The Social Security Disability Process

If you have been working and suddenly find yourself disabled and unable to work, you might be entitled to Social Security Disability benefits, often referred to as SSD or SSDI (Social Security Disability Insurance).  SSD is available for those who 1)  have worked 5 of the last 10 years, 2) have a disability that has lasted (or is expected to last) one full year or more, and 3) are incapable of making more than $1,130 per month (2016 amount).

Differences between SSD and SSI

Many people do not realize that there are two types of Social Security Disability claims: Social Security Disability Insurance (SSD or SSDI) and Supplemental Security Income (SSI).  The topic of this article is SSD, but it is important to note the basic differences between the two.  SSI is asset-based, in addition to disability- and income-based.  While SSD will look at your personal income to determine if you meet the disability requirements, SSI looks at the entire household income and assets.  SSI is typically applied for by individuals who do not meet the work requirements of SSD.  Thus, children will receive SSI benefits, rather than SSD.

How Social Security Will Analyze the Claim:

There are certain eligibility requirements for Social Security Disability benefits.  First, because the benefits are a form of insurance provided by the federal government through the Social Security Administration, you must have paid your premiums.  The “premiums” here are your FICA taxes deducted from your paycheck.  If you have not worked for a certain period of time (generally 5 of the last 10 years), you have not paid enough into the insurance program, and so would not be eligible for SSD (although you might be eligible for SSI, depending on your circumstances).

Second, you must be incapable of holding a job that would provide $1,130 per month (referred to as Substantial Gainful Activity, or “SGA”), according to 2016 rules (this number generally increases each year).  If you can earn (or are currently earning) more than $1,130 per month, you are not considered disabled under Social Security’s rules (even though a state agency or physician may consider you disabled).  Unlike SSI, the SSD analysis is only concerned with your ability to earn income – your savings, assets, and household income is not included in the SGA eligibility requirement.

Finally, your disability must be expected to last (or actually have lasted) 12 months or more.  Thus, a temporary disability determination by a state agency may be important evidence, but is not going to be a “smoking gun” in your SSD case, as many clients believe at the outset.

The other important aspect of the SSD analysis involves your actual condition.  There are two ways to prove disability to Social Security.  First, you can demonstrate that you meet a “listing,” which refers to a particular diagnosis in the appendices of the Social Security regulations, frequently referred to as the “Blue Book.”  These “listings” consist of very specific diagnoses and symptoms.  If these criteria are not met precisely, you will not be considered to have met the listing.

However, most SSD cases are won by the alternate analysis.  This looks at an additional two step process: can you perform your past work, or can you perform other work?  These steps involve looking at your entire circumstances, your daily activities, the effects of medication, treatment, etc.  Under this analysis, you must demonstrate that you are incapable of working in any job in which you could earn the SGA amount.  (This is really the overall evaluation in either scenario, but if you meet a listing, Social Security presumes that you cannot work in any job that would provide SGA).

SSD Step One: Filing the Initial Claim

You should be able to file the claim yourself, but there are a few tips to help your claim’s success at the outset.  First, make sure you bring a list of all doctors and medical providers you have been seeing, whether those doctors have treated you for your disabilities directly or not.  Second, bring your entire medication list with you, including any side effects you may suffer from.  Finally, bringing as many records as you have available with you to ensure that Social Security gets the proper records.  (Thompson Law Offices offers free consultations to individuals at any stage of their Social Security Disability Insurance claim, and can offer more specific guidance to your particular case during a phone call).

Claims may be completed online, on the telephone, or at your local Social Security Agency office, although it is recommended that you go in person.  The claims generally take a month or two to process.  If you are awarded benefits, you will begin to receive them on the sixth month after you are entitled to them.

SSD Step Two: Reconsideration and Appeal

If, on the other hand, you are denied, you will receive a denial letter called the Notice of Disapproved Claim.  This letter will have a date on the top right corner.  You have 60 days from this date to file the appeal.  Therefore, it is imperative that you contact an attorney immediately and schedule an appointment if you desire representation throughout the process.  Note that in New Jersey, you are required to file a reconsideration of the denial prior to filing the request for a disability hearing before the Administrative Law Judge.

Once you have been denied on your initial claim (or your reconsideration if you are in New Jersey) you can request a hearing before an Administrative Law Judge, or ALJ.  The ALJ will hear your side of the story, along with any witnesses you care to bring.  Witnesses are generally a spouse or close friend or relative who frequently interacts with you and has observed your disability.  That way, they can inform the ALJ of your disability, as well.  Because credibility is often an issue in SSD cases, having another individual who can verify what you are saying can be very helpful.

Unfortunately, it take a very long time to appear before the ALJ.  In Pennsylvania, the wait is typically well over a year, and often more than a year and a half.  In New Jersey, due to the reconsideration period, it is often longer than two years.  While this waiting period can be trying and frustrating, it can also be helpful, as it allows us to build your case over a period of time.  By continuing treatment and keeping your attorney informed of your doctors and treatments, the attorney not only has more information with which to present to the ALJ, but sometimes evidence emerges that demonstrates you meet Social Security’s requirements on paper, foregoing the need for a hearing.

SSD Step Three: The ALJ Hearing

Your hearing is designed for the ALJ to meet you and hear how your conditions affect you.  He or she will have viewed and studied the medical record, but needs to know the particular effects the conditions have upon you.  While important to the outcome of your claim, the hearing is not adversarial, meaning that there is no Social Security attorney to cross-examine you.  Generally speaking, the hearing consists of you, your representative, a court reporter, the judge, and perhaps a vocational expert (VE) and a medical expert (ME).  The VE and ME are there to assist the judge for independent job and medical analysis and will generally not ask you any questions.

Thompson Law Offices has experience in all aspects of Social Security Disability, from guidance on the initial claim, to the appeal process, expediting hearings (where appropriate), seeking decisions on the record without the need to wait for a hearing (also where appropriate), and appeals beyond the ALJ.  If you have been denied and need to file an appeal, please call and set up an appointment, so Thompson Law Offices can analyze your claim.  Or, if you are just getting started, or thinking about filing a claim, Thompson Law Offices can assist and advise you.

An Introduction to Pennsylvania Child Custody

The prospect of a custody dispute over your children is daunting enough without the thought of legal terminology, procedures, paperwork, and lawyers.  If you are just beginning a custody dispute, not knowing what to expect can be the biggest cause of anxiety.

Below, you’ll find a brief overview of the process in Pennsylvania.  Although each case is factually different and only you and your attorney will be able to determine which approach is best, there are some required steps and analyses that will be the same in most cases.

  1. Filing a Complaint/Service of Complaint


The process of obtaining a custody order begins with the filing of a complaint.  This is the legal document that tells the court and the opposing party what you want and why.  Many individuals file the custody complaint themselves; however, if you prefer to have an experienced family law attorney draft and/or review the complaint prior to filing, Thompson Law Offices is happy to assist.  Filing fees often amount to more than $200, making filing the biggest initial cost (assuming you know where the other party resides).


If you have been served with a custody complaint, you are not obligated to respond in writing.  Rather, merely showing up at the conciliation conference (see below) will suffice as a response.  This is not always advisable, however, and you should discuss your legal options with an attorney.  You will be given a date and time to appear in court.  Missing a court date can result in an adverse decision against you, so it is imperative that you make all court dates.



  1. Conciliation Conference

After the complaint has been filed and served, the court will schedule a conference with the two parties.  The purpose of this conference is to attempt to facilitate an agreement.  Many counties conduct this much less formally than a hearing, as it is held before a custody master, rather than a judge.  If the parties can come to an agreement, the master will send the recommended order containing the agreed-upon terms to the judge for final approval.  Once the judge has approved and signed the custody order, it takes effect and the provisions must be followed, whether either party is satisfied with them later or not.

  1. The Custody Order

The custody order will outline the specific parameters of custody, both physical and legal.  Legal custody is the right to make major decisions in your child’s life and is protected by the U.S. Constitution.  Physical custody will generally be either primary or shared (often referred to as 50-50).  A number of factors will determine physical custody, such as the living arrangements of each parent, the past history of the parties, the age of the child, and well-reasoned preference of the child (if the child is older).

The custody order will also dictate holiday schedules, how to schedule vacations, and how the parties are to conduct themselves in the presence of the child.

  1. Hearings and Trials

If no agreement is reached, the matter will be referred to the judge supervising the case.  In this case, a hearing or trial will take place, in which both parties will call witnesses and take testimony.  The custody trial is typically frustrating, long, and therefore expensive.  At the end of the trial, the judge will take the matter under advisement and issue a custody order.  Often, but not always, the judge’s final order will look substantially similar to the agreement proposed by the master.  This is because the facts generally do not change and the master and the judge are considering the same facts and circumstances using the same law.  While this does not mean a custody trial is never necessary or advised, it is something to consider while at the conciliation conference.

  1. Modification of a Custody Order

Once a custody order is entered, it is subject to modification.  A modification petition follows the same procedural steps as the complaint.  This means that you will first go before the master (most counties, if they have more than one master, will try to keep the same master on the case).  Then, if no agreement is made, the party seeking modification may seek a custody trial.

While there is no official requirement to petition the court for modification of an existing custody order in Pennsylvania, for practical purposes, these are usually filed after circumstances have changed somewhat since the previous custody order.  If there has been no change, then the master is considering the same factors as the judge, and will generally defer to the judge’s existing order.

  1. Contempt of a Custody Order

When an individual fails to follow the requirements of a custody order, that person may be in contempt of the order.  Punishments for contempt may range from a simple warning, to payment of the non-offending party’s legal fees relating to the contempt petition, to reduced custody, to jail time.

Generally speaking, contempt petitions should only be filed for serious violations of the custody order.  Arriving a few minutes late, even if habitual, probably does not rise to the level of serious contempt and may have the adverse impact of making the filing party appear petty and frivolous.

  1. Emergency Petitions

Sometimes the actions of the other party can place the child in immediate danger.  In those circumstances, the court can hear the case rapidly, usually within a few days, in order to prevent that danger.  Physical danger is generally what the courts mean by “imminent danger.”

Continuing Disability Reviews

Once you received your Social Security Disability benefits, you thought it was over.  You waited a long time to get before the judge, you presented Social Security with the right evidence, provided great testimony, and shortly after, you received your benefits check.  Unfortunately, it may not be over.

By law, the Social Security Administration must review your case every three years to ensure that you are still disabled under the rules (if your condition is not expected to improve or you are over age 55, the Continuing Disability Review, or CDR, as it’s called, may be less frequent).  I have received many calls from clients upon receiving a notice of CDR, often with a bit of confusion as to why they have to prove their disability again.  While it can be frustrating, and certainly confusing, there is good news.

The Process

First, a CDR places the burden on Social Security to show that you are no longer disabled.  Whereas during the initial claim, it is your responsibility to prove to Social Security that you are disabled, a CDR reverses the burden.  Here, it is their burden to show that your condition has improved such that you can now work.

This determination is made based on the Medical Improvement Review Standard (MIRS), which has two parts.  First, your disabling medical condition(s) must have improved and second, the improvement must relate to your ability to work.  This essentially means that your condition must have improved enough that Social Security thinks you can work again.  (To that end, if you have been working part-time while disabled and you begin making more than the Substantial Gainful Activity amount, a CDR might be triggered).

Most people do not lose their benefits under a CDR.  However, it is important that you have continued your medical treatment, that those records are available, and that the records reflect that your condition has not improved, or has worsened.  The best thing you can do is to cooperate with Social Security at this point.

You will receive one of two forms: the short-form or long-form CDR.  The short form is 2 pages and is Form SSA-455; the long form is about 13 pages and is SSA-454-BK.  If you have received the short form, then Social Security most likely does not believe that your condition is one that will improve.  If you have received the long form, however, Social Security is likely looking for a more extensive analysis, as it believes, for any number of reasons, that your disability may have improved.

Additionally, you may be asked to attend a consultative examination, or CE, by a doctor chosen by Social Security.  Social Security will pay for this visit, so you don’t have to worry about paying out-of-network rates or coming up with the money for another visit.  Normally, however, you are only sent to a CE when Social Security feels that it does not have enough information to reach a decision, or if information you provided conflicts (which is another reason to carefully and completely fill out the Social Security forms).

Will My Benefits Stop?

If Social Security ultimately determines that you are still disabled, you will continue receiving your benefits, without change (you will continue receiving your benefits throughout the CDR process).  If, however, Social Security determines that you are no longer disabled, your benefits will cease unless you request reconsideration within 10 days of the decision.  You must complete the request for reconsideration form and return it.

In order to continue receiving benefits throughout the appeal process, you must also fill out the Benefit Continuation Election Statement within that 10 day window.  Likewise, if you are found to be recovered after reconsideration, you must request a hearing within 10 days and again request continuing benefits.  If you are still found to have recovered, you can appeal to the Appeals Council, although your benefits will cease as of the date of the decision.  If, however, the Appeals Council remands your case (meaning it sends it back to the judge for a new hearing), your benefits will automatically resume.

Social Security is entitled to repayment of any benefits that you were not entitled to receive.  Thus, if your case is ultimately unsuccessful, but you elected to continue receiving benefits, you may be required to pay that amount back.  However, you may ask for a waiver, so long as your appeals were in good faith and you needed the income for “ordinary and necessary living expenses.”  Likewise, if you forego your benefits during an appeal, you will be entitled to repayment of any past due benefits (often called back benefits) that you were entitled to.

The law and process surrounding Continuing Disability Reviews can be cumbersome and complicated.  If you have received a CDR notice or one of the CDR forms, Thompson Law Offices, LLC is happy to assist you and guide you through the process.  All Social Security consultations are free, whether you are an existing client or not.