Many of the injured workers we represent eventually reach a point where the workers’ comp case is not enough. The injury that started as a temporary disability never fully resolves. Returning to the old job is not realistic. The light-duty work the employer offered cannot be sustained over the long term. At that point, the question becomes whether the worker qualifies for Social Security Disability — and the answer requires careful work in a federal program that operates very differently from Minnesota workers’ comp.
At Schoep & McCashin, Chtd., we help injured workers and other disabled adults in Alexandria and Douglas County apply for and pursue Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits.
Two Programs, Two Eligibility Standards
The Social Security Administration runs two parallel disability programs that get confused regularly. SSDI is funded by payroll taxes and pays benefits to workers who have worked recently enough and long enough to be “insured” under the program. Benefit amounts come from the worker’s earnings history. Eligibility requires sufficient work credits — generally meaning meaningful work activity within the recent past, with the specific requirements tightening for workers who have not worked in some time.
SSI is a needs-based program funded by general revenue. It pays a lower benefit amount to disabled adults whose income and assets fall below specified limits, regardless of work history. SSI gets reduced by other income the recipient receives, and the asset limits are strict.
The medical standard for disability is the same in both programs. The financial eligibility is what differs. Many of our clients qualify for one program. Some qualify for both — concurrent claims — where the analysis of which to apply for and how to optimize benefits is more nuanced than it first appears.
The Five-Step Process
Social Security uses a structured sequential evaluation to decide whether a claimant is disabled. Each step is a checkpoint, and the analysis stops as soon as the agency reaches a determination.
The first checkpoint looks at whether the claimant is currently working at substantial gainful activity — measured by monthly earnings above a specified threshold. Working above the threshold ends the inquiry with a denial regardless of medical condition.
The second checkpoint asks whether the claimant has a severe medically determinable impairment expected to last twelve months or longer.
The third checkpoint compares the claimant’s condition to the SSA’s Listing of Impairments. Conditions that meet a specific listing get approved at this step without further analysis.
The fourth checkpoint asks whether the claimant can still perform any of their past relevant work — the jobs they have held within the past fifteen years.
The fifth and final checkpoint asks whether the claimant can perform other work that exists in significant numbers in the national economy, considering age, education, work history, and remaining functional capacity. This step uses the medical-vocational guidelines — the “grids” — which produce more favorable outcomes for older workers with limited education and physically demanding job histories.
Most denials come at steps four and five. The agency is not arguing the worker is healthy. It is arguing the worker, despite their problems, could still do some kind of work.
Why Comp Cases and SSDI Cases Connect
Many Minnesota injured workers end up applying for SSDI when the comp injury prevents them from returning to gainful employment. The two programs interact in important ways. SSDI benefits may be reduced by workers’ comp payments under the offset rule in 42 U.S.C. § 424a. The combined monthly benefit is capped at 80 percent of the worker’s pre-disability earnings. Structuring a workers’ comp settlement to minimize the SSDI offset is a real planning issue — one we address when our clients have both cases pending at the same time.
Services We Provide
Our SSDI practice supports clients with:
- Initial SSDI and SSI applications
- Requests for reconsideration after initial denial
- Hearings before Administrative Law Judges at the Minneapolis or Fargo hearing offices serving
- Alexandria claimants
- Appeals Council review
- Federal court appeals when administrative remedies are exhausted
- Medical record development and treating-physician statements
- Vocational expert cross-examination at hearings
- Concurrent SSDI and SSI claims
- Coordination with workers’ comp settlements to minimize SSDI offset
- Continuing Disability Reviews
- Overpayment notices and appeals
- Auxiliary benefits for eligible spouses and children
Initial Denial Is Not the End
Most initial SSDI claims get denied — typically about two-thirds nationally. Reconsideration produces additional denials. The hearing level is where most legitimate claims actually get approved, because the claimant testifies before an Administrative Law Judge who reviews the complete record and assesses credibility. Approval rates at the hearing stage are substantially higher than at the initial application level, and represented claimants outperform unrepresented ones at every stage.
How We Approach the Work
SSDI representation runs on contingency. Federal law caps attorney’s fees at a percentage of past-due benefits, with a statutory maximum dollar amount, and fees come from back benefits when the claim is approved. The client pays nothing out of pocket. We develop the medical record with treating providers, prepare the client for hearing testimony, and present the case in the way the administrative law judge can actually decide in the claimant’s favor.
Contact Schoep & McCashin
If you cannot work because of an injury or illness — including an injury that started as a workers’ comp case — contact Schoep & McCashin for a free consultation about Social Security Disability. We have represented injured workers and disabled clients in Alexandria and west-central Minnesota since 1998.