ptsd Ssdi Awarded With Retro

[halos2]

Been helping a VV vet since 07 with claim...first 30% then over a few years getting worse, another C&P and raised to 50%. Progressively gotten worse. Terminated from job and put in new claim and he did a claim for SSA in Nov 2010. Went into hospital PTSD Treatment program almost 2 months, inpatient stay all days and nights. Continued to receive SSA and 50% VA. No info received from VA...VSO says no movement...requested new C&P exam...waited...finally got in touch with Congressman. Within 3 months new exam C&P for PTSD scheduled. Went to exam and approximately over 1 month granted 70%( had also put in TDIU over 2 years ago)...then 3 days later granted IU with date of exam !! Put in for earlier effective date. Waiting and putting a NOD in a month or so as he had put in for SSDI during this time too. SSDI awarded 4 days after veterans SSA hearing, and effective date used was date vet was terminated. They used all vets records and files to make their decision.(Date put in for SSDI was about 6 months or so post termination date). So the SSA determined termination date as date to use for granting. They could not understand how VA did not grant VA claim earlier...Retro received a few days after granting...all total was 7 days from hearing to receiving grant letter to receiving deposit in the bank. Anyone else this lucky with the SSA? It also didn't hurt that the veteran had an excellent work record prior...even though vet quit jobs within 2 different places over 7 years he kept his sales and income up for the businesses, until his PTSD got so bad he could no longer hide his symptoms!

[Berta]

WOW and Thank You Halos for helping this veteran!!!!!!!!

It sounds to me that his SSDI was solely for the PTSD and the SSA EED preceded the VA EED for TDIU....????.

VA can award one additional year retro ,if an SSA award solely for same SC, precedes the TDIU form by at least one year.

If VA knows of the SSDI award.

[Hollis]

Halo from your post I am happy for him. but I like to ask a question? That is, has your friend been out of work 5 years or more? I was told I did not qualify for SSDI since I haven't work in 5 years. I really didn't get a word in about my PTSD. The clerk also said I made to much, they added my federal retirement and my 70% Disability. I found this odd since I have friends who retired at a higher rate that I was, and there VA disability. I just needed to ask, Thank , and good luck to your friend

[Berta]

Hollis, I think SSDI has to consider SSI eligibility as well as SSDI.

If they cant awarded SSDI, then the SSI criteria ,in some cases might be met....but that depends on income.

Sort of like VA.... if SC cant be awarded , VA will consider NSC wartime pension, but that also depends on income.

[free_spirit_etc]

Halos! Congrats on the good work! That was a VERY fast payment. Sometimes Social Security can move fast. My husband got his payment within 3 weeks of applying. But he had a TERI claim (terminal illness claim) which they now process faster.

My father died August 27, 2010. And my mother's September payment was already increased to the widow's amount, rather than the spouses amount, without her even filing to request that.

I guess when the funeral home notified SS of my father's death, they immediately adjusted my mother's payment since she was already drawing on his record.

[free_spirit_etc]

Hollis,

You need a certain number of quarters in the past 10 years to be able to claim disability. Basically, you need to have worked enough to pay into SS for half of those quarters. As they update, the older quarters drop off. The longer you are out of work, and those older quarters drop off, you eventually run out of insured status. Insured status isn't based on work. It is based on paying into SS. So if you worked jobs that did not pay into SS that affects the mix.

But IMPORTANT TO NOTE - if you can show you were disabled while you still had insured status - you are eligible. But for some reason SS tries to go by the day you APPLY to figure out insured status. If you haven't worked five years from the day you applied, they tend to tell people they are not eligible because they don't have insured status. But say you still had insured status last year, if you can show you were disabled last year, you are still eligible because you became disabled while you still had insured status.

This affects a lot of people because they aren't working because they are disabled, but then when they finally get bad enough they try to apply for SSD, they haven't worked in the past X number of years, and they are told they are no longer insured.

Case in point - My husband had terminal lung cancer. We never even THOUGHT of him applying for SSD. And in fact, he got a job teaching part time. But he got to the point where they wouldn't let him teach anymore until he finished his Thesis. (He was allowed to teach under a provisional term). And so that dropped his income.

I started looking to see about deferring payments on his student loan due to disability and the documents said that they went by the same standards as Social Security to determine if you were disabled. So I looked up their standards on cancer. It said that cancer that had invaded the mediastinum was considered disabled. My husband's cancer was declared inoperable in 2004 because it has attached to the aorta. I told him, OMG! You don't even have to prove you are unable to work - because your diagnosis is already one that they have determined is disabling.

BUT I started counting up his work quarters. He retired from the military in 1998. He was a student after that. And though he had a graduate assistantship and then a part time teaching position - neither of those paid into Social Security. So it was somewhere around May 2006, and it looked like he had run out of insured status in December 2005. At first I thought - dang... it is too late. But then I thought - wait a minute - He WAS disabled in December 2005 - so he was disabled when he still had insured status.

But - when we went to the Social Security office, the lady was actually nice, and seemed very sorry that she had to give him bad news - but she went from the day he was applying and told him she was sorry but he wasn't eligible because he was no longer insured. I asked if they could go back to last year - as he still had insured status then - and he had the cancer then. Her eyes lit up and she said Yes! So she started letting him apply - but she started using December as the date of "onset" because that was when he stopped working. I asked if she could go back to August, since that was when his employment income dropped below the substantial gainful amount. So she agreed to go back to August.

So they approved his claim in a few weeks and went back to August 2005, as that was the date his employment income dropped below substantial gainful. But going back:

1. Made him eligible.

2. Made him able to use those months starting in August as part of his 6 month waiting period and so he got benefits for more months.

SSD can go back one year from the day you apply as far as payment of benefits. But they can go back longer in proving disability. So say you applied today, but lost insured status in 2011. It won't be easy, but if you can prove you became disabled in 2011, and they granted benefits, they would go back one year - deduct your waiting period, and pay you the remaining months.

BUT when you go to the SS office, they usually just count back from that day. So you need to remind them "I didn't become disabled today. I became disabled on X."

It is kind of sad that they don't think of that when you apply. Had I not looked up the information myself, we would have left the SS office thinking my husband was not eligible because he waited too long to apply.

Edited September 5, 2013 by free_spirit_etc

[free_spirit_etc]

Another important thing to keep in mind with SS is to make sure they let you apply. They seem to like to make a determination as to whether you are eligible before you apply. And if they won't let you apply (based on their determination that you aren't eligible) then, if you later apply, it is hard to go back to the initial date because you didn't actually apply back then.

There is no such thing as not being eligible to apply. Anyone can apply. And they should let you apply before they make a decision that you are not eligible. I know it saves them a lot of time processing claims for people who are not entitled, but they should still let people apply.

I ran into a problem trying to apply for mother's benefits. You can't apply for those online. You have to apply at the SS office. But when I went to apply, they let my son apply, but wouldn't let me apply, because they said I wasn't eligible.

When I received a notice that I was not eligible for anything but the lump sum death benefit, I appealed that decision - and said I had tried to apply for mother's benefits and was not allowed to apply, and that I wanted the opportunity to be allowed to apply for benefits before a decision was made that I was not entitled to them.

They let me apply after that (but denied me two days later). And that ended up getting me tagged on the SS system, which made my whole claim difficult because no one wanted to help me because I was labeled on the system as a trouble maker.

They let me apply, But they didn't file the appeal because as Mr. S&^%* (guy who labeled me in the system) informed me, I wasn't allowed to appeal - because he said a decision had not been made on my claim. I showed him that a decision HAD been made on my claim. I was informed I was not eligible for anything but the death benefit on my husband's record. I appealed THAT decision. He swore that decision ONLY covered lump sum death benefits, and since I got the lump sum death benefit, I couldn't appeal.

Ironically, when I appealed the decision that was made on the mother's benefit application, I received a letter from Social Security that said my appeal was not timely because I was notified on ___ that I was not entitled to any other benefits, and I did not appeal that decision.

That was total BS, as I had the right to appeal the most recent decision that had been made on my claim, regardless if I had appealed prior decisions. But they tried to say I was notified on ___ (the decision I first appealed, that the worker refused to file) and that the most recent decision was merely reiterating the first decision. Uh.. no.. the most recent decision was a new decision that was made after I was finally allowed to actually apply for the specific benefit (mother's benefits).

So one SS worker said I couldn't appeal (though I did appeal) and another SS worker said that since I didn't appeal (at the time the other worker said I couldn't) that I lost my right to appeal subsequent decisions on that claim. Again BS. But they kept things tied up forever.

I didn't realize at that time, but you can't appeal a decision that your appeal was not timely. The local office decides if your appeal is timely and you can't appeal that. So I thought they had me. The only thing I could do was to keep submitting evidence to try to get them (the same people who were playing games with me) to reopen my claim.

When I applied to a hearing, I received a notice that I was not entitled to a hearing, because I had not received a reconsideration (I only got a letter telling me my appeal was not timely).

But I found a section of law that said you could ask the Appeals Council to reopen your claim if there was an "error on the face of the evidence." I wrote to the Appeals Council and told them I realized I had no right to appeal the decision that my appeal was not timely, but asking them to reopen my claim as there was an error on the face of the evidence, which denied me my right to due process on my claim. Though I provided evidence that I had actually appealed the initial decision, I also pointed out that even if I had not appealed it - I still had the right to appeal the subsequent decision made after I filed an application. I stated there was an error on the face of the evidence if SS determined that in order to appeal a decision, I had to file an appeal before the decision was even made.

The Appeals Council reopened my claim, and sent it back for the RO to do a Reconsideration, which then entitled me to receive a hearing.

I know it is a long story - but an important point is:

You should be allowed to apply even if they think you won't be eligible.

You should be allowed to appeal even if they think you have no right to appeal.

They might deny your application. They might decide against your appeal. But at least the application and appeal are in the system, which entitles you to due process.