Social Security Disability Lawyer

Social Security Disability Insurance Denial Lawyers – Tampa, Jacksonville, Miami, Fort Lauderdale

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Social Security Disability Insurance (SSDI) is based on work credits you earned by paying into the Social Security trust fund through your taxes. The SSDI will then act as an insurance to workers who have earned sufficient credits based on taxable work. There is, however, something worth noting: paying into the Social Security trust does not automatically earns you the right for those benefits; you need to have reached the minimum credits required to be able to apply for such benefits.

Supplemental Security Income (SSI), on the other hand, differs from SSDI because it is based on income level, along with age and disability, and is funded by the U.S. Treasury general funds, unlike SSDI. So, in simpler terms:

  • SSI = Age 65 or above OR Disability + limited resources or income (or none at all)
  • *In most states, if you are granted SSI you automatically qualify for Medicaid

  • SSDI = Disability + sufficient work credits

*You qualify for Medicare 24 months after you are entitled to receive the benefits

It is also worth noting that you can apply to both SSI and SSDI benefits if you have limited income AND a work history.

Requirements for Applying for SSDI in Florida

The earnings needed to earn credits vary with time. For 2021, an income of $1,470 USD earns you one Social Security or Medicare credit and an income of $5,880 USD earns you four credits, the maximum for the year

Overall, the number of work credits you need to qualify for disability benefits will depend on your age when you become disabled. As a rule, if you are 31 years old or older, you need 40 credits, where 20 of those 40 need to have been earned in the last 10 years, counting the year you become disabled, meaning at least 2 credits per year. However, younger workers may qualify with fewer credits.

If you apply for benefits when you are 24 years old and before turning 31 years old, you need to calculate the credits required depending on your age along this metric. Although you are applying at 24 years old or older, but before turning 31, to calculate the credits required you need to count the years passed from age 21 until you become disabled; then this quantity is divided by half and turn those years into credits. To exemplify this, imagine you become disabled at 27 years old, then the years passed from age 21 until 27 are 6, meaning that you would need 3 years of work (12 credits) in order to apply for social security benefits.

If you apply for benefits before you are 24 years old, you may qualify if you have 6 credits earned in the 3-year period ending when your disability starts.

If you are not 65 years old, but 62 years old or close to the age of retirement and disabled, while you can opt for or early Social Security retirement benefits it will reduce the amount you will receive from SSDI based on how many months you received early retirement. That is why it is better to apply for SSDI, unless you need the money. In that case, you may apply for retroactive SSDI along with your early retirement to be steps ahead and see that, if granted SSDI before your early retirement, you get the difference between your early retirement payment and that of the SSDI.

Duration of SSDI benefits

It is also worth noting that for Social Security Disability payments have no termination IF you suffer from severe and permanent disabilities, in that case you will continue to receive such payments until your retirement, when at that point these benefits will become retirement payments until your death.

For this to be determined, if you are awarded with the benefits then your case will be categorized into one of these categories: [1]

  • Medical Improvement Expected (MIE). This means the SSA expects your condition to improve, so they will schedule a continuing disability review (CDR) in approximately six to eighteen months. If the condition has improved and you are able to return to work, your benefits will be discontinued; if it hasn’t improved, the SSA will continue to schedule a review until you are able to work again.
  • Medical Improvement Possible (MIP). This means the SSA believes your condition may improve expects, but does not has certainty. The CDR will take place at least once every three years and will continue until you are able to work again if that is the case.
  • Medical Improvement Not Expected (MINE). This means the SSA does not expect your condition to improve, in some cases in can even worsen with time, this is why the CDRs are scheduled with less frequency, ranging between 5 to 7 years between each one.

What is “Disability” and Other Criteria

Now, when talking about “disability”, we need to understand what the Social Security Administration (SSA) defines as one. More than a definition, the guidelines of the SSA give a criterion the applicant needs to meet in order to apply for SSD benefits, these being:

  • You cannot perform your previous occupation. (Meaning you cannot assist to work, or need to take breaks more than often, interfering with you performing your duties at work)
  • You cannot adjust to other work because of your medical condition(s).
  • Your medical condition(s) must last or be expected to last for at least one year and/or to result in death.

In addition to the criterion, the SSA usually complements it with a medical guide called the Blue Book to determine if the applicant is eligible for SSD benefits. This Book has sections for different body parts and systems (respiratory, circulatory, etc.) and each section has listings for disabling conditions that may apply to that specific part of the body. This is why you will need to provide hard medical evidence to support your claim and to show that you meet the criteria of the listing.

Also, you need to fall under the criteria of Substantial Gainful Activity (SGA) meaning that there will be a study to determine if you have a minimum monthly earning of $1,310 USD, or $2,190 USD for statutory blind persons.[2]

Which Disabilities Were Awarded Benefits More Regularly?

According to the annual report of the SSA for 2019, published on October 2020, the most common disabilities from people that received benefits were:

  • Musculoskeletal system and connective tissue (29.9%) (average monthly benefit $1,320.73 USD)

Examples of musculoskeletal system conditions:

  • Amputation
  • Anterior Poliomyelitis
  • Apert syndrome
  • Avascular Necrosis
  • Back Pain
  • Bone Spurs
  • Bursitis
  • Carpal Tunnel Syndrome
  • Club Foot Deformity
  • Cubital Tunnel Syndrome
  • Degenerative Disc Disease
  • Degenerative Joint Disease
  • Dwarfism
  • Fibromyalgia
  • Fracture of the Femur, Tibia, or Pelvis
  • Fracture of an Upper Extremity
  • Gout
  • Hernia
  • Herniated Disc
  • Hip Pain and Related Disorders
  • Hip Replacement
  • Inflammatory Arthritis
  • Joint Pain
  • Knee Pain and Related Disorders
  • Knee Replacement
  • Low Birth Weight
  • Lumbar Stenosis
  • Lyme Disease
  • Major Dysfunction of a Joint
  • Nerve Root Compression
  • Muscular Dystrophy
  • Neck Pain and Neck Problems
  • Osteoarthritis
  • Osteomalacia
  • Osteoporosis
  • Paralysis
  • Piriformis Syndrome
  • Reflex Sympathetic Disorder
  • Rheumatoid Arthritis
  • Ruptured Disc
  • Scoliosis
  • Shoulder Pain and Shoulder Problems
  • Shoulder Replacement
  • Soft Tissue Injury (Burns)
  • Spina Bifida
  • Spinal Arachnoiditis
  • Spinal Cord Injury
  • Spinal Fusion
  • Spine Disorders
  • Torn ACL
  • Undifferentiated and Mixed Connective Tissue Disease
  • Whiplash
  • Mental disorders, but more specifically:
    • Mood disorders (12.6%) (average monthly benefit $1,118.33 USD)
    • Intellectual disability (8.7%) (average monthly benefit $795.81 USD)

Example of Mental disorders:

  • Attention Deficit Hyperactivity Disorder
  • Asperger’s Syndrome
  • Bipolar Disorder
  • Chronic Insomnia
  • Depression
  • Drug Addiction
  • Dysthymia
  • Eating Disorders
  • Hallucinations
  • Intellectual Disability
  • Memory Loss
  • Mood Disorder
  • Obsessive Compulsive Disorder
  • Panic Attacks
  • Postpartum Depression
  • Post Traumatic Stress Disorder
  • Schizoaffective Disorder
  • Social Anxiety
  • Nervous system and sense organs (9.8%) (average monthly benefit $1,243.73 USD)
  • Circulatory system (7%) (average monthly benefit $1,368.91 USD)

Examples of circulatory system conditions:

  • Arrythmia
  • Blood Clots
  • Budd-Chiari Syndrome
  • Chest Pain
  • Chronic Pulmonary Hypertension
  • Cor Pulmonale Secondary Chronic Pulmonary Hypertension
  • Heart Attack
  • Heart Failure
  • Heart Valve Disorder
  • High Blood Pressure
  • High Cholesterol
  • Hypertension
  • Left Ventricular Assist Device
  • Marfan Syndrome
  • Mitral Valve Prolapse
  • Sinus Bradycardia
  • Syncope/Fainting
  • Venous Insufficiency

Initial Claim: Process and Documentation

When filing the initial application and filling the SSD benefits forms, you need to provide to the most of your capacity and availability the following documents:

  • a comprehensive list of your medical providers, including their contact details and dates of treatment service
  • copies of your medical records, including exam notes, surgical notes, test results, imaging records
  • Copies of anything else that proofs your medical condition as well as its restrictions and limitations

It is worth noting, however, that if you are suffering from a single or multiple medical conditions, if you develop along the way another impairment, the amount of your monthly benefit payment remains the same.

In other words, your benefits do not increase based on the development of an additional impairment. That being said, you should always keep the SSA informed of any changes in your medical condition.

While it is true that the application process varies depending on the severity of the disease, the thoroughness of the application, and the geographical area where the applicant lives, the national average for processing the initial application is of 3 to 5 months to complete if the medical providers are quick to respond and when any additional information required by the Social Security Administration (SSA) is promptly received.

In Florida, an average of 70% of this initial claims are denied[3]. And from this 70% denied claims, less than 10% are awarded during the reconsideration process[4].

If the claim needs additional analysis, the SSA requests that the applicant meet with a disability doctor, usually the original doctor who determined the condition, to get more insight into the severity of a specific medical condition, unless there are location difficulties to visit the original doctor or that there are inconsistencies in the original report that disqualifies said doctor. If this happens to be the case, then an independent examiner will be appointed.

Once the Disability Determination Services (DDS) determines it has sufficient medical information, it will proceed to decide whether you can be awarded with the benefits.

What Happens If I Am Denied of the Benefits in My Initial Claim?

When the DDS denies a disability claim, it can fall under two considerations:

  • Technical refusal – You did not paid enough taxes to the SSA for coverage. (this can be confusing, since it means that not because you have paid taxes into the disability program it necessarily translates into you having the coverage. You need to pay a certain amount into the program for coverage to begin)
  • Medical refusal – You did not meet the definition of disability.

If the initial application is denied, you have 60 days from the date of refusal to file an appeal of consideration, where a different examiner to your initial application will review your case under the same rules and same documents initially filed, unless there is new medical information that needs to be provided to the examiner. This is one, if not the main, reason why reconsiderations have a really low percentage of awarding SSD benefits, which, as mentioned earlier, can be less of 10% of in the State of Florida. This process has an average, nationwide, of taking 3 to 5 months for completion.

If the reconsideration is denied, you could then opt for an appeal for hearing, which you would have to apply for within the 60 days following said refusal, and where in this occasion will reviewed a final time by an Administrative Law Judge at a local hearing office. This, however, can take more to process, as the time nationwide to receive an appeal hearing date ranges from 10 months to two years, depending on the geographical area of the applicant, with the average processing time for a hearing on a social security disability case being of 349 days nationwide.

In Florida, approximately 60% of disability benefits are granted at the appeals hearing.

If you, however, fall under the 40% that is denied at the appeals hearing, your next option would be to request that the Appeals Council review the judge’s decision (Appeals Council Review), having 60 days from the day of denial to file such request.

If you are then denied again, your final option will be filing a civil action in Federal Court.

How Much Will I be Awarded?

If benefits are granted, the amount will be calculated according to a formula based on the income on which you have paid Social Security taxes. The monthly maximum Federal amounts for SSI in 2021 are $794 for an eligible individual, $1,191 for an eligible individual with an eligible spouse, and $397 for an essential person.[5] For SSDI, you can obtain an estimate by using the SSA’s Benefit Calculators.

Jacksonville, Florida SSDI Denial Lawyer

As of March 2021, Jacksonville has an “average wait time until the hearing is held” of 8 months, with an average process time of 315 days (days until final deposition).

Currently, there are 16 hearing offices in Jacksonville.

Jacksonville, Florida SSDI Denial Lawyer

For Jacksonville, out of the 16 judges in the city, at least 8 judges granted more than 50% of the hearings:

  • Taylor, William F: 100% out of the decisions made
  • Meisburg, Jr., John M: 85.59% out of the decisions made
  • Collins, Yelanda: 73.30% out of the decisions made
  • Landrum, Bruce: 69.15% out of the decisions made
  • Mahon, Janet: 65.05% out of the decisions made
  • Barlow, K.: 62.42% out of the decisions made
  • Calvarese, Stephen C: 52.22% out of the decisions made
  • Koster, Guy: 52.17% out of the decisions made

Tampa, Florida SSDI Denial Lawyer

As of March 2021, Tampa has an “average wait time until the hearing is held” of 7 months, with an average process time of 291 days (days until final deposition).

Tampa, Florida SSDI Denial Lawyer

Currently, there are 22 hearing offices in Tampa.

For Tampa, out of the 22 judges in the city, at least 12 judges granted more than 50% of the hearings:

  • Piloseno, Jr., Daniel A 92.55% out of the decisions made
  • Johnston, Paul L: 89.87% out of the decisions made
  • McIntosh, Melissa J: 80% out of the decisions made
  • Bauer, Edward T: 68.36% out of the decisions made
  • Ballieu, Robert: 66.87% out of the decisions made
  • Zanotti, Barbara J 64.38% out of the decisions made
  • Craig, Margaret: 61.39% out of the decisions made
  • Marzan, Shirley A: 59.28% out of the decisions made
  • Slahta, Steven D 58.54% out of the decisions made
  • McGhee, Carl C: 55.19% out of the decisions made
  • Kirzner, Ryan: 53% out of the decisions made

Miami, Florida SSDI Denial Lawyer

As of March 2021, Miami has an “average wait time until the hearing is held” of 9 months, with an average process time of 312 days (days until final deposition).

Miami, Florida SSDI Denial Lawyer

Currently, there are 14 hearing offices in Miami.

For Miami, out of the 14 judges in the city, at least 7 judges granted more than 50% of the hearings:

  • Thompson, Michelle: 80% out of the decisions made
  • Pennock, Carol J: 68.89% out of the decisions made
  • Celaya, Gracian A: 59.55% out of the decisions made
  • Wolfe, Rebecca: 56.80% out of the decisions made
  • Aranda, Clara H: 56.07% out of the decisions made
  • Lang, Jerry M: 55.71% out of the decisions made
  • Hemming, Norman: 54.78% out of the decisions made

Fort Lauderdale, Florida SSDI Lawyer

As of March 2021, Fort Lauderdale has an “average wait time until the hearing is held” of 6 months, with an average process time of 265 days (days until final deposition).

Fort Lauderdale, Florida SSDI Lawyer

Currently, there are 15 hearing offices in Fort Lauderdale.

For Fort Lauderdale, out of the 15 judges in the city, at least 7 judges granted more than 50% of the hearings:

  • Rodriguez, Michael A: 83.33% out of the decisions made
  • Gill, Robert: 82.72% out of the decisions made
  • Perez-Gonzalez, Jose: 73.76% out of the decisions made
  • Sprague, Jonathan: 63.69% out of the decisions made
  • Hunn, Wendy: 60.29% out of the decisions made
  • Ortiz-Valero, Richard J: 58.20% out of the decisions made
  • Hemming, Norman: 57.14% out of the decisions made

Benefits of Hiring a Specialized Attorneys Social Security Disability Lawyer in Florida

One of the advantages of hiring a region-familiar attorney is that the attorney might have become familiar with the judges of the region. And while you may opt to hiring the services of an advocate, we do strongly suggest hiring an attorney specialized in SSD benefits claims, since the training and educational background might differ significantly.

In addition to this, and as noted earlier, the whole process can be confusing, strict and punctual and, because of this, complicated. That is why an attorney that practices social security disability law is crucial, since he/she understands this process and is familiar with the deadlines for each phase.

One of the first complications you might encounter when filing for SSD benefits is not providing the full and/or correct information required. That is why the attorney will help you compile all the medical documentation needed and oversee that doctors answer all questions accurately and completely.

What Would be My Attorney Fee and How Many Payments Do I Have to Make?

Attorneys are never paid unless you win. The fees are limited to 25% of the accrued benefit amount, and they cannot exceed the amount of $6,000. This payment will be made only after the benefits are conceding (a favorable determination for the applicant). And it also guarantees that there are no out-of-pocket expenses.

[1] Program Operations Manual System (POMS)

[2] Substantial Gainful Activity

[3] Florida Social Security Disability Lawyers

[4] Florida Social Security Disability Lawyers

[5] SSI Federal Payment Amounts for 2021

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