Find the Answers to Your Pennsylvania Workers’ Compensation and Disability Benefits Questions
Most people navigating the workers’ compensation and disability benefits application processes come to us with questions and confusion. Here, we share some of the questions that we answer most about the disability and workers’ compensation application and appeals processes. If you have a question for us, check out this page to see if we have answered this question for others!
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What are the non-medical requirements a claimant must meet to be entitled to Social Security Disability benefits?
To qualify for Social Security Disability benefits, the claimant must have worked the required number of quarters and paid required social security taxes for generally five to ten years.
If I collect unemployment compensation benefits, will it hurt my application for Social Security disability benefits?
To be eligible for unemployment compensation benefits, you must be ready, willing and able to work. To be eligible for Social Security disability benefits, you must be disabled from all forms of employment. Claimimg that you are ready, willing and able to work is inconsistent with a simultaneous claim that you're disabled from all employment.
There are situations in which an application for unemployment compensation benefits is consistent with an applicant for Social Security disability benefits. If you are capable of working light duty work only and are 55 or older, you could be found disabled using rules from the Social Security Medical-Vocational guidelines.
Some administrative law judges understand that people need money to live and are willing to forgive an inconsistency between a claimant's receipt of unemployment compensation benefits and their application for Social Security disability benefits. Many judges, however, are not particularly impressed by application for Social Security disability benefits when the only reason you are not working is you were laid off because of a lack of work or a plant closing. Under the law, receipt of unemployment compensation benefits is not conclusive proof that you are not disabled. Nonetheless, you need to understand that if you apply for and receive unemployment compensation benefits (and you are not entitled to Social Security disability benefits under the medical vocational guidelines), a judge may view your receipt of unemployment compensation benefits as evidence that you are not disabled.
What types of disability qualify me or my family to collect Social Security disability benefits?
In general, to qualify for benefits, you must be suffering from a condition that renders you completely disabled from all substantial gainful employment for a year or be suffering from a disability that is expected to last more than a year or result in death. Certain family members of a disabled person are also entitled to receive benefits.
How long will it take to receive my Social Security disability benefits?
One of the most frustrating experiences we have a people in today’s world is the knowledge of an indefinite wait time. Social Security Disability Insurance (SSDI) benefits do not offer the same convenience as say, your local deli counter, which assigns you a number and you have an approximate idea of when your turn has arrived.
There are horror stories circulating of people waiting years to receive SSDI benefits, and the media is flooded with reports on the overwhelming backlog in the disability system. While these stories may hold some truth, many of the tales of multi-year waits are the result of multiple mistakes and appeals on a single claim.
Much of your personal timeline will depend on factors that you can control—factors like making sure you have included the proper paperwork and medical documentation as well as meeting all deadlines and requests promptly. Below is an approximate timeline that you can expect for your own SSDI benefits, from application through success:
- From your first application, you can expect to receive an initial decision from your claims agent in about 3-6 months. If you are asked to return or resend any forms, or attend a consultative exam to gather more information, do this promptly in order to avoid further delay.
- If your initial application is denied—and don’t worry, many people are denied in their first attempt to collect SSDI benefits—you can file an appeal. Once the appeal is filed, you can expect to hear back in another 3-6 months. You may be requested to resend forms or attend another consultative exam, and again, the quicker you act, the sooner you will receive a decision.
- If your initial appeal is denied, you can file a second appeal. This appeal takes place in front of a judge, and can take a year or more even to be scheduled.
You Can Receive Benefits for the Time You Spend Waiting
That’s right: if your application and appeals process takes excessive time, you can collect backlogged benefits once you finally receive approval. In most cases, you will receive a lump-sum settlement for the money you should have received while waiting for a positive decision. That settlement will come shortly after you start collecting monthly SSDI benefits.
One of the best things you can do to speed along the process is to ensure that your application or appeal is error-free and complete. While this sounds simple enough to do on your own, there are veritable mountains of required documents and information that can often be left out if you are not experienced with the Social Security disability system.
If you are considering applying for SSDI benefits, or your application has been denied, our experienced Philadelphia disability attorneys can help you get the results you have worked so hard for. Schedule an appointment to discuss your claim today—just pick up the phone or click on the live chat link to be connected with a firm representative now.
If I am receiving Worker’s Compensation benefits, can the Social Security Administration offset those benefits?
Yes. Under the Social Security Act, a disabled person is not entitled to collect Social Security and Worker’s Compensation benefits which together total more than 80% of the person’s pre-injury earnings.
For more detailed information from our document library, click here.
How does Social Security calculate pre-injury earnings?
The Social Security Administration computes the disabled person’s “ACE” which stands for “Average Current Earnings.”
To calculate the Average Current Earnings, the Social Security Administration looks at the disabled person’s earnings year in which he became disabled and the 5 previous years.
In a second method, the Social Security Administration looks at the disabled person’s 5 highest consecutive years of earnings in his lifetime, and divides the 5 years of income by 60 to get a monthly average. Whichever method produces the highest number yields the Average Current Earnings.
Can people with terminal illnesses be approved for Social Security benefits?
Yes. If you have a terminal illness that meets the Social Security Administration’s definition of a disability, you are eligible for Social Security Disability Insurance benefits.
How long after I am approved will I begin receiving SSD benefits?
Your entitlement date for monthly benefits is set after a mandatory waiting period of 5 full months after the Social Security Administration determines the date of your disability. The Social Security Administration also compensates you for the period of time it takes to approve your application. You receive a one-time only lump sum that represents the number of months that you are entitled to benefits.
Are there medical conditions that are pre-approved for Social Security Benefits?
Yes. These conditions are included in the Social Security Administration’s Compassionate Allowance Initiative that quickly identifies applicants who clearly meet the Social Security Administration’s definition of disability. Claims are processed within days instead of months. Confirmation of the medical diagnoses with supporting medical information is often all that is needed to get approved.
How long does the Social Security application process take?
The Social Security Disability Insurance initial application process typically takes 3-5 months. Appeals of denied claims may take significantly longer. Due to the extensive backlog of claimants waiting for appeals with an administrative law judge, it could take a year to get approved.