Social Security Disability–Do I Qualify?

By: James R. Burn, Jr.

Many clients who call this office with questions about Social Security disability benefits think that they have to be unable to do anything at all, practically trapped in their own homes, to qualify for Social Security disability benefits. This is not the case.

To qualify for benefits, you have to be totally and completely disabled from “any and all substantial gainful activity.” This does not mean that you cannot live your life. This does not mean that you can’t socialize or even attempt to hold down a job. This means you cannot work.

The older we get, the less restrictive the laws can be in order for a person to qualify. For example, for a person in their 20s to qualify, they would probably have to be completely restricted from any work from their doctors. However, the same person with the same injury in their mid-to-late 50s with light-duty restrictions would be able to make an argument that they are entitled to benefits.

The important thing is to pick up the phone and ask for an evaluation of your situation. For every call that we receive to see if the person calling qualifies, it is sad to know that many other people simply chose not to pick up the phone. There is no obligation to ask the question, “Do I qualify”?

Social Security Application–Why Wait?

By: James R. Burn, Jr.

To qualify for Social Security disability benefits, the applicant for benefits must prove that their disability is going to last for 12 months or more. This does not mean that a person seeking Social Security disability benefits has to wait a full year before filing their claim.

If an individual seeking Social Security disability benefits has been advised by their doctors that they have an injury or disability that is expected to last more than 12 months, they should not wait to file their claim. They should do so immediately. It can take anywhere from 12 to 18 months from when the initial application is filed to have a hearing in front of an Administrative Law Judge assuming the Level 1 Application has been denied.

Additionally, you may be entitled to back pay. Therefore, why wait? If you believe your injury and disability is going to keep you from doing any significant work for more than a year, and your doctor supports such a position, file the application, and do not hesitate to call us right away.

One Accident; Multiple Cases

By: Roger D. Horgan

Our firm has a varied, injury based practice. We handle workers compensation claims, automobile accidents, trip and fall accidents, social security claims, veteran’s claims, and other injury related matters, often all for one client, for one injury. An individual is struck and permanently disabled by an automobile on the job may well have several claims to bring: a Worker’s Compensation claim, a claim against the negligent driver, a claim against his own automobile insurance Company, a claim against a disability plan, and, finally, a claim for Social Security disability benefits. Our experience and expertise across these various types of cases can be very important when a particular accident leads to two or more claims.

Proceeding with any one of these claims without accounting for its impact upon other potential claims can lead to unexpected, and potentially disastrous, results. One potential disaster would be failing to meet the prerequisites for bringing an underinsured motorist claim, also known as UIM, against one’s own insurance company. A UIM claim arises when the defendant driver’s automobile insurance policy limits are not adequate to meet the value of the claim against him. If the victim has purchased UIM coverage it would step in where the defendant’s liability limits leave off. So, if the defendant has the state minimum liability limits of $15,000, and the case is worth $30,000 a victim who has purchased UIM coverage will have a claim for the difference. However, if the victim has taken the $15,000 offered by the defendants insurance company without notifying and obtaining approval from his own insurance carrier, he will have lost his right to bring the claim for UIM benefits. That is because his insurance company has the right to pursue a claim against the driver for anything it is required to pay its policyholder. This is commonly known as a waiver of subrogation. While insurance companies very rarely refuse to waive subrogation, they routinely rely upon the failure to obtain waiver of subrogation before the settlement with the defendant driver to defeat claims for UIM benefits.

As another example of one case affecting another was seen in the recent case of McConnell v. DelPrincipe from Lawrence County. The victim in that case was hit by a car during the course of his work day. Because it was a work related accident his first step was to bring a Worker’s Compensation claim. In that case, the Worker’s Compensation Judge determined that the victim was not disabled, did not sustain a loss of earnings and that he had fully recovered from his cervical strain/sprain caused by the accident. The victim did not file an appeal from the Worker’s Compensation judge’s decision.

Thereafter, he brought a lawsuit against the driver claiming that he had suffered injuries including a herniated disc in his cervical spine, headaches, cervical sprain/strain, aggravation of degenerative disc disease, and other injuries that limited his work activities. However, because the issue of his injuries had been previously litigated in the Worker’s Compensation claim he was prohibited under the doctrine of collateral estoppel from claiming anything more than a cervical sprain/strain in the lawsuit against the driver. The failure to coordinate the handling of these cases, and in particular the failure to file an appeal from the Worker’s Compensation decision, made the claim against the defendant driver nearly worthless.

At Abes Baumann, we are vigilant and experienced in coordinating the various claims that may arise from one accident so as to maximize recovery and prevent unexpected and negative results.

Don’t Give Up

In the twenty-five years that I have practiced Social Security Disability, one of the most important things that I advise clients or potential clients is not to give up at the initial level. Most claims at the initial level are denied. It is amazing to me that many of these clients or potential clients needed to meet with a lawyer in the first place. What concerns me is that, for every one client with whom we meet, there are probably at least five other claimants with valid claims who throw their hands up and choose to do nothing.

If you have filed a Social Security Disability claim or an SSI claim and you have been denied at Level 1, do not give up. You have sixty days to appeal. I am prepared to meet with you and review your claim to see what steps we can take to ensure that you receive the Social Security Disability or SSI benefits that you deserve.


We only get paid when you win, so you don’t have to worry about hourly rates or fees. That means you’ll never see a bill unless you win. Fill out the form below and you’ll hear back from us immediately.