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Can’t Work Because of a Spinal Cord Injury?

November 2, 2011

Dennis Liotta

By Dennis Liotta, Esq, Partner at Edgar Snyder & Associates

If you or someone you love sustains a spinal cord injury, it changes your life forever. Your independence may be compromised, and everyday activities you once took for granted may become a challenge.

Spinal cord injuries require extensive medical care – lengthy hospital stays, long-term rehabilitation, devices to adapt to living at home, etc. As if dealing with your injury isn’t enough, the piles of medical bills and debt can seem too much to bear.

No two spinal cord injuries are the same, but insurance companies see you as a claim number – not a person with a family and a unique situation. With the economy unpredictable and still in trouble, many people living with spinal cord injuries and their families are struggling financially.

If your spinal cord injury prevents you from working, you may want to pursue Social Security disability benefits (SSD). However, the application process is a complicated one. Learning how to navigate the system can mean the difference between being accepted or denied for SSD benefits.

Determining Eligibility

You may be eligible for SSD benefits if you can answer “yes” to the following questions:

• Do you have a spinal cord injury or disease that prevents you from working? The diagnosis does not guarantee you benefits; you are eligible for benefits only if your disability is severe enough to prevent you from holding a job.

• Does your disability prohibit you from working in any capacity – not just the job you held previously?

• Has your disability continued– or is it expected to continue– for at least one year? Or, is the disability life-threatening?

• Do you have an earnings record that shows you have paid into the Social Security system within the past five years? If you have not paid enough into the system, or have not paid recently enough, you may also be eligible for Social Security Income (SSI) benefits.

Unfortunately, the government denies many claims, even for people who are entitled to receive benefits. If your claim is denied, you may need to appeal the decision.

Applying for SSD Benefits

To get started, contact the Social Security Administration at 1-800-722-1213, visit www.ssa.gov to file online, or make an appointment at a local Social Security District Office. Your local Social Security office can help you determine if you’re eligible for SSD.

The claims process can take 120 days or more. Those approved receive SSD benefits after their sixth full month of disability.

If approved, your SSD payments are retroactive from the date you were evaluated as disabled. Money you receive is based on your average top earnings over the past 15 years of your work history. Note, however, that your SSD medical benefits do not kick in until the 29th month from the date you were considered disabled.

Denied Claims and Terminated Benefits

Denied benefits? Don’t give up – but act quickly. You have only 60 days to appeal. You can reapply after that time period, but only by starting a new application.

If you appeal the decision, you’ll be granted a hearing, which will take place within 12-18 months. You can represent yourself at an appeal hearing, but you may want to consider contacting an experienced attorney if you get overwhelmed. Typically it takes a judge several months after a hearing to issue a decision. If the judge does not issue a favorable verdict, you can move on to the Appeals Council.

The Appeals Council can choose to:

• Review your claim and render a decision

• Not review your claim

• Give your claim back to the Administrative Law Judge for reconsideration

If that doesn’t work, you can move on to the last and final step – you can pursue a case in Federal Court. You will definitely need an attorney at the federal level.

Navigating the System

Applying for SSD benefits can be a long and difficult road for people living with spinal cord injuries and their families. Learning about the SSD system and knowing what to do may make all the difference.

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Attorney Dennis Liotta, a partner at the law firm of Edgar Snyder & Associates, has over 20 years of experience helping people with physical and mental disabilities get Social Security disability benefits. For a comprehensive overview of SSD, with answers to commonly asked questions, download a free guide at: http://www.edgarsnyder.com/ssd-guide .

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