The onset of permanent disability, often frightening in its own right, can be devastating economically and can bring about the end of or substantially interrupt one's working life. Social Security disability insurance, which is managed by the Social Security Administration, is designed to provide lifelong financial support to workers who become disabled, provided that they are eligible.
SSDI and the Determination of Permanent Disability
Social Security disability insurance provides income for eligible workers with significant disabilities. For the purposes of SSDI coverage, a disability is defined as "the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment 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."
Meeting this test requires that the impairment be severe enough not only to preclude returning to past work but also to prevent the worker from undertaking any substantial gainful work available in the national economy. SSA publishes a threshold earnings amount that it considers evidence that employment is gainful and for 2009 the amount was $980 or more per month. "Make work," or work that requires little effort and contributes little or nothing to the employer, is not considered substantial gainful employment.
Whether an injured worker's SSDI claim is successful often turns on complicated questions about the nature of his or her injury. The SSA publishes a list of severe impairments that automatically meet the definition of "severe impairment." The SSA relies on a residual functional capacity test to determine the severity of impairment for disabilities that do not automatically qualify the applicant for benefits.
SSDI Earnings Test
SSDI benefits are available to eligible workers who have earned sufficient wages in employment covered by Social Security. SSA first considers the worker's recent work history based on age. If the onset of disability occurred before age 24, the worker must have accumulated one and a half years of work during the three-year period ending in the quarter the disability began. For workers becoming disabled between 24 and 31, the worker is required to demonstrate that he worked half of the time from the date he turned 21 until the quarter he became disabled. Workers becoming disabled at age 31 or older must have worked five of the 10 years preceding the quarter in which the disability began.
The duration of work test sets forth an additional requirement based on the worker's lifetime work history. The worker must show that he meets the minimum lifetime work requirements based on his age at the onset of disability. Those requirements range from one and a half years of work for workers becoming disabled prior to age 28 to nine and a half years for workers becoming disabled at age 60.
Claim for Supplemental Security Income (SSI)
For those individuals who do not have the required work credits to be eligible for SSD, the Social Security Administration has another program called Supplemental Security Income. The disability standards for SSI are the same as they are for SSD. However, while SSD is paid based upon an individuals own work record, SSI benefits are not. As a result of this there is a MEANS test for determining whether or not an individual has a limited amount of assets that would allow the payment of SSI. The dollar amount on the SSI can vary from year to year. An individual can check with their local Social Security office to determine what the value of asset level is for the current year. If the total assets of the claimant are below that level then the income eligibility step has been met.
Filing and Supporting an SSDI or an SSI Claim
SSA requires an SSDI or SSI applicant to fill out an application for Social Security benefits. Social Security benefits, a disability report, releases to allow doctors and hospitals who treat the disabled individual to provide information on his or her medical condition to SSA and a form describing the disability and how it affects the applicant's ability to work. There is a five full month waiting period from the time an individual becomes disabled until the time benefits can be collected. In those cases where there is a possibility of improvement we recommend that individuals wait and file approximately four months after the disability begins. That will give SSA a better picture of the likelihood that the condition will last for the 12 month requirement alluded to above. For those conditions that are severe and that clearly will not improve and where there is no question about the disability of the individual then those claims should be filed immediately. That will not eliminate the waiting period but there would then be an assurance that benefits would start at the sixth month. The applicant will be notified by mail of eligibility or ineligibility for SSDI and/or SSI generally within 120 days after filing the request for benefits. If the claim is denied the individual has 60 days in which to file a request for a hearing in front of a Federal Administrative Law Judge. No individual should appear before the Administrative Law Judge without representation by counsel.
Know Your Rights
Applying for and receiving the benefits you deserve is not always easy. An attorney experienced in SSDI or SSI can help you navigate the complex process and can make sure that your interests are represented if problems arise. If you or someone you love has questions about SSDI or SSI, contact our office today.