Applying for Disability Benefits Under Social Security

The degree to which Blepharospasm is disabling varies, of course, with the individual. But some persons are so impaired by Blepharospasm or other dystonias that they are unable to work and may qualify for special disability benefits under the Social Security program.

The Benign Essential Blepharospasm Research Foundation frequently receives inquiries about disability benefits from persons afflicted with Blepharospasm, Meige or Hemifacial Spasm. Many Blefros have succeeded in getting Social Security disability benefits.

The Foundation has assembled a packet of material that can help the impaired or disabled Blefro pursue additional benefits as efficiently as possible through the proper channels.

As you will learn from reading the booklets in the packet, Social Security pays disability benefits under two programs: the Social Security Disability Insurance program (SSDI) and the Supplemental Security Income (SSI) program.

The medical requirements for disability payments are the same under both programs, and a person's disability is determined by the same process. While eligibility for Social Security disability (SSDI) is based on prior work under Social Security, SSI disability payments are made on the basis of financial need.

The following has been drawn from remarks by Attorney Andrew Kline of Minneapolis at the 1994 BEBRF conference and from a recent article by Attorney Warren H. Gould of Ft. Worth, TX, in the publication of the National Organization of Rare Disorders (NORD).

Application

The initial step in learning whether you qualify for disability payments is to call (800) 772-1213 or visit your local Social Security Administration office to obtain the proper forms to fill in and return.

It is important to base your answers on your disability, not what you think you can do or what you wish you could do. Be realistic. You also will be asked to sign medical authorizations so that Social Security can obtain medical records from your physicians.

When an application is filed, Social Security evaluates a claim in this sequence:

  1. Are you working? Generally, if you are working (achieving "substantial gainful activity"), you are not entitled to benefits.

  2. Do you have a severe impairment? You must also prove that your impairment is expected to last for 12 months or longer.

  3. Are you disabled according to Social Security=s Listing of Impairments(found in most libraries, in the Code of Federal Regulations at 20 CFR404). At this level, your diagnosis becomes important, and your medical records supporting your doctor's opinions become critical. Your doctor will have to explain your symptoms in a letter to the Social Security Administration.

  4. Can you do your past relevant work? Social security considers work you have performed during the 15 years prior to your disability and will determine whether your diagnosed medical condition prevents you from returning to that work. If you can return to that work, you are not disabled. If not, the fifth step is applied.

  5. Given your age, education, work experience and residual functional capacity, are there jobs which exist in the national economy which you can do? This is the basis for denial of most cases.

You are entitled to legal representation at any stage of the Social Security process. Fees charged by your lawyer must be approved by Social Security. Most lawyers will take a case on a contingent-fee basis (lawyer gets paid only if benefits are awarded). The fee usually is 25 percent of retroactive (past due) benefits which you should have been paid but were not. Past due benefits can go back only one year.

Appeal for Reconsideration

If you are unsuccessful in your initial application, as is very likely, you may appeal within 60 days to the reconsideration level where your claim is reviewed.

Hearing by Administrative Law Judge

If your appeal is denied, the next review step is to apply for a hearing before an administrative law judge who has the right to review and reverse earlier determinations. A vocational expert and a medical advisor (probably a neurologist or ophthalmologist) will be present for this hearing. Both are impartial and are there to state what a BEB patient can or cannot do. If the case is properly prepared, a disabled claimant stands an excellent chance of being awarded benefits at that level.

Appeals Council

If you are denied after the hearing, file an appeal (in the form of a letter) with the Appeals Council. This appeal usually results in a denial.

Federal Court System

Finally, you may pursue your case through the Federal Court System. You must have an attorney at this level. This is an adversarial situation, and an attorney will be opposing you.

Remember, don't give up! It can be a long and frustrating process. It might take six to eight months to get a hearing, and more than a year can elapse before you get a determination. In the initial process, each determination takes 60 to 90 days.

It's also important to tell the Social Security examiners if you have developed depression, anxiety, or other emotional problems as a result of your ophthalmological or neurological condition. Social Security is required to consider you as a total person.

For a list of attorneys who specialize in Social Security appeals, write: National organization of Social Security Claimants' Representatives, 19 East Central Avenue, Pearl River, NY 10965, or phone (800) 431-2804.

At some point in the process of applying for disability benefits, Social Security probably will ask for a professional description of your affliction -- Blepharospasm, Meige, etc. Your doctor probably can prepare this explanation, or either of you may request from the BEBRF in Beaumont, TX a reprint of one or more articles prepared for the Foundation's newsletter by eminent specialists in movement disorders. The Foundation's address is:

BEBRF
P.O. Box 12468
Beaumont, TX   77726-2468
Phone:(409) 832-0788
Fax:(409) 832-0890
E-mail: bebrf@blepharospasm.org

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