In general, there are a number of different benefits that people can collect from various government agencies if they qualify as having a medical disability. Disability benefits are one of the most common sets of benefits that the federal government may issue to persons who meet the eligibility requirements. Specifically, disability benefits are among the many types of government benefits distributed by the U.S Social Security Administration (“SSA”).
Every once in a while, the SSA will review a recipient’s disability benefits case to determine whether or not they are still eligible to receive such benefits. If the SSA decides that a recipient is no longer disabled after reviewing their current case file, then they will stop sending the recipient disability benefits.
To qualify for disability benefits, a recipient will typically need to demonstrate to the SSA that they have a physical or mental condition. They must prove that the condition interferes and/or prevents them from performing a substantial portion of the work required for many jobs.
For instance, a person who has a terminal illness, such as stage four cancer, will be eligible to collect disability benefits. It is very unlikely that the SSA will stop sending disability benefits to those who have a terminal illness.
There are two main programs that the SSA uses to distribute disability benefits. The first is called the Social Security Disability Insurance (“SSDI”) benefits program, and the second is known as the Supplemental Security Insurance (“SSI”) benefits program. Each program has different requirements that must be met before an individual will be permitted to collect such benefits.
If an individual fails to meet the requirements for either one of these two programs or if an individual no longer qualifies for disability benefits under either program, then the SSA may cease sending them disability benefit payments.
Thus, if you believe you are entitled to disability benefit payments and that you have been wrongfully denied them, you should speak to a local government lawyer immediately for further advice. A lawyer can provide guidance on the next steps you should take to start or to continue to collect disability benefit payments.
What Are My Options?
There are two primary options that a recipient can choose from if they encounter an issue involving a cessation of their disability benefits. These two options include:
- A recipient may either submit a new application, which is also referred to as the re-application process; or
- They may choose to appeal the initial decision issued by the SSA.
It should be noted that while the appeals process may take longer, a recipient will be permitted to continue collecting disability benefits if they notify the SSA in time. The same will not hold true if a recipient simply chooses to re-apply.
Should I Re-Apply?
While it is possible for a recipient to re-apply for disability benefits after they have been denied benefits or if the SSA has stopped sending them disability benefits, the SSA generally recommends that a recipient file an appeal rather than re-apply. The following list contains some of the most common reasons as to why the SSA may suggest appealing a decision, as opposed to re-applying.
These reasons might include:
- The fact that a recipient may no longer be eligible for the benefits or may lose a portion of their benefits if they re-apply;
- The application will likely be denied for the same reasons that a recipient’s disability benefits were initially stopped in the first place; and
- Unlike the appeals process, a recipient will not be permitted to request that they continue to receive payments through disability benefits while awaiting a decision on a new application.
Should I Appeal the Decision?
Whether or not a recipient should appeal a decision that the SSA has issued about stopping the recipient’s disability benefits, will largely depend on the facts of each individual case. Thus, it is highly recommended that a recipient consult a knowledgeable government attorney who has experience with such cases before filing an appeal with the SSA.
When a recipient appeals a decision made by the SSA regarding their disability benefits, the SSA will review the recipient’s entire disability benefits case to confirm that no errors were made in issuing the initial decision for their case.
Generally speaking, about fifty percent of all appeals concerning disability benefits are found in favor of the disabled recipient. It is important to note, however, that this is a very loose number and many factors may change the outcome of a particular disability benefits case.
Starting on the date that a recipient receives the SSA’s decision to deny or to cease allowing a disabled individual to collect disability benefits, the recipient will have sixty-five days to notify the SSA in writing that they intend to appeal the initial decision. If a recipient chooses to pursue an appeal, they will have four opportunities to have the SSA’s initial decision overturned.
The first stage of an appeal will begin with the reconsideration process. During this process, an official from a recipient’s local Social Security office will be assigned to review their claim and to reconsider the decision to stop or deny the recipient from collecting disability benefits. Depending on the outcome of this stage, the recipient may or may not have to move on to stage two.
Stage two involves having an administrative law judge review the claim on an independent basis. This stage sometimes requires the recipient to appear before this type of judge at an administrative hearing.
Next, a recipient will have their claim reviewed by the Appeals Council. Again, this is only if the results of the administrative law judge’s findings are not to the recipient’s satisfaction. Once the Appeals Council reviews a recipient’s claim, the decision that it issues will be considered to be final. This means that the recipient has officially exhausted all avenues of an administrative remedy.
This also means that the recipient will have to proceed to the fourth and final stage, which involves bringing a lawsuit against the SSA in their local federal district court. Hence, why it is so important to retain legal counsel before starting the appeals process.
May I Continue Receiving Payments while Appealing?
While a disability benefits decision is pending on appeal, a recipient may still be able to collect payments through their standard disability benefits. However, in order to ensure that these payments do not cease during the period of the appeals process, the recipient must notify the SSA in writing.
A recipient may do this by sending a written letter to the SSA within ten days from when they received the decision by the SSA that initially stated that their disability benefits would cease. If a recipient is able to submit this letter on time, then their disability benefit payments should continue until a decision is issued on the claim pending on an appeal.
In addition, every time that a recipient appeals a decision issued by the SSA, they must immediately notify the SSA in writing of both their intent to appeal as well as to continue receiving disability benefit payments. In the event that a recipient loses their appeal, however, they may be required to return some or all of the money they received during this period back to the SSA.
Do I Need a Lawyer?
The laws and policies that govern the social security benefits system in the United States can be quite difficult to interpret without the help of a legal expert. This is especially true when it comes to cases involving a denial of benefits or when a disabled recipient stops receiving such benefits.
Thus, instead of having to handle the stress of a medical condition and the loss of social security benefits on your own, you should hire a government lawyer who handles these types of legal issues and practices in your jurisdiction. A qualified government lawyer will be able to explain why you may have been denied social security benefits and can determine whether or not there is a way to reinstate your disability benefits.
Your lawyer can also assist you with the process of both re-applying for disability benefits and/or appealing the SSA’s decision regarding your disability benefits. If you need to appeal a decision issued by the SSA, your lawyer will be able to provide legal representation before an administrative law judge, the Appeals Council, and in federal court if necessary.
In addition, your lawyer can help you to complete any required forms and gather solid evidence to support your claim. Your lawyer can also ensure that you meet all filing deadlines and comply with the applicable laws.
Finally, your lawyer may also be able to recommend other options of government benefits if it turns out that you are no longer eligible to receive disability benefits.