Social Security Claims Representatives and Disability Claims

Experienced Social Security disability attorney Jeff Scholnick discusses the process that Social Security claims representatives go through as they approach each disability claim.

A Social Security (SS) claims representative performs initial interviews with potential Social Security disability claimants. The claim representative may conduct this interview by phone or in person. Once the SS claims representative has completed the interview, they will begin to process your claim.

Preliminary eligibility check. This includes checking your eligibility for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). SSDI eligibility depends on the number of years you’ve worked at a job paying FICA taxes. SSI eligibility depends on your income and assets.

Status checks. While your Social Security disability claim is being processed, you may contact your claim’s representative to provide additional information or check the status of your claim. This can be helpful in providing you peace of mind as you wait for your claim to be processed.

Expedited claims. If you suffer from a medical condition on the compassionate allowances list (CAL), you have a terminal illness (TERI), or your case qualifies for quick disability determination (QDD), the claims representative should route your application and alert DDS that you have a qualified claim.

Advance disability payments. If you applied for SSI and the claims representative sees that you have a serious medical condition that qualifies for advance payment of disability, the claims representative can grant you presumptive disability payments. Presumptive disability payments may be an option if you are a double amputee, suffer from total blindness, deafness or confined to a wheelchair, among other things.

Substantial work test. The claims representative will perform a check to see whether you’ve been working, and they will further determine whether you’ve been doing a substantial amount of work. If so, this could disqualify you for disability benefits. SS considers making over $1,090 per month as substantial gainful activity (SGA).

Final eligibility check. Once the state disability agency has made a medical decision on your claim, the claim will be returned to your local Social Security office. If your claim has been medically eligible for disability, the claims representative will again check whether you have worked and performed SGA since you applied for disability benefits and whether you still (financially) qualify for SSI. If your claim was denied because you were not found medically disabled, you will be sent a denial letter and you can appeal the decision should you feel that you were wrongfully denied.

Understanding the roles of a Social Security claims representative can be helpful. However, complexities and confusions still arise in delving deeper into SSDI or SSI applications. For more information on Social Security disability and the current situation you’re in, contact experienced Social Security disability attorney Jeff Scholnick in Maryland, today.

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