SSDI

Social Security Disability claims are evaluated using a Five-Step Sequential Evaluation process defined in the Code of Federal Regulations. In part 2 of our six-part blog series, we gave an overview of Step 1 of the Sequential Evaluation Process used by the Social Security Administration in determining eligibility for benefits under the Social Security Act. At Step 1, the SSA determines whether a claimant is working at the Substantial Gainful Activity level. Today we review step 2 of the process – Determining whether the claimant has a severe impairment?

Social Security Disability benefits can be paid retroactively up to 12 months prior to a claimant’s application date if all requirements are met. SSI benefits however are not retroactively paid before the date of the application; in other words, there is no retroactive effect of an SSI application.

For SSI applications there is an effective waiting period until the first of the next month after all requirements are met before benefits begin. For social security disability there is a five month waiting period after the onset date, the date disability began, during which no social security disability benefits are payable. Because only full months are counted, the actual waiting period is nearly always more than five months. Only when a person becomes disabled on the first day of the month is the waiting period exactly five months.

Social Security Disability Insurance Eligibility Requirements-Quarters of Coverage

The social security program for workers functions like an insurance plan. There are requirements that a claimant for disability insurance must have: 1) Contributed to the program (paid social security taxes) over a sufficiently long period to be fully insured and 2) Contributed to the program recently enough to have disability insured status. In short, a worker must have paid social security taxes in order to be insured, just like paying the premiums for a private insurance policy. After stopping work (and therefore no longer paying social security taxes), there will come a time when the claimant’s insured status will lapse, just like with a private insurance policy.