Social Security disability is a payroll-based, tax-funded insurance program that assists individuals who struggle with a physical or mental impairment that keeps them from working. To be qualified the individual must establish that he or she cannot engage in substantial gainful activity for a period expected to exceed one year. In Pennsylvania and everywhere else, the applicant for Social Security disability must be under 65 and generally have accumulated enough social security “credits” to be qualified.
Such credits are based on length of time worked and paid into the system in the past. The requirement of having paid into the system makes it an insurance program. Additionally, the applicant must establish the claim by medical proof of a disability. There is a principle followed by the SSA which gives preference to the opinion of the treating physician.
The Social Security Administration can have you examined by another doctor. The SSA also employs vocational experts to submit reports and testify at hearings. Although the claimant may have proved the inability to engage in prior work, the vocational expert may testify that the applicant can perform some kind of sedentary work available in the national economy. This final issue should be prepared in advance because it is often the escape hatch that loses a disability claim for the claimant.
Most applicants are represented in a disability claim, either by private counselors or by approved attorneys. These representatives may be with an approved organization or they may be qualified attorneys. The claimant does not pay up front, and no fee is paid if the case is lost. Payment is based on 25 percent of the award up to a maximum of $6,000. The SSA will usually deduct the fee from the award and send it directly to the representative.
In Pennsylvania and nationally, the fee agreements are signed in advance and sent to the judge’s office so that there is rarely a problem or dispute with respect to fees. The whole fee process in a Social Security disability claim is monitored and recorded by the SSA. Generally, it may take several months after the hearing for the judge’s decision to be issued.
Source: brainerddispatch.com, SOCIAL SECURITY Q&A, Jon Noyes, Jan. 13, 2014