I am now 100% P&T, what do I need to know to apply for Social Security Disability?

[traveler]

I have recently been raised up to 100% P & T for VA disability.

How do I find out about applying for Social Security?

Is there any source where I can learn about it, from being in my situation?

I don't know ANYTHING about it.  Please help!

[Rivet62]

3 hours ago, traveler said:

How do I find out about applying for Social Security?

Is there any source where I can learn about it, from being in my situation?

I don't know ANYTHING about it.  Please help!

First of all, VA and SSA are two separate entities and each have different parameters for disability benefits.  You have 100%P&T but you can still work with a 100%P&T status (unless you were TDIU before). My point is that VA calls you 100%P&T but that doesn't automatically sway the Social Security Administration.  With SSA, you're either too disabled to work or you're not (it's black and white with no gray in between, unless advanced age is calculated in).  Just keep that in mind. I have links below for the age factor.

Anyway...

I first applied in 2007 but didn't have enough medical records and so I was denied (I wasn't service connected for vets disability at the time).

I applied again in 2012, and again I had few medical records, and so I was denied (I wasn't service connected for vets disability at the time).

I applied in 2015, had the medical records, and was denied (I wasn't service connected for vets disability at the time). I attribute the 2015 denial to something that SSA does because I did not have any of the conditions on the Compassionate Allowances list (see link below).  However, a social security attorney will usually not see you for the first consult until you have been denied. I had already been in touch with a social security disability lawyer, and she said to come back once I have the denial letter.  I got the denial letter, and I had the first consult with my SS disability attorney.  She looked over my medical records and despite having a medical basis for disability she noted that I had little documented work difficulties. Meaning that for every job I could not do, and for every job I left, I had little documentation as to why I left and/or little documentation of how my disabilities interfere with work (no sick leave, or on the job injuries, no FMLA and no medical transfers and no doctor supported medical resignations, etc).  She told me, "we can go the short route and try for disability, in which case we have a strong chance of denial. Or, we can go the long route by building up documentation of work related difficulties, in which case she could guaranty a win in about 3 years. I chose the long route.  Desperate, I applied at Burger King and within 2 days I had a medical absence signed by my doctor, and within weeks a statement saying that I could not work in the foreseeable future, and so I medically resigned from Burger King. I needed more documentation. I chose to seek employment at my local VA Medical Center (VAMC), and because I had a Schedule A certification from my local state's vocational rehabilitation office (which adds 5 preference points to my eligibility) I was hired to work part-time in the Food Service department of the VAMC. I worked 4 months and switched to full time in the Food Service department and within 1.5 months I was in the emergency room with back strain. The documentation grew into sick leave, paid leave, unpaid leave, FMLA, and then a medical transfer to a sedentary position.  Once in the sedentary position I continued to experience back problems and had frequent doctors' appointments and my major depressive disorder really impacted the sedentary position, and so once again the documentation grew into sick leave, paid leave, unpaid leave, FMLA, and then a medical resignation.  By this time, because of the timing of things, I had already been granted 80% service connected vets disability and so the income from work at the VAMC wasn't crucial to me.

I returned to the social security attorney with everything I had, including repeated attempts at retraining over the past 20 years, and we requested a hearing before a social security administrative law judge. I won. It took me about 3 years.

So that's my story. Meanwhile, you can look through some of the links below. Good luck.

 

Since you have good medical records it is easier to apply. However, keep in mind that you will likely be denied the first time you apply unless you have an illness that automatically grants SSDI. These are called Compassionate Allowances Conditions, found here:

https://www.ssa.gov/compassionateallowances/conditions.htm

Benefit eligibility screening tool:

https://ssabest.benefits.gov/benefit-finder/

The other thing to consider are work credits and the timeframes which you must protect, otherwise you can lose them and your SSDI eligibility. You can call SSA to find out about your work credits. Or, online with a registered SSA account to get your work history to calculate from.

My attorney required me to get my work history from SSA so that she could see that I qualify based on work credits. Here's a quick table of required work credits per age of applicant.

https://www.ssa.gov/benefits/retirement/planner/credits.html

Here's an SSA overview:

https://www.ssa.gov/benefits/disability/qualify.html

Social Security disability factors in age, called the Grid Rules and it becomes easier to get SSDI. 

https://www.disabilitysecrets.com/topics/disability-grid-rules-age

 

Edited February 6, 2022 by Rivet62 (see edit history)

[broncovet]

Read the above, then apply.   With social security, in my home town, they will have an employee help you..  

Go to social security, tell em you want to apply and ask for a list of necessary documentation.  Make an appointment, bring the applicable documents, and they will help you apply.  

You should have an answer in 60 to 90 days, then, an attorney may help you with an appeal.  That is what I did.  I won upon appeal.  

Social security should be easier than VA.  Why?   Because you have to prove your injury/illness was related to military service, where social security doesnt care how you got your injuries/illness.  

Show social security your letter being granted 100 percent, and it will likely expedite your social security disability claim.  

Edited February 6, 2022 by broncovet (see edit history)

[Buck52]

Due to the covid pandemic

SSA OFFICE REQUIRES YOU TO CALL  THE SSA # NEAR YOU AND REQUEST AN APPOINTMENT.THEY WILL OR SHOULD GIVE YOU A CALL AND SET UP YOUR APPOINTMENT  BUT DON'T EXPECT THEM TO CALL YOU FOR A WHILE.

 I BEEN WAITING ON MY APPOINTMENT NOW FOR 3 MONTHS, ALTHOUGH I CALLED THEM AGAIN AND THE LADY CHECKED AND SEEN WHERE I HAD CALLED FOR THE APPOINTMENT AND SHE CALLED ANOTHER SSAOFFICE IN ANOTHER SMALLER  TOWN ABOUT 30 MILES FROM ME AND THEY WILL CALL ME TO COME IN,  THEY ARE ABOUT A 3 MONTH WAIT LIST..I AM STILL WAITING FOR MY APPOINMENT  BUT THE FIRST TIME YOU CALLED   THEY HAVE THAT IN THE COMPUTER AND IF YOUR APPROVED FOR WHAT YOUR ASKING FOR  THEY WILL GO BY THE DATE IN THE COMPUTER THAT YOU FIRST CALLED  FOR EFFECTIVE DATE OF YOUR BENEFITS.

ANYWAY THIS IS THE WAY IT IS IN TEXAS  IT MAYBE A LITTLE DIFFERENT IN YOUR TOWN  DEPENDS ON HOW BOOKED UP THEY ARE.  THIS COVVID19 HAS EVERYTHING SCREWED UP.

[Tbird]

You can now apply on line Read the below PDF or go here to Apply and read more https://secure.ssa.gov/iClaim/Ent002View.action

 

Here is a checklist for what you will need

 

[broncovet]

Like Tbird and Buck said, and thanks for correcting me and updating.  I got my "check list" at the social security office, but Im sure its widely available online too, to save you a trip.  

Lots of people do stuff online..my self included.  But, I prefer to go to the social security office and talk to a person, rather than trying to guess stuff online...My experience was the social security disability clerk was helpful.  Im not saying all this could not be done online, but I can also see the advantage of a personal interview, "to include" a follow up visit, if necessary, and ask the person again (you may get someone else) "What do I need to make this happen?"  Many will tell you and you can benefit from their years of experience with SSD claims.  A little kindness goes a long way.  

[Banned]

I started my application online in June of last year.  They give you 6 months to complete and submit your application, to save the date.  I forwarded my application in November (cause I procrastinate) .  With the online application, you do not include any medical records, etc., you just submit the application.  They will give you the oppertunity to submit records, etc, after you get the ball rolling.

Since I do not have one big mailidy, I listed all of my disabilities and will let them sort it out.  I am 60 years old and haven't worked for 2 years, which helps, and I am going the "wore out worker" route.  I listed the VA medical clinic, VA doc and the VA for my medical records, to include my 100% P&T.  I did not submit any medical records on my own.  Will see how that pans out.

A couple weeks after I submited my application, I recieved a call from the local SS office and had a brief phone interview.  She asked me about my work history and when and why I do not work anymore.  I told her what I did for employment and why I can't do it anymore.  She said it (my application) looked good and that she would send it forward for medical evalutation.

I can and do follow it online and they have a percent done meter, which currently puts me a 43%, and an estimate of 7 months to complete.  Not sure if that is 7 months from November, or 7 more.  I assume its 7 months from November as that disclamer never changes.  

Just as with VA claims, the sooner the better.  Your clock starts when you submit your intent.  Remember, you don't get benefits for the first 6 months, and you don't get Medicare for up to 24 months from your start date.  You will have plenty of time to get your ducks in a row later, 

or add ducks,

Hamslice

 

 

[Rivet62]

3 hours ago, Buck52 said:

ANYWAY THIS IS THE WAY IT IS IN TEXAS  IT MAYBE A LITTLE DIFFERENT IN YOUR TOWN  DEPENDS ON HOW BOOKED UP THEY ARE.  THIS COVVID19 HAS EVERYTHING SCREWED UP.

Same here in my little city in Alabama. I went to the SSA office to pick up a printout of my lifetime work history. The doors were closed, and signs taped to the door, along with a free standing sign to call the 1-800 number.  I called the 1-800 number and she told me that SSA is no longer printing out the work history (you need the earnings history so that a prospective appeal attorney can be sure you qualify based on work credits). The lady on the phone said that I would have to request the work history from some third party outfit in Maryland and that I WOULD HAVE TO PAY A FEE FOR IT.  Or, I can access my records online, which I have had trouble with all along. I finally could see my records online, but this aspect leaves a lot of people unable to access their records in a timely fashion.  You used to be able to go in, and take a number, and wait for a clerk to print it out.

Anyway, the lady seemed to agree that SSA wants to move everything online and make it self-serve. Sign of the times. Covid being the go-to excuse for budget problems, imho.

[Rivet62]

1 hour ago, Hamslice said:

Just as with VA claims, the sooner the better.  Your clock starts when you submit your intent.  Remember, you don't get benefits for the first 6 months, and you don't get Medicare for up to 24 months from your start date. 

They also don't pay retro beyond two years anymore. I fell into that group of the 2 year limit. They used to go back beyond 2 years, and maybe they still do under a certain circumstance...I don't know.

[traveler]

Thanks a lot for all the replies.  I will reply after I have moved the ball a tad.

[john999]

If you have a mental disability like ptsd, depression, panic disorder, bipolar it is easier to get SSDI.  Nobody can xray your brain to determine your level of disability.  If you have serious physical disability then you probably suffer from some sort of depression.  Depression would be a secondary condition to your physical problem.  I got SSDI in about 4 months after I applied because I had a DX of bipolar disorder.  I had a good shrink and SSA just threw in the towel after asking me if I would submit to an exam.  Of course, I would submit I replied.  The SSA just granted my SSDI.  The problems that really made working so hard were physical and job related.  I got worker's compensation as well.  I knew people that had VA 100%, worker's compensation and SSDI with certain offsets.

[traveler]

Thanks for the responses to my question on applying for SSDI.

Yes, I have the mental stuff. 

Thing is, I work 2 days a week, and from what I am reading, to get a mental disability, I have to NOT be working.

When I apply online, Do I have the opportunity to tell them about it? 

Can I attach my copies of C+P's etc that bolster my claim?

Can I tell them where the info can be found?

Thanks in advance.

[El Train]

I work damn near 40 hours a week.  I'm 100% ptsd/tbi P&T with SMC-S.  It's pretty rare, but doable.  It helps that I have sheltered employment.  I've told every C&P examiner this info.  This won't fly with SSDI, but maybe it will when I'm done working in a couple of years.  I can't take the stress much longer.

[john999]

Does SSDI not consider sheltered employment as a factor for granting benefits.  With your disability I think you could get SSDI pretty easy.  How old are you?  If you are over 50 it is easier to get SSDI.  Maybe if you are still able to work you might want to do so as long as you can because they you get bigger SSA check.  I got SSDI when I was 51 for about the same thing you have. It was pretty easy in Florida,   but I had a hell of a good private doctor write me an IMO.  The IMO is what did it.  Man, if you got 100% plus "S" you damn sure should be able to get SSDI when you stop working.  However, with SSDI depending on your situation it can take a long time including getting a lawyer etc.  Save every penny you can for a wait after you hang up the job.  These benefits are unpredictable.  When I got fired from my job I applied for worker's compensation on the way out the door.  I got those benefits which did tide me over until I got SSDI and TDIU.  You must use every avenue you have in our situation.  I worked for the post office and they were bastards to me.  I got OPM retirement and all the rest and each benefit was different with certain requirements.  For me TDIU with the VA was the hardest.  The VA took me over the hurdles but I got it. 

[Rivet62]

7 hours ago, john999 said:

For me TDIU with the VA was the hardest.

What was your rating when you applied for TDIU?  You may have said somewhere but I can't recall.

[traveler]

"100 plus "s" "?  I don't follow, Sir.  Being retired military, you get concurrent receipt which is a retirement check AND a VA disability check, if over 50% VA Disabled and 20+ years of military service, i.e. retired military.  The C+P I just had 3 months ago is what got me to 100% P+T.  I am really beat up.

Edited February 12, 2022 by traveler (see edit history)

[Rivet62]

On 2/7/2022 at 11:18 PM, john999 said:

If you have a mental disability like ptsd, depression, panic disorder, bipolar it is easier to get SSDI. 

Ultimately, if you're not already in a VAMC, then I think it depends on what state you're in, and what access to Medicaid or other access to healthcare you have. Each state administers Medicaid, like gatekeepers to this federal funding. Some states qualify you on just income. Other states, like my ex-state, will deny deny deny Medicaid.  You have to be disabled to get Medicaid in my ex-state, but you can't get your disability because you can't get Medicaid to get the diagnosis for disability.  You can get Medicaid in a snap if you have children in the home, so for me, in my experience, in some ways yes it's easier to get SSI or SSDI with an MH condition, and in other ways no it's not easier because like you said they can't see the disability with an x-ray and MH itself is debilitating making it harder to follow through. it's harder. I had to develop the documentation to win my SSA case at the appeal level.

I finally had the MH diagnosis, after 35 years of little to no healthcare.  After I got into the VAMC, 35 years post discharge, then I was 70% service-connected for it straight away.  I had records of it in service.  Even so, I had 35+ years of a work history, post discharge, with just an average annual income of just $4,600 over 35 years in my SSA earnings record. and my highest ever earning was $17k (you would think that alone should be enough, but no it wasn't).  I couldn't win an SSA claim on my records as is. I managed to scrape together recent work credits, but still it wasn't enough.

Even after a solid diagnosis at the VAMC it still wasn't enough. What I didn't have was documentation of how MH interfered with work. When I had problems with work I just wouldn't go back, or I had frequent unexplained absences (unexcused absences, meaning no doctor's note, because no health insurance and no healthcare). I would begin to falter at work, and then I couldn't cover it up, and the humiliation was too much, then I just wouldn't go back. I would hear the alarm clock in the morning and freeze and I was filled with unbearable dread.  I couldn't even get out the door.  Then I couldn't pay the rent, then I couldn't keep car insurance, a steady history of pulling myself up and repeatedly spiraling down.  That was my life. The performance reports I needed to show the SSA were never there because I would do well, but then I would just leave.  

A good DX will help, yes.  But if you can't get the DX, like me, because your state would rather sit on Medicaid rather than help you then you're in a catch-22 of needing to prove MH problems or physical problems with no medical records and/or no work documentation. Truly, had it not been for my access to healthcare at the VA I could never have won SSDI.

The funny thing about VA healthcare is that veterans could go decades, like me, not realizing their eligibility to apply. If you're a vet who got out of the service decades ago, like me, then you didn't have the benefit of a VHA rep enrolling you into the VHA as you out-processed your discharge. You had no one encouraging you to file claims for service-connect. No one told me I could use the VHA. I thought it was for retirees or combat wounded. No one told me. I went to a VARO about 7 years after I discharged to get an idea of what benefits I had, and healthcare was not among them because the VA doesn't consider healthcare a benefit, like they do the home loan or the education benefits. So, I never knew. But I do know this, if I owed the IRS money then they could notify me in a heartbeat as soon as I connected their dots through a new employer's tax paperwork. But VA healthcare? Nah. 

I connected with VA healthcare when there was the public push to get veterans off the street. Remember that? All kinds of outreach programs came into existence, and for me it was a homeless shelter that received federal grant money to help vets. That's how I finally connected with VA healthcare.

So. one may ask, geez how did you survive?  Marriages, and state and federal student aid. I was a professional student off and on. Student aid doesn't count as income, so there were many benefits out of that (but not healthcare).

Thanks for bearing with me in this long winded post, but I think I'm just thinking out loud in preparation for an MH C&P exam coming up because I applied for TDIU.

Edited February 12, 2022 by Rivet62 (see edit history)

[Rivet62]

18 hours ago, john999 said:

Does SSDI not consider sheltered employment as a factor for granting benefits.

SSA will not consider CWT at a VA as taxable income for the purpose of SSDI, because it's therapy. SSA will if your application is about SSI. In addition, at the state and local county level they will consider it as a resource, and it will lower food stamps to probably zero.  SSA will consider sheltered employment income as a disqualifier for SSI and it will disqualify you for SSDI. It's important for an SSA applicant to know the difference between CWT or a like-kind program and "sheltered employment" under VA's definition.  For SSA, you're either employed or not, sheltered or not. The only way to get out of that hard and fast rule is to be in a CWT-like program.  Even so, CWT will impact SSI but not SSDI. And a vet has to be careful with a CWT program because it has an ongoing aspect of evaluation that could land a veteran into a status of being employable, but on the outside that may not be the case over time. In other words, CWT could complicate your SSA application or add years to proving that you are not employable even though CWT says you are.

SSI is like welfare. It is needs based.  SSDI is what you have earned in your work history out of every paycheck when you had SS and Medicare withheld from your social security wages (as it's called on your W2).  You have to have a record of having paid into the system sufficiently enough for SSDI. Otherwise, you fall into the SSI category and then your assets and other resources come into play like any other welfare program.  For me, I had just $16 over the SSI monthly payment. I had just enough work credits to fall into the SSDI category, and because it was SSDI I could get my SSA back pay. If you fall into the SSI category, then you will not get SSA back pay (and I don't know how an attorney gets paid from a successful SSI case, --I don't think they do--  My attorney wanted to see if I had enough work credits to qualify for SSDI, otherwise she wouldn't have taken my case. SSI doesn't require sufficient work credits). If you are a veteran receiving vets disability, then your vets disability income affects SSI qualification, but it will not affect SSDI because (like insurance) you have been paying premiums into it.  And as we all know, there is no offset in receiving SSDI and vets disability together. But there is an offset if it's about SSI.

Edited February 12, 2022 by Rivet62
brain not working (see edit history)

[Rivet62]

6 hours ago, traveler said:

"100 plus "s" "?  I don't follow, Sir. 

I think he's talking about 100% P&T and in addition getting SMCs (Special Monetary Compensation). There are categories of SMCs.

https://www.va.gov/disability/compensation-rates/special-monthly-compensation-rates/

He's saying that if you are 100% P&T AND getting SMCs??!! Yeah, you're slam dunk for getting SSDI no problem.

 

Edited February 12, 2022 by Rivet62 (see edit history)

[traveler]

Nope.  VA 100% P+T.  40 credits with Social Security.  3 months ago C+P with a shrink, it should be sufficient to get it done.

[traveler]

Okay, So I applied for SSDI online.

The process is, you fill it all out and submit it.

THEN they give you an address to submit any copies of evidence you have, which is a perfect time to send them copies that are highlighted so as to make the job easier for the reviewer.  From reading what the guys above have said, you have to make it so that it meets the "blue book" listings.  If your condition is in the  BLue Book Listings, it gets approved....at least that is what I am hearing and reading.

So, after applying, it stated the average submission takes 200+ days to complete.  I am thinking, if you have a blue book listing condition, and you have provided copies of medical records with those listings highlighted, it SHOULD be fairly straightforward.  The idea is to make the job EASY for the reviewer.  They are backlogged, and don't spend too much time on any record, as it is easier just to deny, deny, deny to get through their work stack.  If I make it easy, I think it MAY work out for me.

Sound good, or am I missing something?

Edited February 25, 2022 by traveler (see edit history)