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Learn More About Qualifying For Social Security Disability [Interview]

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Today I Am Doing An Interview With Mr. Jonathan Ginsberg

NOTE: Would you prefer me to present this information to you in video format? Watch the video below for the interview with Mr. Jonathan Ginsberg. Enjoy!

DAVID:  Mr. Ginsberg is a social security disability attorney in Atlanta, Georgia, and has been in practice for almost 30 years. Mr. Ginsberg represents social security disability applicants, which is the topic of today, learning a little bit more about the social security disability process.

He represents those applicants who are seeking benefits for permanent disability. He’s also the author of The Disability Answer Guide, a how-to guide for disability applicants.

Mr. Ginsberg regularly teaches about disability issues at continuing legal education seminars. He has the largest active YouTube channel focusing on social security disability issues, and he writes about SSDI and SSI for a variety of publications.

Mr. Ginsberg, welcome to today’s program. Thanks for joining.

MR. GINSBERG: Thank you very much. I appreciate you having me here.

DAVID:  Yeah. So why don’t you tell us a little bit about your background and how you got involved in helping people with their social security disability concern?

MR. GINSBERG: Well, I’ve been a practicing attorney here in Georgia. I’m licensed in the state of Georgia. I’ve lived in Atlanta for about 30 years.

I’ve done a number of different things over that time. Personal bankruptcy was one area of practice, personal injury, and about 20 years ago I started getting calls for social security disability.

I didn’t really know very much about it at that point. I started asking around, and it turns out that there’s a lot of folks who really need assistance with disability cases.

The process is extremely difficult to do on one’s own because it’s very opaque. There are not a lot of instructions from social security.

You have a lot of people who really deserve to be on disability who’ve worked and paid into the system, and they don’t know how to get their money out of the system. And so that’s basically what I do.

DAVID:  When you say disability, how does social security define the term disability?

MR. GINSBERG:  Well, they define disability in terms of your capacity to work.

A lot of people, myself included when I first started, thought that disability was about medical problems, and it is about medical problems to some degree. But the real relevant point here is how does your medical issue limit or impact your capacity for work?

social security

If you don’t have an obvious medical condition, you will almost certainly be rejected for disability.

In order to be disabled for social security purposes, you have to have a medically determinable condition, which means something that’s been diagnosed, that has lasted or is expected to last for 12 consecutive months, and that interferes with your capacity to perform what they call substantial activity or a simple job.

In other words, to think about it this way, if I said to you, “Here’s a job. You’re sitting at a table putting ink pens in a box eight hours a day, five days a week, earning minimum wage.”

Could you do that eight hours a day ongoing? If you cannot and the doctors support you in that, you would meet the definition of disability for social security purposes.

DAVID:  Right. So what are the different types of disability benefits that are offered by the Social Security Administration?

MR. GINSBERG:  Well, there are two main types.

One type is called SSDI, and that’s for people who’ve worked and paid into the system. You have to have paid in within the last 10 years before you became disabled.

The second type is called SSI, and that is essentially a welfare benefit for people who do not have an earnings record.

The big difference with SSDI is that the amount that you get per month is a function of what you’ve paid in. So typically I’m seeing $1,200 to $2,000 a month for an applicant.

SSI is going to be a little bit less than $800 a month maximum. In addition, with SSI, there are a lot of offsets.

If you have a spouse who’s working, the spouse’s earnings are going to offset your SSI. They do not offset SSDI.

SSDI is really the one that we look for more because the benefits are higher, and there are less offsets. In addition, if you become eligible for SSDI, you become eligible for Medicare two years after you’re first eligible for SSDI.

With SSI, you become eligible for Medicaid right away, but I think Medicare does offer more substantial benefit

DAVID: For the SSI recipient, say maybe a homemaker, is Medicare something that’s offered immediately, or is it still the two-year waiting period?

MR. GINSBERG:  No, it’s immediate. If you become eligible for even a dollar of SSI, you become eligible for Medicaid right away. And I say that because many times there’s an offset that results from household income or assets.

DAVID:  Gotcha. Okay. How does someone start the application process?

MR. GINSBERG:  There are three ways to do it.

You can go down to Social Security in person, which I would not recommend because they have long lines and it’s not a real fun process. Having sat in those offices waiting to be called, it’s not a lot of fun.

ssa website

By far the easiest way to apply for disability is online. Avoid going to the office in person at all costs!

You can do it by phone by calling 800-772-1213, or you can go online to www.ssa.gov/forms/apply-for-benefits.html. That’s really the best way to do it.

I have a lot of criticisms about how long the delays are, but to its credit, Social Security has gone paperless, which is really a great thing because you can do all this online.

If you do apply online, the process will go a little bit faster because again, they’ve gone paperless so everything being done online keeps it paperless instead of having to do it on paper and then recreate it online.

DAVID:  Yeah. I sell life insurance, and I see a lot of people who either are considering going down the disability route or have been through it, and many of them remarked on the length of time.

I would think that representation would be something definitely worth considering, but obviously most people are going to have the concern of what kind of cost it takes in order to hire a lawyer. So what are your thoughts on that? Do you really think that a lawyer is absolutely necessary for them?

MR. GINSBERG:  Well, that’s a multi-part question, so let me kind of break it down.

First of all, as far as the fee, there is no upfront cost when somebody hires me. It’s all done on a contingency. I get paid on past due benefits.

Social Security has to approve my fee, which is 25 percent of past due benefits with a cap currently of $6,000. So even if somebody is eligible for $100,000 of past due benefits, my fee is going to be capped at $6,000. So there’s no upfront cost.

As far as whether you need an attorney, honestly, when you first call that 800 number or go online, you don’t need an attorney to do that. There’s really no reason. There’s nothing I can really do at that point.

Social Security will request medical records. They will make their determination. You don’t really need an attorney.

Most people are denied. It takes about four or five months, and you have to file an appeal which is called a Request for Reconsideration. That’s typically when most people hire an attorney because filling out those forms can be very, very confusing.

You noted in your intro that I wrote a book about this, and that’s why I wrote the book because there are literally hundreds of pages with no instructions. So to appeal a denial, you don’t NEED an attorney, but it starts to make sense to get somebody.

Then if you request a hearing, you don’t want to go in front of a judge without an attorney because they speak in shorthand. There’s all these acronyms. It’s very, very confusing, Even for people who are pretty sophisticated.

It just doesn’t make sense to do it without an attorney, especially with the delays. People are now waiting two to three years to get to a hearing.

You don’t want to wait three years to get to a hearing and then not understand what the process is or not understand about the requirements to update medical records and so forth. So that’s really when an attorney makes the most sense.

DAVID: Yeah. You mentioned something earlier on that I’ve found out as well when I talk to my clients. Most people I deal with who have disability

can organ transplants get life insurance?

Most people’s disability claims are rejected more than once, which is why they end up needing an attorney.

say they were declined at least the first time, if not several times after that.

I’m just curious. What reason would you give as to why so many people are declined so shortly after they apply?

MR. GINSBERG:  Well, a couple reasons. One is the people that make the decisions are essentially claims adjusters. They’re not attorneys; they’re not judges.

They’re looking for what I call magic words. They’re looking for something called a listening, which is basically where Social Security has identified certain medical issues that are so severe that a person is assumed not to have the capacity for work.

If it’s not laid out very clearly in the medical records, it’s not going to be approved on the listing. And of course, doctors are focused on getting you better, not on filling out forms for Social Security.

I think that’s the main reason. The people that are doing the initial review are really not that well-trained to interpret medical records. They’re looking for very, very clearly.

And I’d say about a third of the people who do apply are approved because they have significant problems. They have metastatic cancer, they have an amputated leg, they have some terrible immune system problem. I think those cases do get approved.

But you know, right now the approval hearing rate is about 47 percent. So all those people were denied twice.

Again, it’s because the folks that do the initial application or reconsideration are really not trained to review medical records to the degree that an attorney would be or a judge would be.

That’s why people are denied. Not because they’re not deserving, but because the medical records don’t address how this medical issue affects their capacity for work.

Since the medical records don’t talk about that, you’re not speaking Social Security’s language. That’s ultimately my job is to translate the medical records into work capacity limitations.

If I do that, we win.

DAVID: Yeah. You mentioned things like cancer or an amputee as being the most quickly approved type of claim. What other kind of cases are most often approved?

MR. GINSBERG: Well, the biggest ones that we see are musculoskeletal, which would be back issues: severe back problems, herniated discs, severe bulging disc, nerve impingement. It could be in the neck region. It could be in the lower back region.

An amputation would certainly do it, but it doesn’t have to be an amputation. Essentially the way to look at musculoskeletal issues is does it affect your capacity to walk, sit, and stand?

Are you in such severe pain you cannot sit or stand or you have radiation pain into your arms, your legs? So that’s one big, big area.

We see a lot of cardiac problems, heart issues, congestive heart failure where the heart capacity is reduced. Sometimes we’ll see heart capacity at 30 percent, 20 percent. Those cases are strong.

Circulatory system problems: We see DVTs a good bit. Again, we see problems with the circulatory system where blood isn’t flowing throughout the body. That can lead to a lot of problems.

Cancer certainly is a big area. Any issue with organ damage. If there’s a problem with the kidney, the liver, or any sort of organ, those are going to be big things.

neurological-disorders-final-expense

Medical issues that are not physically obvious are almost always denied.

I see a lot of mental health cases, depression, anxiety, PTSD. Those are getting more difficult. Not impossible but more difficult because, again, it’s not objective. Social Security likes things where they can do an MRI or a CT and really see it in an objective radiographic test.

The mental health cases are getting a bit more difficult, but they still are viable. So I’d say the back issues, neck issues, heart issues, organ damage are the big ones I think are probably the strongest.

DAVID: Gotcha. Obviously part of this deal is recovering money that the applicant thinks they should have received. How much does an approved applicant generally recover?

MR. GINSBERG: Well, for an SSI case, which is the welfare benefit, it’s going to be a little less than $800 a month. For SSDI, it’s typically about $1,200 to $2,000 a month.

Realize that because the delays are so long that, if you get approved and you’ve been waiting for three years, you get three years of benefits. So let’s say you’ve got a thousand dollars a month and it’s been 36 months, that’s $36,000 you’ll get as a lump sum.

That’s where it can be a significant amount of money. And of course, it’s very difficult to survive during that two to three-year period, but if you can survive, there’s a light at the end of the tunnel.

DAVID:  Is there a cap on that length of time?

MR. GINSBERG: No, no. Well now, I will say this. You can’t keep waiting to apply for a couple of reasons.

If you apply in 2018, for example, you can’t go back to 2012 for disability and get paid. You can get your onset back that far, but you don’t get that much money.

You only get paid one year prior to your date of application for SSDI and as of the date of application for SSI. So you want to apply as soon as you realize that you’re not going to be able to go back to work.

Even if you’ve not been out for a year, it’s still worthwhile to apply because the process takes so long. But you have to be out for at least a year.

Sometimes I have people that are out for a year, and they go back to work. I can get them what they call a closed period case where I get them that 12 or 15 months of benefits and then they go back to work.

DAVID: And so, opposite of the last question, what cases are the most difficult kinds to win?

MR. GINSBERG:  Well, I think that any case where there’s no objective medical evidence. Again, mental health cases have got to be pretty severe.

Depression is something we see a lot of, but it’s got to be really, really severe. It can’t be a mild case of depression.

I typically look for a mental hospital hospitalization. I might look for suicide attempts or things like that.

I see a lot of fibromyalgia cases which are very, very difficult to win because there’s nothing objective. Reflex sympathetic dystrophy or complex regional pain syndrome are difficult cases because there’s nothing you can point to in the record and say this is proving what this person has.

Anything mild that they can work past are not going to be as strong of cases. But sometimes a combination of mild situations can add up to a very, very severe limitation on work.

Again, it’s not what the applicant thinks. It’s what the doctor will go on record to say this person would not be a reliable employee.

DAVID: Gotcha. Well, thank you, Mr. Ginsburg, for that. If somebody is interested in reaching out to you to learn more, how can they do so?

MR. GINSBERG: They can reach out to me by going to my website which is ssdanswers.com. I’ve got a website with a free survival kit I put together that explains this whole process. It gives them a lot of information.

I’ve got a blog, links to a lot of different, very useful websites, I think, with disability. They could call me on the phone 770-393-4985. Email me. My direct email is Ginsberg@gmail.com, or of course, reach me through the SSDanswers website.

DAVID:  Make sure you check out Jonathan’s YouTube page. It’s excellent. Lots of great resources there. And I’ll make sure to link what Jonathan mentioned below in the description box.

Thank you so much for joining me today.

MR. GINSBERG: My pleasure. Good to see you.

DAVID:  Thank you.

MR. GINSBERG: Take care.

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