Understanding Social Security Disability Requirements
If you are disabled and can no longer work, you may be entitled to disability benefits under the federal Social Security Act. There are two different disability programs coordinated by the Social Security Administration (SSA):
- Social Security Disability InsuranceThis functions like an insurance plan. A worker must have paid social security taxes in order to be “insured,” just like paying the premiums for a private insurance policy. These are the payroll taxes known as “FICA taxes.” The amount of benefits you can receive is determined by your work history and the contributions (payments) you have made.After stopping work (and stopping paying social security taxes), there will come a time when insured status will lapse, just like with a private insurance policy.
- Supplemental Security Income (SSI)In contrast, SSI is a federal welfare program that pays monthly benefits. You do not need to have worked to be entitled to SSI. Read more about the SSI disability requirements here.
As you will see below, applying for and winning Social Security Disability benefits is a complex, lengthy process. Good lawyering can go a long way towards helping the good and honest taxpayers get the disability payments that they deserve and have paid for through their years of payroll deductions.
How Do You Qualify for Social Security Disability Benefits?
First, you must meet the “Non-Disability Requirements.” This means that as a worker,
- You have contributed to the program (by paying social security taxes) over a sufficiently long period to be “fully insured.”
- You have contributed to the program recently enough to have “disability insured status.”
Contributions are counted in “quarters of coverage,” or QC, and minimum earning requirements apply. To be fully insured, you must have one QC for every calendar year after the year in which you turned 21, up to the calendar year before becoming disabled.
The rule for disability insured status if you are over 31 years old is that you must have 20 quarters of coverage out of the 40 calendar quarters before you become disabled. Significant work in five years out of the last 10 years usually satisfies this requirement.
If you are disabled before age 31, there is a reduced QC requirement.
Second, you must meet the “Disability Requirements.”
This means you must be determined “disabled” under the specific requirements of the Social Security Administration (SSA). The SSA has a strict definition of the term disability. This definition includes both the medical and vocational components that you must meet in order to qualify.
- Social Security Disability Requirements – Medical ComponentsThe Social Security Act defines the term disability as the:”inability to engage in 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.” 42 U.S.C. § 423(d)(1)(A).
- Social Security Disability Requirements – Vocational ComponentsThe Social Security Act states that a claimant will be found disabled only if his impairment or impairments:”are of such severity that he is not only unable to do his previous work but cannot, considering his age, education and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.” 42 U.S.C. § 423(d)(2)(A).
The Social Security Administration then follows a rigorous 5-step evaluation process using these medical and vocational guidelines to determine whether you are disabled.
This 5-step evaluation asks questions in a specific order until a question is answered affirmatively or negatively in such a way that a decision can be made that you are either disabled or not disabled, and therefore entitled to benefits under Social Security Disability Insurance, or Supplemental Security Income (SSI)
How Do You File A Social Security Disability Claim?
Anyone wishing to file for disability benefits can do so at any local social security office, by telephone, or over the internet. It is our experience that filing in person is best. The initial application begins with what is known as the “administrative review process.”
Qualifying for these benefits is not easy, and many claims are denied. This is because the social security regulations are complex, and most people – including many attorneys – don’t fully understand the extent of proof required by the Social Security and SSI disability programs.
SSA Denied Your Disability Claim – Now What?
You must never give up. If you have been unfairly denied disability benefits, ask a lawyer who is Board Certified in Social Security Disability Law to help.
Winning your case takes an organized effort and understanding of Social Security Disability law and procedures. Claimants with representation from a qualified disability attorney have a better chance of approval. Call us today for a free case evaluation. 800-562-9830
Next, find out what it takes to appeal your disability claim.