help with the organization of documentation would be extremely helpful.
Laura Holland: Absolutely. It is so important to get every piece of evidence you possibly can in front of the judge, everything going back to the date that you became disabled. You want them to have a full breadth of knowledge about your case, about your medical history, about your impairments, and about your work history also because that’s something that they look at, is what your previous job was and what your duties were, in evaluating your case. It’s so easy to get into so many different things when you’re talking about social security, but yes. Medical records, developing that, that is a huge part of what we do and what we help people do. Because really developing your case is extremely important.
Cindy Speaker: Yeah. Laura, you mentioned that first initial application about 70% are denied. Do you have any stats on the appeal what kind of percentage is accepted? Also, secondly, if there’s any statistics, and I don’t know if there are or not, of the success when you have an attorney involved versus not having an attorney. Any stats on any of that?
Laura Holland: Really, with the … I know in our area in particular we have 15 judges who hear social security cases. Each one of those judges has a different approval rating. Social security does keep statistics on the judges and what their approval ratings are. Most judges, their approval ratings in Mobile, are around between 40 and 60%.
You have a better chance in front of the judge once you get in front of them and once you can have that time to explain to them what you’re going through, what your symptoms are, what your day-to-day life is like. They’re going to listen to that and they’re going to look at your medical records. What they want to see is that those are going side by side, that those are … Your doctors are saying exactly what you’re telling the judge.
In cases where we have that, that’s all we can hope for. That’s the best thing we can show them, is that … The judges are receptive to that. That’s what they want to see. So when we have that, I think the approval ratings just go through the roof when we have that and when we can show that symptoms are the same across the board. No matter what doctor you’re seeing, all of your doctors are stating the same things. You’re saying the same things. That’s really best case scenario, and that’s when the judges are really very receptive to a case.
Cindy Speaker: Yeah, that makes sense. Let me just clarify one more time. When you get involved, a lot of this documentation, you’re assembling it. Is that true?
Laura Holland: Yes, we do. We-
Cindy Speaker: A lot of the medical records and things like that?
Laura Holland: We get all the medical records, we organize those-
Cindy Speaker: Okay. That’s huge.
Laura Holland: … and get those sent to social security. Yes, and that’s something that we try to do every time we speak with a client. We talk to them and we say, “What doctors have you seen since the last time we’ve spoken?” Sometimes people will come to us years after their onset date, after their initial disability, and we’ll say, “Well, let’s go through and make a list of every doctor you’ve seen since then,” try to jog their memory, try to help them think of who they’ve seen, how we can get …
We’ll take care of getting the records. We don’t ask them to go get any or go make their own requests. We take care of that, but we do try to, every time we speak, talk about what doctors they’ve seen, what needs to be updated, and we get all that in and get it sent to the judge so they can review it.
Then we also go over what the judge is looking for in the hearing. We go over what kinds of questions they’re going to ask and just try to get people as prepared as possible to go in front of those judges and know what their medical records are saying, know what their doctors are saying, and really let them know what to expect in the hearing. That’s what we do and what our process is throughout their case, throughout the pendency of someone’s case with the social security system.
Cindy Speaker: Yeah, very helpful. Laura, if somebody has questions and they want to reach you, how they can they do that? What’s the best way?
Laura Holland: Email. My email is firstname.lastname@example.org. I try to respond to emails as quickly as I can, so that’s probably the best way. Also, our office number. 251-343-1111.
Cindy Speaker: Then, also gardberglaw.com. I know you have all the information on your website as well.
Laura Holland: Yes, we do. We have blogs. There’s a blog that’s connected to that website that we go through and explain so many different areas of social security. We have just touched on a tiny piece of it today. There are so many issues, so many things that go into it, so many questions that people have. A lot of those questions are already answered on our blog, so if you want to look around there first it is gardberglaw.com and there’s the little tab on there that says Blog, so feel free to look at that. Then if you have any questions after that, send me an email or call our office and we’ll be happy to help.
Cindy Speaker: Terrific. We appreciate it. Well, listen, Laura. Thanks a lot for your time today.
Laura Holland: Oh, you’re welcome. It was great talking with you.
Cindy Speaker: You too. To those of you that are listening, either live or by replay, you can also leave your questions right on this page. Just post them in the comments and we’ll make sure Laura addresses them for you, gets you some answers. We’ll see y’all again soon. Thanks, Laura.
Laura Holland: Thank you.