A 50-year-old woman was on vacation with her family when a fluke jet-ski accident left her with a serious concussion that renders her incapable of concentrating for more than an hour a day. Her vision is blurred; she gets dizzy. Doctors say there are things they can try, but it may never go away.
Long-term disability insurance covered her for the first six months, but now administrators are reluctant to extend benefits. It could be time to apply for Social Security Disability insurance. “Even missing just one day a month makes you an undependable employee,” says Ardmore-based attorney Mike Silver.
As you might’ve guessed, with any federal program, it’s not quite that simple—and specialists like Silver are few and far between. Social Security Disability’s target demographic is people 50–67 who’ve been employed for the past five years. But even if you’re under 50 and unable to work for a variety of reasons, you might qualify. Favorable odds increase based on the severity of the disability and your age. And children as old as 18 can receive half of what goes to a disabled parent.
Long-term disability insurance covers 26 weeks, and you often don’t have to be completely disabled to collect private benefits. “The heavy construction guy who can’t operate machinery anymore but can still be a greeter at Walmart can [usually] receive his company’s disability,” says John Stanzione, a disability and workers’ comp expert at Lamb McErlane in West Chester.
To be eligible for SSD benefits, you basically have to be unemployable—and that’s tough to prove. After the initial 26 weeks of long-term disability, you may need to apply for SSD, as your LTD insurance company often gets a federal credit at that point. Still, you won’t necessarily know this by reading your policy. “Talk to a lawyer if you’ve been turned down for your private disability insurance,” says Stanzione.
As a young attorney, Silver took on two Social Security Disability cases offered to him by a partner. He worked like he was “studying for the bar” in the short time he had to prepare for each. “And I happened to win [them],” he notes.
Word spread, and Silver logged 400 SSD cases over the next year. Silver’s expertise requires an understanding of the medical field. It’s a good fit for a guy who nearly became a doctor. Evidence in SSD cases comes in the form of medical reports and expert testimony from doctors. “I need to work with those guys, so I don’t do medical malpractice,” Silver says.
The jury is still out on how the coronavirus is affecting disability cases. “If you’re still having [pulmonary or heart] symptoms and medical providers are telling you it’s related to the virus, don’t be shy about applying for benefits,” Silver says. “We see a lot of Lyme disease, too. It’s very diﬃcult to prove because the effects are greatly disputed.”
The public doesn’t hear much about SSD because lawyers don’t make much on the cases. With the biggest SSD settlements, the award for the attorney is capped. Most cases don’t get approved in the first round, and it takes three to six months to hear back on each appeal. “I don’t take a retainer for this work,” says Stanzione. “It can drag on for years.”
Regardless of the hassles, both Stanzione and Silver encourage people to reach out. “I like to help people. I consider SSD pro bono,” says Silver, adding that he wins 80% of the cases he takes on. “I figure if I help people with this, they might think of me for other things.”