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Legal Issues Surrounding Traumatic Brain Injuries and Social Security

On Friday, May 12, Varnum personal injury attorney Debbie Palmer met with the Southwest Michigan Brain Injury Network at the Disability Network Southwest Michigan.

Those with traumatic brain injuries often find it difficult to return to work and support themselves or their families. We often support our clients by clarifying the complex legal issues surrounding Social Security disability benefits as it relates to traumatic brain injuries.

Under the Social Security Act, a person must meet several conditions to qualify for disability benefits. Applicants must establish that they have a medical condition that will last for at least twelve months, and that this condition prevents them from earning a monthly income over a certain amount set each year, called Substantial Gainful Activity (SGA). For 2017, that amount is $1,170 for those who are not blind, and $1,950 for those who are blind.

There are four types of disability benefits a person can apply to receive.

1. Social Security Disability (SSDI)
This benefit is available to those who have worked and paid enough into the Social Security system to be eligible.

2. Supplemental Security Income
This is a needs-based benefit. To qualify, your total combined household income and non-exempt assets must be less than a certain amount.

Supplemental Security Income is a capped benefit, meaning there is a set monthly amount a person can receive. Individuals may receive up to $735 per month and couples may receive $1,103.

3. Adult Child Disability Benefit
An adult who became disabled before age 22 may qualify for this benefit. Individuals who qualify for this benefit may also qualify for SSDI, if their parent(s) contributed enough to the Social Security system.

4. Disabled Widow Benefit
To qualify for this benefit, you must be between the ages of 50 and 60, have been married to the deceased spouse for at least nine months, be unmarried, and not qualify for a higher Social Security retirement benefit.

Applying for Benefits

There are currently three ways to apply for disability benefits. Individuals may apply in person at a local Social Security office, over the phone, or online (currently only available for SSDI).

The Social Security Administration uses a five-step process to determine if a person is disabled. A doctor is usually hired to do a medical review to answer these questions.

  • Are you working? If the answer is yes and you earn over the SGA level, you will not be eligible.
  • Is your medical condition considered severe?
  • Is your medical condition or illness recognized as a disabling impairment?
  • Are you able to do the same work you did in the past?
  • Is there any work you are able to perform?

If a person is denied, he or she should immediately contact an attorney because there are strict timelines to appeal that denial.

Returning to Work

A person can work and still qualify for benefits if he/she earns less than the SGA, or $1,170 per month. A nine-month trial period is also available wherein the disabled person may return to work and still receive disability benefits regardless of income.

Another option, called the Plan to Achieve Self-Support (PASS) exists to help the disabled person obtain the items, services or skills he or she needs to return to work. Any money the disabled person sets aside for things like transportation to work, childcare or tuition won’t count against disability benefits under this plan.

The Ticket to Work program is also available for those who would like to attempt to return to work. People ages 18-64 are eligible to enter certain employment networks that help people find jobs and vocational rehabilitation agencies that will work with a disabled person. This is a safe way for a person to reenter the workforce without benefits being immediately terminated.

Maintaining Benefits

Usually when a person is approved for disability benefits, there is a date set for a review to determine whether the person is still disabled. Claimants sometimes stop treatment with their physician and this can be used as a basis for termination. To prevent this from happening, it is recommended to continue treatment while receiving disability benefits.

If you or a loved one have experienced a traumatic brain injury that makes it impossible to work, the last thing you want to worry about is the plethora of paperwork and legal issues entailed in getting disability benefits. Our attorneys have years of experience helping clients get the benefits they need and deserve.