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Can I file before I stop working? How long does it take? Do I have to take an exam?
Question from Kristen:
When you apply can you be currently employed?
How long does it take to get an answer from the time you file?
Do you have to go through any physicals or is determination based on your medical records?
Thank you
Kristin
Response from Alan: Hi Kristin—
Thanks for your questions. Here are some thoughts:
When you apply can you be currently employed?
Yes. You can be employed when you apply, but your earnings must be under the limit for “Substantial Gainful Activity.”
That subject has some complexity to it, but it’s basically a limit on gross earnings. If your COUNTABLE gross earnings exceed $940 per month, they will be regarded as substantial, and SSA will conclude that you aren’t so disabled that you can’t earn a substantial wage. If they’re under $940, they’re not considered substantial.
I emphasized "countable" because Social Security might overlook some parts of your earnings:
If you are not fully earning the wages you receive, for instance if your employer lets you take extra breaks without docking your pay, or lets you skate by on lower production than other employees in the same job, SSA counts only the value of the work you actually perform;
If you must spend money on things that overcome your disability in order to work, that amount can be subtracted from your gross earnings;
If someone helps you work but isn’t paid for it, the value of their help can be deducted.
How long does it take to get an answer from the time you file?
An initial claim for disability is usually decided within about 3 months. There is wide variation, however. I have seen some cases allowed in as little as a week, and others that take up to a year. There is a wide range of reasons for the differences too. For PH’ers, delays might happen if the decision maker doesn’t know much about PH and has to learn as they go. Also, if someone has a condition with an unknown prognosis, SSA may put off making a decision at all until some time has elapsed to see how much they recover. Many other times the delays involve getting copies of medical records.
Do you have to go through any physicals or is determination based on your medical records?
SSA strongly prefers to use your own doctor’s records. When you apply, you will be asked for the names, addresses, phone numbers and dates of treatment of all the doctors and hospitals that have treated you. If those records have enough information for SSA to make a decision, they’ll do so. It’s not a bad idea to get copies of your medical records ahead of time and submit them when you file—that cuts down on one of the major delays.
Sometimes, however, they need some extra piece of information to decide your claim. It could just be an update of some lab work. It might also be that you mentioned a problem no one has treated you for yet, or it could be that one or more of your doctors didn’t send your records. In those cases, SSA will set up an appointment with a Dr. in your community to get the missing information. It’s rarely a comprehensive physical exam; usually it’s only a “fill-in-the-gap” process. SSA will pay for that exam. (If your claim is being evaluated and SSA sets up an exam for you, it’s a good time to call and ask what’s missing. If it’s something you know should be available from your own Dr., go get it yourself and send it to SSA!)
Hope that helps some! Feel free to post again if you have additional questions.
Alan
February 7, 2008
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