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Why do I need an attorney in a Social Security Disability Claim?

Although you are not required to have an attorney, having someone who understands the legal proof necessary to establish a Social Security claim is most helpful. The fact is that Social Security Disability claims are, for the most part, initially denied.

Our firm has successfully represented thousands of disabled claimants on both the initial application, as well as Appeals, before Administrative Law Judges of the Social Security Administration. We combine a complete knowledge of the law with an understanding of the requirements demanded by individual judges. We are available to discuss potential claims and there is no fee for a consultation.

In what geographical areas do you practice?

Our practice covers Long Island and New York City for the most part, but we will continue to represent you should you move during dependency of your claim. Should you move to an area too far a field for us to litigate your case, we will recommend competent counsel in your geographic area.

Who qualifies for Social Security Disability Benefits?

As a general statement, we recommend not applying for Social Security Disability Benefits until you have been out of work for six months. At that point, if you have been gainfully employed for sufficient years and at sufficient funds, you may be considered eligible for SSDB. Your disability has to be severe enough to meet the criteria of the Social Security Administration, and we will advise you of your likely eligibility and potential for success in your claim.

If your claim is successful, you will become eligible for monthly cash payments and members of your family may also qualify. After two years of payments, you will also qualify for Medicare health insurance benefits.

Remember that your period of disability (out of work), must be expected to last at least 12 months, for your claim to be viable.

Is there an age requirement for receiving Social Security Disability Benefits?

No. Younger individuals may get Social Security Benefits based on the disability. If you have a history of working, but can no longer do the job because of an illness or injury, you may be eligible to receive Social Security Disability Benefits.

Is there a time limit for filing a claim?

No. As soon as you are convinced you’ll be out of work for a 12-month period, we suggest you contact us for an initial discussion; and at the point where you are out of work for six months, we will proceed with your claim if you wish.

Does every injury or illness qualify me for Social Security Disability?

No. To qualify for Social Security Disability Benefits, the Social Security Administration has defined the requirements as having a physical or mental impairment that keeps you from doing any substantial work for at least a year, or a condition or illness that is expected to result in your death.

If I am disabled under other benefit plans, such as Workers’ Compensation, does that mean I will qualify for Social Security Disability Benefits?

No. The definitions of disability are different between various government programs. Someone who has been “classified” as having a permanent, partial disability, under the Workers’ Compensation Law, may nonetheless be considered totally disabled, under the Social Security Disability Benefits law. This is why we so strongly recommend that you speak to an attorney, who practices in the area of Social Security Disability Benefits, to determine the viability of your claim.

Is there a time limit for applying?

No, but remember that the longer you don’t file, the more benefits you may lose by delaying.

How are you paid for your services?

Unlike some Social Security Disability law firms, we do not charge “up front” for taking your case or filing your claim. We take cases on a contingency basis. This means that unless we win your case, there is no fee. The Social Security Administration approves all attorneys’ fees and, in most cases, they approve a fee of 25% of any benefits due retroactively, up to a maximum fee of $6,000, whichever is less. The Social Security Administration will deduct our fee from your award and send it to us. Absent an error by the Social Security Administration, the client does not pay us directly.

What is the usual timeframe for processing a Social Security Disability claim?

It will usually be five or six months before the Social Security Administration decides on an initial claim, and then an additional six months to a year before there is a hearing before a Judge (if Social Security has denied your claim initially).
With an attorney, there is the potential for considerable shortening of the time periods on Appeal.

What will you do if my claim is denied?

We will file an appeal and request a hearing before the Social Security Office of Hearings & Appeals. Statistics issued by the government indicate you have a greater likelihood of winning your appeal, when you appear before the Judge with an attorney.

How long do Social Security Disability Benefits last?

If you are found to be eligible, your benefits will last for as long as you are unable to work and remain disabled, or until you become eligible for Social Security retirement payments. Your claim for Social Security Disability benefits will not deprive you of your old-age Social Security Benefits. If you are out of work prior to applying for old-age benefits, and do not prove that you are disabled while out of work, your later retirement benefits may be affected.

What else should I know about applying for Social Security Disability Benefits?

You should be aware that you can collect Social Security Disability Benefits, Workers’ Compensation benefits, and long-term disability payments from a long-term disability policy at the same time. You should be also aware that the long-term disability benefits provider may offer to help you with your Social Security application at “no cost”. However, sometimes they don’t ask for sufficient information due to the many complicated Social Security forms, and the Social Security Administration receives less than fully accurate information. This could ultimately jeopardize your entitlement at a later date to long-term disability benefits, or to Social Security Disability Benefits. You should have an attorney helping you.

Should I expect the finding of eligibility to be permanent?

Unfortunately, the Social Security Administration reviews most disability claims at three-year intervals to be satisfied that you remain disabled.

We continue to represent those clients who we have helped with their initial application at the time of such reviews.

There is never a fee for a consultation. Contact us for an interview to discuss your claim.

When is Retirement Disability available?

Disability Retirement is available to workers that can no longer perform the full duties required of their specific title. This legal standard means that you must no longer be able to perform your job, it does not require that you be disabled from all jobs in the United States like Social Security Disability. If you and your treating doctors believe that your injury or illness will not allow you to return to your previous work, an application for Disability Retirement should be file.

How does NYCERS determine if I am disabled?

NYCERS has established a Medical Board to hear each application for disability retirement. This three doctor panel is charged with reviewing all the evidence a member submits in support of their claim for benefits and is also required to physically examine the injured/ill worker. Once examined, the Medical Board will recommend to the NYCERS governing body, the Board of Trustees, whether or not to approve or deny your claim. By law, the Board of Trustees cannot overturn the Medical Boards determination regarding a member’s fitness for duty, but must make its own determination on issues regarding the accidental nature of your injury and casual relationship, that is, whether your injury was caused by the specific accident alleged in the application.

If I am approved, will I receive medical benefits from NYCERS?

Technically, the answer is no. NYCERS does not administer medical benefit coverage. Instead, medical benefit coverage is a contractual issue. Rest assured, almost all contracts today treat disability retirees the same as service retirees, preserving their medical benefits upon retirement.

Can I work another job as a Disability Retirement recipient?

Yes, however you will be subject to income limitations, which change annually. Whenever you decide to take new employment, you should contact NYCERS to find out the current income limitation.

Can I receive a Disability Pension, Social Security Disability, and NYS Workers’ Compensation together, without offset?

Yes, Tier 4 Disability Pension benefits are not offset by the receipt of either SSD or NYS Workers’ Compensation and a member can receive all 3 benefits payments under the law.

When should I file a Disability Retirement application?

The Retirement and Social Security Law has various filing deadlines for disability retirement depending on the pension Tier the member has been assigned. Tiers are determined based on one’s original membership date with NYCERS. Although the law sets guidelines on the latest date a member can apply for a disability pension, the basic rule of thumb is that an injured worker should apply for a disability pension as soon as they and their physician determine that they are no longer able to return to their prior work, but not later than 6 months after an injured worker has been absent from work on an approved medical leave. Remember, the law allows your employer to medically separate you after one year of absence. Therefore, in order to avoid medical separation, and possible interruption of medical insurance coverage and other benefits, it is in a worker’s best interest to file as early as possible.

Statute of Limitations for Filing

Within 3 months of the date a member was last paid on payroll, or within 1 year of when a member received notification that their employment has been terminated as long as the member was on an employer approved medical leave of absence prior to termination.

Definition of Presumption

If an individual’s pre-employment records/medical records before 9/11 don’t have a diagnosis of a “qualifying condition” and if they worked at the World Trade Center disaster site-particular to the areas outlined below-NYSLRS can “presume” the individuals diagnosis stemmed from the work they did in the aftermath of 9/11.

World Trade Center qualifying locations, as defined by the NYS Comptroller’s Office:

  • The World Trade Center site (defined as the area below a line starting from the Hudson River and Canal Street bearing east on Canal Street to Pike Street, continuing south on Pike Street to the East River; and extending to the lower tip of Manhattan);
  • The New York City (NYC) morgue or any temporary morgue;
  • The Fresh Kills Landfill; and
  •  On the barges that ran between Manhattan and the Fresh Kills Landfill.

 

Do I still qualify if I worked at locations different from those in Question 1?

The guidelines to qualify for presumption benefits are based on:

  • qualifying locations and/or qualifying duties.
  • The length of time/period of time which duties were performed.

Per the NYS Comptroller’s Office, if an individual performed any kind of clean up duties during the first two-day period after the first plane crash, or worked a cumulative 40 hours from 9/11/01 to 9/12/02 at one or more of the locations in Question #1, they meet the qualifications for presumption. They also are eligible if specific duties were performed at particular NYPD, FDNY, or EMS locations during the first 24 hours of clean up operations, or fixed cars/equipment effected by debris, whether or not it was done at one of the locations in Question 1.

 

Does this cover accidental disability benefits?

The WTC Presumption Law only provides Presumption Benefits. However, if an individuals retirement plan has accidental disability benefits, and they were deemed permanently disabled, this law could make them eligible for WTC Accidental Disability Presumption. There is no deadline for the WTC Accidental Disability Presumption form (Form RS6047-W), as long as they file a World Trade Center Notice on/prior to 9/11/2022, as required by the NYS State Comptroller’s Office. If an individual has already retired with accidental disability benefits, they are not eligible for other benefits.

What is the filing deadline?

The deadline was recently extended to September 11th, 2022. An individual who wants to file for Presumption must fill out both the Presumption form (RS6047-W) and the Notice form (RS6047-N) by 9/11/2022.

What about individuals who retired before 9/11?

Those who retired prior to 9/11 are not eligible.

If I opt for a Partial Lump Sum payment, can I still file for a reclassification of benefits?

Yes.  Please take note an individual must pay back the Partial Lump Sum along with accrued interest, and that this only applies to accidental death benefits.

If an individual dies as a result of their condition, what does this provide for their beneficiaries?

Beneficiaries could potentially change disability retirement benefits into WTC accidental death benefits if the person they are a beneficiary of passes away within 25 years of the day they retired and if that same person filed a WTC Notice by 9/11/2022. This will depend on the policies in the respective individual’s retirement plan concerning their beneficiaries.