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Top Questions

Who is PCG Human Services?

PCG Human Services staff has nearly 25 years experience and is considered a national leader in SSI/SSDI screening, application processing, tracking and post award advocacy services.  PCG Human Services is a practice area of Public Consulting Group (PCG) a consulting and management firm founded in 1986 and headquartered in Boston.

Why would I need a representative to file a Social Security Disability application?

Social Security disability is a very complex and complicated program that requires a lot of paperwork and understanding of the process. PCG Human Services assists individuals at all levels of adjudication starting at the initial application, we will be able to walk you through each process and explain all correspondence received from SSA as well assist with all forms required for appeals. Below is a breakout of SSA’s published approval rates compared to PCG Human Services.  By selecting our team of experts you are getting a knowledge base that significantly increases your chances in achieving the best outcome with relation to your disability application.

Allowance rates

Initial

Hearing

SSA    WWW.SSA.gov

29%

69%

PCG Human Services

65%

85%

 

What is the definition of disability?

a. For all individuals applying for disability benefits under Title II (SSDI), and for adults under the age of 65 applying under Title XVI (SSI) of the Social Security Act, the definition of disability is the same. The law defines disability as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 month. http://www.socialsecurity.gov/redbook/eng/overview-disability.htm#5

The definition of disability in children is as follows:  An individual under the age of 18 shall be considered disabled for the purposes of this subchapter if that individual has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. (42 USC 1382c(a)(3)(C)(i)

What are the differences between SSI and SSDI benefits?

The Social Security Administration (SSA) is a federal agency that administers the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs. While the medical and functional criteria used to find a person eligible for these programs is the same, there are some basic differences that you should be aware of, which have been outlined for you below:

Social Security Disability Income (SSDI)

Supplemental Security Income (SSI)

  • Provides for payment of disability or retirement benefits to individuals who are eligible due to earning work credits.
  • These credits are earned when an individual’s wages are posted to Social Security records.
  • Provides for payment to certain dependents. This is called auxiliary or survivor’s benefits and can be payable to a spouse or child of a deceased, disabled or retired wage earner’s account.
  • Provides payment to disabled widows who meet specific criteria.
  • Your wages determine the amount of your SSDI benefits.
  • Provides payments to people who are disabled and have limited income/resources in the following categories:
    • Individuals (including children under age 18)
    • Aged individuals over the age of 65 (disability not required)
  • There are no work credits needed to be eligible for this program
  • The Federal Benefit Rate (FBR) for most individual SSI recipients in 2010 is $674/mo. Your other income may offset these payments.

Will PCG Human Services improve my chances of receiving a favorable decision sooner?

Yes. Having PCG Human Services represent you will help your chances of receiving a favorable decision sooner.  PCG Human Services represents individuals at all levels of adjudication with a strong focus at the initial level.  We strive to get all our cases allowed faster by working closely with SSA and the Disability Determinations Services (DDS) to ensure your claim is being reviewed timely and appropriately. PCG Human Services has been extremely successful at the initial level with an overall allowance rate of 65 % compared to SSA’s 29%. Even with this focus however, some cases will end up at the hearing level. PCG Human Services’s success rate at the hearing level is 85% compared to SSA’s success rate of 69%. 

What can I expect the hearing to be like?

These hearings are fairly informal. You will go to the Office of Adjudication and Review (ODAR) on the date of your hearing. The only people in the room with you will be your representative, the Administrative Law Judge, the Judge’s clerk and sometimes a medical and/or vocational expert.  Social Security does not have an attorney there working to oppose your claim.  PCG Human Services has over 20 years of experience representing clients at the hearing level.   PCG Human Services’s representatives and development staff will work with you to ensure you are prepared for the hearing. 

Will someone be at the hearing with me?

Yes! PCG Human Services will have an experienced representative at the hearing with you who are thoroughly knowledgeable of your individual claim.

What happens if I receive an unfavorable decision after my hearing?

PCG Human Services will review your hearing decision and decide if there was an error of law in the decision issued after your hearing.  Once the review process is complete, PCG Human Services will discuss the outcome with you and if an appeal is warranted will file the form, SSA 520 on your behalf to ensure a timely appeal is receive at SSA and the Appeals Council.  If the Appeals Council agrees that there was an error in law in your hearing decision they will remand your claim back to the Administrative Law Judge and you will potentially have the opportunity to present your case at another hearing.

Can I earn income while I’m applying?

Yes.  However there are some specific criteria you need to follow.  Social Security puts a limit on the amount of money you can earn from Substantial Gainful Activity (SGA).  The SGA amount for individuals with disabilities other than blindness is $1000.00 in 2010.  The SGA amount for individuals who are blind is $1640.00 in 2010.   SSA also has programs in place for a person who is already receiving disability called Trial Work Programs.  These programs allow individuals to test out their ability to work without a cap on earnings.  These are very specific to each individual and can be discussed further with your representative after a favorable decision has been issued.

How soon will I be eligible for Medicare?

SSA will automatically enroll you in Medicare after you receive disability benefits for two years.  SSA starts counting the 24 months from the month you were entitled to receive Disability, not the month when you received your first check.

The exception to this rule is for individuals with permanent Kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease).  These individuals will receive Medicare beginning with the month they become entitled to disability benefits. 

Is it necessary for my representative and I to be located in the same state or location?

No. PCG Human Services currently represents individuals all across the United States from one central processing center.  Because the application process is filed on-line and documentation is typically mailed or sent through a Electronic Records Express (ERE) all communication with our clients can easily be done over the phone. At PCG Human Services our clients are the priority.  We remain in close contact with our clients on a regular basis giving them access to their own personal advocate

The exception to this rule is if it is necessary to attend a hearing.  In the event your claim proceeds to a hearing PCG Human Services will always provide a Hearings Representative to attend the hearing with as your advocate.

What are the different levels of the SSA Adjudication process?

The Social Security application process has four levels of adjudication. You can be allowed for disability benefits at any level. The levels are the initial application, reconsideration, hearing and appeals council. The reconsideration level is not available in all states. PCG Human Services is able to assist you at all levels of your application process.

What is the average length of time from when my hearing is filed to when my hearing is actually scheduled, and what can I expect from PCG Human Services during that time?

This depends on which ODAR you are assigned to based on your geographical location. On average somewhere between 18-24 months. There is a large backlog within Social Security right now. It is not uncommon to wait the full 18-24 months before having a hearing scheduled. PCG Human Services will contact you every 3 months at a minimum to verify your doctors and medications and update the medical records in your file. We continue to gather all the medical records needed to fully develop your case up through the date of your hearing.  In addition we ask our client to update us with any changes or additions to your medical conditions.