Legal Term Glossary
Sometimes the legal world can get confusing with all it’s words, so we put together this list of definitions to help keep you up to speed.
Activities of Daily Living
Your ADL includes everything you would normally do in a day, such as showering, dressing, using the bathroom, cooking meals, and simply getting around. If you are unable to do some or all of these things on your own, your disability claim may have a higher chance of being accepted. If you are not able to perform ADL, you likely cannot be gainfully employed.
Administrative Law Judge
This judge looks at claims and disputes. They preside over bench trials where there is no jury. If you request a hearing and go before a judge for your SSDI claim, this judge will hear the facts from both sides and make a decision based on those facts and the law. You can appeal that decision if it does not come out in your favor.
Alleged Onset Date
The date that your disability first occurred. This date should not be arbitrary, so the more information you have to prove and back up your claim, the better your chances of receiving disability payments (SSDI). The “onset” of a disability is when it first occurred, and/or when it was first noticed in such a way as to affect your life, ability to work, and activities of daily living.
The Appeals Council of the SSA will look at your claim for disability if you apply, are denied, and choose to appeal the decision. Most people get denied at least once, especially if they file on their own without the help of an attorney. Once you are denied even once, your subsequent attempts for disability will go to the Appeals Council to make a decision on your case.
This is how long it may take for your disability claim to be approved. The timeline can vary depending on the claim you are making, the information you provide, and the other cases that are currently under consideration. A high volume of cases can slow your approval timeline down, simply because of the level of activity at the SSA during that time.
When you are approved for your disability claim, your pay will be retroactive, meaning it will go back to your disability onset date. That back pay often comes as a lump sum in addition to the monthly payments you will be receiving. It can take months to receive your back pay, and it is important to make sure you follow up on your claim and that the pay you receive is correct.
When you have a temporary disability, you may be eligible for benefits during that time only. That is the closed period of benefits, and you will not be able to receive those benefits after the end date, unless you become disabled again. Having a temporary disability does not necessarily make you ineligible for any benefits, so working with your attorney is important.
This exam is done to help verify the information you make in your claim. It is done by a doctor approved by the SSA, and can help you get your claim put through properly. This doctor can certify that the information you are giving about your claim is true, and that the disability you are experiencing is legitimate and significant, keeping you from being able to work and seek out gainful employment.
Date Last Insured
The last date you were insured matters, as many people lose their health insurance if they are disabled and cannot work. That can lead them into serious financial problems because they cannot pay their medical bills properly. Without insurance they may also have to go without care they need, which can make their disability and other medical conditions worse.
Date Last Worked
The last date the person was employed matters for a disability claim. This may coincide with the onset of the disability, and can show that the disabled person is not able to work in the job and field they previously worked in. Additionally, this may show why there is a need for disability payments to begin quickly, if the person has not worked for a long time and appeals have continued.
Dire Need Letter
A dire need letter is provided when the benefits need to begin quickly for a significant reason. This could be the impending loss of a house, medical bills, court proceedings, child support, or nearly anything that must be paid and that failure to pay would turn into a serious hardship. Claiming a dire need must be done correctly, though, in order to ensure the highest chance of being accepted.
Disability Determination Services
These are state agencies that are part of the SSA network. They will carefully look over a claim and determine whether they believe it should be allowed or denied. They are the first step in getting a claim processed and paid. If they deny the claim, you can appeal it and have it heard again, so you have a higher chance of having it accepted. Often, more information will be required for an appeal.
Disability Insurance Benefits
These are the actual benefits that are paid to you when you have disability insurance and a provable disability. How much will be paid to you depends on the type of insurance you have, the disability you have, and whether that disability is a temporary condition or likely to be permanent. There are a number of companies that provide disability insurance that can be purchased like other forms of insurance.
District Office (DO)
The district office is the SSA office that serves your particular area. Information about your claim may have to be taken or mailed there in order to begin or continue the processing of that claim. By working with your district office you may be able to move the process along faster, since information does not need to travel as far to be received by the SSA for processing to begin.
Federal District Court
If your appeals case works its way through the SSA without satisfaction, you may need to go further to get your benefits. Having your case heard in Federal District Court is the most logical step. That can ensure that everything involved in your disability case comes to light before a judge, so you can work toward receiving the benefits you need and deserve.
Grids are rules used by the SSA, and based on age, activity level, and other factors, to help determine your eligibility to receive disability benefits. If you are not able to perform your past job, cannot even do sedentary work, or are in an older age group, you may be more likely to have your claim approved. These rules are used to make a determination on your claim, but that does not mean you cannot appeal if you are denied.
Each time you ask that your claim be reconsidered or you appeal it, you will have another hearing. That hearing may be moved up the chain of command, depending on what type of claim you are making and the information you have provided to prove your claim. There are many options for hearings, and continuing your appeals may be the only way to get your claim to go through so your benefits can begin.
There are specific impairments and disabilities that are considered temporary or permanent. There are also some that are not considered acceptable for a disability claim. The listing of all disabilities and impairmhearients can help you determine whether you have a claim, and your chances of being approved. Your attorney can advise you on whether your claim should go forward based on the listed impairments.
Medical denials come when the SSA rules that your medical condition is not sufficient for you to be on disability and receive payments. If you are medically denied, you may be able to appeal. One of the ways you can strengthen your appeal is by providing more evidence as to the severity of your condition. Your doctor may be able to help you provide this.
Medical experts are often called in on appeal cases and hearings, in order to show whether the person making the claim is disabled to the point that they cannot be gainfully employed. These experts can be used by the SSA and by you and your attorney. Having an expert testify for you is not a guarantee of approval, but it may help your case move forward.
Office of Disability Adjudication and Review (ODAR)
This used to be called the Social Security Hearings Office, and is where most of the claims and appeals will ultimately be decided. Your case will be considered and examined, and from that point your claim or appeal will either be approved or denied. You may have to go through the procedure more than once to get a claim approved.
On the Record
When something is on the record, it means it is part of the case. Speaking “off the record” keeps that information from becoming part of the case and the knowledge that belongs to your claim or appeal. Everything about your case should be on the record, so you have transparency and honesty in dealing with the SSA and working toward getting your claim approved.
Many SSDI claims are denied the first time, whether you apply on your own or through an attorney. You will be told the reason for the denial, and then you will want the government to reconsider, so they can approve your benefits. You may have to work with your attorney and the government for some time to get your claim processed.
SSDI attorneys are limited in how much of a fee they can collect from their clients. If you receive back pay, or past-due benefits, your attorney may collect up to 25% of these benefits, with a maximum amount of $6,000. They are not allowed to take any more than that, or any of your current benefits, no matter how much those amount to.
Request for Hearing
A request for a hearing is made most often in cases of appeal, so you can have a decision made regarding whether you will receive disability benefits. If you believe you are being unfairly denied, or that your case is not being addressed properly, requesting a hearing may bring everything to light and help the SSA reach a satisfactory decision based on all the information you and your attorney can present.
Substantial Gainful Activity
This is basically the same as employment. There is a set amount a person can earn every month while on SSDI, and if they earn more than that they are considered to be involved in substantial gainful activity. They could lose their benefits at that point, since they are able to work. If you work at a job and are trying to get on SSDI, you will most likely be denied.
Supplemental Security Income
SSI is paid by the government to people who are low-income, and who are blind, disabled, or over the age of 65. While it is paid through the Social Security Administration, the funds actually come from the US Treasury and not the trust fund that makes up Social Security. If you are not low-income, you generally do not qualify for SSI payments, even if you have a disability.
A technical denial occurs when your claim is denied, but that is not based on your disability or medical condition. Instead, this denial may come from incorrect paperwork, income restrictions, the fact that you have a job, or other factors that are unrelated to the physical or mental health condition that has led you to make a disability claim.
Trial Work Period
A trial work period is one in which you are employed in order to determine if you are capable of working with your disability. With accommodations, many people who have disabilities can still work and be gainfully employed. If you are not able to do this, you may still have a claim for disability from the SSA.
A vocational expert is a person who can help you find the kind of job you can do with your disability, and who can also testify about why you can or cannot perform that job. Additionally, they may be able to work with you to determine if there is any job you can realistically perform based on your medical condition, and help you with a satisfactory claim if you are truly unable to work.
Every time you work and make money, you pay into Social Security. You also receive work credits that count toward your SS payment in retirement. These credits also count toward SSDI if you become disabled and cannot work for any reason. The more work credits you have, the more money you will be eligible for as a disability payment or in retirement.