Social Security Disability is different from retirement in that age has nothing to do with qualifying for disability benefits. Social Security Disability benefits require you to meet certain technical factors along with meeting Social Security’s definition of disability. There are two types of disability benefits, both having different technical requirements. The first program is for Social Security Disability Insurance or SSDI. SSDI is a program based upon the length of time you have worked and the amount you have paid in Social Security taxes. The general rule is that you will qualify for SSDI coverage if you have worked the past 5 out of 10 years, paying Social Security taxes. This program is a type of federally regulated insurance. You will have the coverage as long as you have paid enough in taxes. The coverage will only last for a certain amount of time. Generally, you will have this insurance coverage for approximately 5 years from the time you stop paying Social Security taxes. This simply means you will need to prove your disability began prior to your insurance coverage expiring. The monthly benefits you may be eligible for are solely dependent upon the amount you have paid in taxes over the years.
The second disability program is Supplemental Security Income or SSI. SSI differs from SSDI in that this is a needs-based program. This program does not consider the amount you have paid in taxes previously. It only looks at your current financial situation. This benefit is maxed out at $733 per month and is reduced by any income or assistance you may receive. For example, if a family member is paying your rent then Social Security will reduce your SSI monthly amount by the amount of rent your family is covering.
The second prong to qualifying for Social Security disability is meeting Social Security’s disability definition. SSA defines disability as the inability to engage in substantial gainful activity due to a physical or mental condition that is expected to result in death or can be expected to last for 12 months. Both the SSDI and SSI program requires the individual to meet the same medical requirements.
So how does an individual meet the medical requirements for disability? SSA evaluates your claim using a five-step process. The first step is determining whether you are engaging in substantial gainful activity. If you are earning more than a certain amount per month your claim analysis will stop right there and you will be denied disability benefits. SGA changes every year. In 2016, the SGA amount is $1,130. Meaning, if you gross over $1,130 per month you will be found not disabled. The second step in your disability determination is whether you suffer from a severe impairment. This requirement is fairly lax. As long as you suffer from a condition that can be deemed to have more than a minimal impact upon your ability to work you will pass this second step. Step 3 considers whether you meet one of Social Security’s Listings. The Listings are conditions that SSA deems severe enough to prevent an individual from engaging in substantial gainful activity. To show you meet a listing the medical evidence must meet all of the criteria and also show that your condition is expected to last for at least 12 months. If SSA determines you do not meet a Listing then they will consider Step 4 which is whether you are able to perform your past relevant work. Past relevant work is any work you have performed in the past 15 years, which lasted for at least 2 months and you earned SGA. To determine whether you are able to do your past relevant work, SSA considers your maximum functional ability despite your physical and/or psychological impairments. If SSA determines based on your conditions that you are able to perform past relevant work at Step 4 then you will be denied disability benefits. However, if SSA finds you are not able to perform past relevant work then they will consider if you are able to perform any other type of work in the national economy, which is Step 5. This is the final step in the medical evaluation process for disability. If SSA finds you are not able to perform any other type of work you will be found disabled. However, if there are jobs out there that SSA feels you may be able to perform you will be denied benefits.
As you can tell, the disability program is significantly different from the retirement and Medicare program. There are several steps in the process both for the technical aspect and the medical aspect of the evaluation. If you are unable to work due to a physical and/or mental condition you should contact a Social Security disability attorney for help applying. Trying to navigate the social security system alone is a risky venture. If you call me at the LaBovick Law Group we will provide you with a free consultation to help determine if this is the right program for you.
[1] One little-known fact is that you are able to collect early retirement benefits in conjunction with social security disability benefits. If you retire at age 62 due to a physical or mental condition you should look into applying for disability benefits as well as early retirement benefits.
