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What You Need to Know About the SSI Application and Appeals Process

As Social Security disability (SSD) lawyers in Cleveland, Ohio, we encounter a great deal of confusion about Supplement Security Income. SSI is related to, but always dependent on, SSD, and qualifying for one type of federal benefit does not automatically mean qualifying for the other. We welcome additional questions and offer free consultations to individuals or families who are considering applying for or appealing to receive supplemental income payments. You can schedule an appointment by calling (800) 678-3318 or completing this online contact form.

An SSI Applicant Has an Undeniable Right to Request Advice, Assistance and Representation From a Social Security Attorney

In Cleveland, across Ohio, or anywhere else in the United States, people who apply for SSI benefits can consult with or hire a lawyer who knows the ins and outs of the program. Arranging for legal representation can be particularly important if appealing a denial of benefits. The reasons behind a denial are not always clear, and it sometimes takes a court cases to secure your payments.

Strict Eligibility Criteria Apply

You can only receive SSI benefits if you are eligible for other types of Social Security benefits and can prove that you are blind, permanently disabled or older than 65. U.S. citizenship and residency rules also apply and no one who is in prison or committed to a government-funded institution can qualify for SSI.

Most People Who Receive SSI Payments Also Receive Social Security Disability Benefits

While SSI is an income-based program, it is designed to support people who cannot work enough to pay for food and shelter. No one needs to apply or qualify for Social Security Disability Insurance (SSDI) to receive SSI, but many people apply for both at the same time. And, as noted, proving that a permanent disability exists can be key to having an SSI application approved.

The Social Security System Asks SSI Applicants to List All Their Financial Resources

The SSI application must include details about all the following (when they exist):
  • Cash held by the applicant
  • Bank accounts in the applicant’s name
  • Stocks and other investments held by the applicant
  • S. savings bonds held by the applicant
  • Real estate owned by the applicant
  • Vehicles owned by the applicant
  • Personal property of significant value such as jewelry and collectibles owned by the applicant
  • Life insurance taken out in the applicant’s name
  • Anything else owned by the applicant that could be sold for to cash to buy food and pay the rent or mortgage
Applicants should also provide information on their monthly living expenses, including rent or mortgage payments, total grocery and utility bills, loan payments, clothing expenses and entertainment budgets.

All Monthly Income Must Be Disclosed

All funds from work or benefits programs must be listed on the application. SSI payments are capped for individuals and families, and monthly income is subtracted from the maximum possible payment. Note that no one gets rich on SSI. During 2018, the most an individual could receive was $750 per month. A beneficiary whose spouse also qualified for SSI could receive, at most, $1,250 each month. Still, the federal income supplement can make a huge difference in a disabled or elderly person’s quality of life.

Applicants Can Appeal a Denial of SSI Benefits Four Times

The Social Security Administration grants the following levels of appeals:
  • Reconsideration — resubmitting the application, often with additional information
  • Hearing by an administrative law judge — a review of whether the rules were applied correctly to all the evidence supplied by the applicant
  • Review by the Appeals Council — a further review of the decisions made to this point
Federal court review — a civil lawsuit in which the SSI applicant sues the Social Security Administration


How Employment Lawyers Help Both Employees and Employers

Employment law covers hiring, firing, workplace policies, and benefits. Recognizing this makes plain how a Cleveland employment lawyer could help an employee or an employer in any given negotiation or lawsuit. An employment lawyer’s knowledge of federal and state laws and practices regarding discrimination, rights, and contracting often proves invaluable when issues between workers and management arise.

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How Will a Personal Injury Settlement Affect my Ohio Workers' Comp Benefits?

First, understand that you may have grounds for filing a personal injury compensation claim if you get hurt on the job. While Ohio makes it nearly impossible for an employee to sue his or her employer for negligence, you can sue the driver who hit you while you were using a company vehicle or the maker of a defective tool that failed while you were completing a task. What you cannot do, in most cases, is receive full workers’ compensation benefits and a maximal car insurance or product liability settlement. You will not actually lose any money, but you must know what to expect.

The Rule

If you succeed with what lawyers call a third-party claim, the settlement or jury award you receive on your Cleveland, Ohio, personal injury compensation claim will not reduce your Ohio workers’ compensation benefits. However, the amount paid out on your personal injury claim may be reduced by up to the full amount required to reimburse the workers’ comp program. This will happen because Ohio recognizes an insurance rule called subrogation. You do not need to know the exact definition of that term. Nor do you need to dive deeply into the details of how subrogation works. Your Cleveland personal injury attorney and workers’ comp advocate will handle it. In fact, at Agee Clymer Mitchell & Portman, we take special care to ensure that our clients are not financially harmed by subrogation.

An Example

What you need to know about subrogation is best explained by giving an example. Say you work as a delivery driver. A car runs a red light and slams into your truck while you are out on your daily rounds. Your obviously work-related car crash injuries keep you out of work for a month. Between medical expenses and wage replacements, the workers’ comp program pays you a total of $20,000. You consult with a Cleveland personal injury lawyer and decide to file claims for medical costs to date, lost wages, ongoing physical therapy, and pain and suffering. When your case finally settles, you receive $80,000 from the at-fault driver’s car insurance policy. The higher car insurance settlement reflects the fact that workers’ comp stops paying medical benefits when you get cleared to return to your job. Also, workers’ comp only replaces two-thirds of your lost wages, and workers’ comp does not compensate people for pain and suffering caused by on-the-job accidents. Under the subrogation rule, the Ohio Bureau of Workers’ Compensation will get paid back the $20,000 it gave you in benefits. You will still receive $60,000 from the car insurance settlement. The transfer of funds is arranged between the insurance company and the workers’ comp program, so you do not spend anything out of your own pocket.

Help With a Third-Party Claim

Attorneys in the Cleveland, Ohio, offices of Agee Clymer Mitchell & Portman represent clients with personal injury compensation claims and workers’ comp cases. We offer free consultations and stand ready to help any Ohioan recover the compensation and monetary damages they deserve from the negligent individuals or corporations who harm them. Let us know how we can be assistance to you by calling us at (800) 678-3318 or connecting with us online.


Tips to Help You Succeed with Your Ohio Workers Comp Claim

No “one weird trick” ensures you will win your workers’ compensation claim. Each case is unique, and your employer and the Ohio workers’ comp program will look for almost any excuse to deny benefits. Still, as Cleveland-based attorneys who have decades of experience with helping people who suffered injuries on the job or who developed occupational illnesses, we are happy to offer several tips on how to win a workers’ compensation claim. Here are seven rules to follow when filing and pursuing claims for replacement wages and coverage of medical expenses.

Focus on Your Workers’ Comp Claim

A couple of laws and state court decisions make it nearly impossible for employees to file a personal injury or wrongful death lawsuit against their employers. Some injured or ill workers may be able to pursue what are called third-party claims against a negligent driver or the maker of a defective tool. Let your workers’ comp attorney worry about that possibility. Concentrate on winning your workers’ compensation claim.

Do Not Wait to File

Ohio imposes a one-year statute of limitations on workers’ comp claims. The deadline to request benefits for a work-related injury, illness or death hits exactly 12 months after the date of the workplace accident, diagnosis or loss of life. The workers’ compensation program automatically rejects every application that arrives outside the statute of limitations.

Make Sure You Have Filed an Accident/Incident Report With Your Employer

Winning your workers’ comp claim requires presenting evidence that your disability resulted from doing your job and, also, that you did not harm yourself intentionally or while ignoring safety rules. Filing an accident or incident report with your employer ensures that an investigation will be performed. The findings from that investigation can stand as strong evidence for your right to claim benefits. Note that you are not required to report anything to your employer immediately. After all, you may not be physically able to do so.

Keep All Your Medical Bills and Prescription Slips

Medical evidence goes a long way toward making your case for workers’ comp benefits. At a minimum you need proof that you sought treatment and that the work-related injury or illness kept you from working for weeks or months.

Comply With Doctors’ and Therapists’ Orders

Workers’ comp is designed to tide people over as they recover from a work-related injury or illness. Beneficiaries are expected to return to their jobs and, importantly, do what they can to return. An employer or the workers’ compensation program can cite missed doctor’s appointments, unfilled prescriptions and failure to complete rehabilitation assignments as reasons to deny claims.

Be Prepared to Appel a Denial of Benefits

Do not be shocked or give up if you do not win your workers’ compensation claim the first time you apply. Employers contest claims vigorously, and officials who work for the workers’ comp program have long lists of reasons why they can reject applications. Three rounds of official appeal exist, and injured or ill workers have the legal right to take their claims to court if the regular appeals do not succeed.

At the Very Least, Consult With a Cleveland Workers’ Comp Attorney

Seeking advice and assistance from a lawyer who has helped hundreds of Ohio residents navigate the application and appeals process will give you your best shot at winning your workers’ compensation claim. If you would like to learn what we could do for you, call our Cleveland offices at (800) 678-3318 or connect with us online. The first appointment is free.

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