Social Security Disability insurance is a program administered by the federal government and funded through payroll tax revenues that pay benefits to those who have worked and paid taxes on their earnings for the past 10 of 15 years and are unable to work due to a long-term medical condition. The condition must last or be expected to last for at least one year or result in death. If you are having difficulty performing normal work activities due to a long-term medical condition, you may be eligible for Social Security Disability benefits.
Many people who may be eligible for benefits wonder when the right time to apply would be. First, to qualify, one must not be engaging in any work activity that rises to “substantial gainful activity” levels. Substantial gainful activity levels are gross income thresholds that are calculated on an annual basis by Social Security. For 2022, the substantial gainful activity threshold is $1350 per month in gross (not take home) earnings. Therefore, if you are able to continue working enough to earn at least $1350 per month in gross pay, you would not be eligible for benefits, even if you needed to reduce your hours or modify your job duties due to your condition. The time to apply for benefits would be when you need to stop working or reduce your income significantly under substantial gainful activity levels due to symptoms or treatment related to your medical condition.
It is also important to note Social Security’s definition of a “severe impairment” when determining the right time to apply for disability benefits, and whether Social Security Disability benefits are the right option for your situation. As previously stated, to qualify, the medical condition must be one that lasts or is expected to last for at least one year or result in death. This does not mean that you must wait one year after you have stopped working due to your condition to apply. One way to determine whether your condition would meet the durational requirement is to ask your doctor what your prognosis is. If you had major surgery but are expected to resume normal functioning in a few months, then it would be best to pursue any form of short-term disability plan that may be available to your through your employer or other means. However, if your doctor states that your condition will not get better within a year, then Social Security Disability benefits would be appropriate. You may also consider any treatment that is required for your condition. For example, if you are receiving infusion treatments that cause you to miss work several times a month and would not be able to maintain your job due to absences, then Social Security disability benefits may be available if the treatment regimen is necessary on a long term basis. If you have several surgeries planned over the course of a year which require significant recovery time, this would meet the durational requirement as well.
If your condition improves enough that you are able to go back to work, but has lasted for at least one year, Social Security may not continue to pay you benefits on an ongoing basis. You may have to demonstrate that you are receiving accommodations from your employer for your condition. This may include a modified work schedule or more frequent breaks. If you are able to return to work because your employer is modifying your job duties or schedule, it is very important to have written documentation of these accommodations. You can ask your supervisor or human resources department to issue a written statement confirming your accommodations. It is also helpful to save any email correspondence related to your conditions or accommodations with your employer, which you may use as documentation confirming your accommodations. You also may consider applying for a closed period of benefits if you have successfully returned to work without accommodations but were not able to work for at least a year due to your conditions. In this instance, Social Security will pay disability benefits for the period of time when you were unable to work due to your condition (minus the required five-month waiting period).
Waiting too long to apply for benefits when you have a serious condition and have stopped working can cause significant difficulties in getting approved. It is important to know that the work credits you earn from taxes paid on earnings are not indefinite. You must prove that you became disabled before your “date last insured” expired. The date last insured is the last day of the quarter that a person meets insured status for disability. In other words, it is the last date that you are eligible to qualify for benefits. Similar to any other type of insurance policy, you must prove that your illness or injury took place prior to the date your coverage through work credits stops. For example, if your date last insured expired on December 31, 2021, you must prove through medical records that you became disabled prior to that date to remain eligible for benefits. Social Security will also not consider any changes to your condition that occurred after your date last insured. As medical records are needed to establish your date of disability, keep in mind that it can be very difficult to obtain medical records from providers after several years have passed. Therefore, it is important to apply as far in advance of your date last insured expiring as you can. Once you are approved for benefits, your date last insured will no longer be relevant and you will continue to receive benefits on an ongoing basis.
Determining the correct time to apply for Social Security Disability benefits can be complicated and is often very dependent upon the specifics of your case and your health situation. I would recommend discussing your case with a Social Security Disability attorney for further guidance on the best way to proceed. Call LaBovick Law Group at 561-625-8400 for a free case evaluation. Our expert legal team will guide you through the often-challenging Social Security Disability benefits process.
