Readers are reminded that the following information is general and should not be relied upon to determine the course of action to take in your case. Every Social Security case is different and many factors affect the answers to what appear to be simple questions. Therefore, to get answers to questions regarding your specific case, you should consult an attorney who specializes in the area of Social Security.
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Q: AM I ELGIBLE FOR SOCIAL SECURITY DISABILTY?
A: To be eligible for benefits, a person must be unable to do any kind of substantial gainful work because of a physical or mental impairment (or a combination of impairments), which is expected either to last at least 12 months, has lasted at least 12 months or to end in death.
Q: What kind of disability benefits does Social Security pay?
A: People who are severely disabled may be eligible for monthly benefits under one or more of the programs we administer. Both the Social Security Disability program and the SSI program provide a monthly income for people with severe disabilities. However, the eligibility requirements for the two programs are different.
The Social Security program pays benefits to disabled or retired workers and their families and to the families of deceased workers. To be eligible for Social Security disability benefits, you must be found disabled by the SSA and must have "insured status." Generally you will qualify if you have worked at least 5 out of the last 10 years to be considered "insured."
The SSI program provides monthly income to people who are age 65 or older, or are blind or disabled, and have limited income and financial resources. Effective January 2000, the SSI payment for an eligible individual is $512 per month and $769 per month for an eligible couple. If you are married, and only one person is eligible, a portion of your spouse's income may be counted. In addition, your financial resources (savings and assets you own) cannot exceed $2,000 ($3,000 if married). You can be eligible for SSI even if you have never worked in employment covered under Social Security.
Generally, to be eligible for SSI, an individual also must be a resident of the United States and must be a citizen or a non-citizen lawfully admitted for permanent residence. Also, some non-citizens granted a special status by the Immigration and Naturalization Service may be eligible.
Q: What is the difference between Social Security disability and SSI?
A: Social Security disability insurance is a program that workers, employers and the self-employed pay for with their Social Security taxes. You qualify for these benefits based on your work history, and the amount of your benefit is based on your earnings.
SSI is a program financed through general tax revenues-not through Social Security trust funds. SSI disability benefits are paid to people who have a disability and who don't own much or have a lot of income.
If you qualify for SS Disability you can be entitled to one year of retroactive benefits calculated from the date you apply. SSI will only pay benefits from the date you apply.
Q: What are the disability requirements for an adult?
A: The definition of disability in the Social Security law is a strict one. To be eligible for benefits, a person must be unable to do any kind of substantial gainful work because of a physical or mental impairment (or a combination of impairments), which is expected either to last at least 12 months or to end in death.
If, because of a medical condition, a person cannot do the work that they performed in the past, then age, education, and past work experience must be considered in determining whether the person can do other work. If the evidence shows that the person can do other work, even if it involves different skills or pays less than their previous work, they cannot be considered disabled for Social Security purposes.
The S.S.A. uses 5 step analysis to determine whether you will qualify as being disabled. The process includes the following five questions:
1. Are you working?
If you are and your earnings average more than $700 a month, you generally cannot be considered disabled.
2. Is your condition severe?
Your impairments must interfere with basic work-related activities for your claim to be considered.
3. Is your condition found in the list of disabling impairments?
The S.S.A. maintains a list of impairments for each of the major body systems that are so severe they automatically mean you are disabled. If your condition is not on the list, the S.S.A. will decide if your impairment is of equal severity to an impairment on the list. If it is, your claim is approved. If it is not, the S.S.A will go to the next step. It is very very difficult to meet the "listings" and therefore most cases will be decided at step 4 or 5.
4. Can you do the work you did previously?
If your condition is severe, but not at the same or equal severity as an impairment on the list, the S.S.A. must determine if it interferes with your ability to do the work you did in the last 15 years. If it does not, your claim will be denied. If it does, your claim will be considered further.
5. Can you do any other type of work? ( Substantial Gainful Activity )
If you cannot do the work you did in the last 15 years, the S.S.A looks to see if you can do any other type of work. The S.S.A. considers your age, education, past work experience, and transferable skills, and they review the job demands of occupations as determined by the Department of Labor. If you cannot do any other kind of work, your claim will be approved. If you can, your claim will be denied.
For a listing of all disabling impairments, contact your local Social Security Administration office.
Q: I receive Social Security disability benefits. Will my Social Security benefits change when I turn age 65?
A: When you turn age 65, nothing will change, except for Social Security purposes, your benefits will be called retirement benefits instead of disability benefits.
Q: How do I apply for Social Security disability benefits?
A: You can apply by calling your local Social Security Office, or calling the 800 number. A representative will schedule an appointment for you. You can apply in person or over the phone. You should apply as soon as you become disabled. However, Social Security disability benefits will not begin until the sixth full month of disability. This waiting period begins with the first full month after the date we decide your disability began. Although you do not need an attorney to complete the application, it is recommended that you contact an attorney familiar with Social Security shortly after the application is completed to assist you with the process. Many claims are denied at the Initial Determination stage, however an attorney may be able to assist you with the process to increase the change of a favorable initial determination, even before you need to go before an Administrative Law Judge.
Q: What will I need to apply?
A: The claims process for disability benefits is generally longer than for other types of Social Security benefits, from 60 to 90 days. It takes longer to obtain medical information and to assess the nature of the disability in terms of your ability to work. However, you can help shorten the process by bringing certain documents with you when you apply and by helping the S.S.A. get any other medical evidence you need to show you are disabled. Helpful documents include the following:
your Social Security number;
your birth certificate or other evidence of your date of birth;
your military discharge papers, if you were in the military service;
your spouse's birth certificate and Social Security number if he or she is applying for benefits;
your children's birth certificates and Social Security numbers if they are applying for benefits;
your checking or savings account information, so your benefits can be directly deposited;
names, addresses, and phone numbers of doctors, hospitals, clinics, and institutions that treated you and dates of treatment;
names of all medications you are taking;
medical records from your doctors, therapists, hospitals, clinics, and caseworkers;
laboratory and test results;
a summary of where you worked in the past 15 years and the kind of work you did;
a copy of your W-2 Form (Wage and Tax Statement), or if you are self-employed, your federal tax return for the past year; and
dates of prior marriages if your spouse is applying.
The documents presented as evidence must be either originals or copies certified by the issuing agency. The S.S.A. will not accept uncertified or notarized photocopies as evidence since they cannot verify their authenticity. Do not delay filing for benefits just because you do not have all of the information you need. The Social Security office will be glad to help you. If you are applying for Supplemental Security Income benefits you also need the following:
information about the home where you live, such as your mortgage or your lease and landlord's name;
payroll slips, bankbooks, insurance policies, car registration, burial fund records, and other information about your income and the things you own.
How many credits are required to be eligible for disability?
To qualify for Social Security disability benefits, you must have worked long enough and recently enough under Social Security. You can earn up to a maximum of four work credits per year. The amount of earnings required for a credit increases each year as general wage levels rise. Family members who qualify for benefits on your work record do not need work credits. The number of work credits you need for disability benefits depends on your age when you become disabled. Generally you need 20 credits earned in the last 10 years ending with the year you become disabled. However, younger workers may qualify with fewer credits.
Q: How does a child qualify for disability benefits?
A: Children who are severely disabled may be eligible for monthly benefits under one or more of the programs we administer. Both the Social Security program and the SSI program provide a monthly income for people with severe disabilities. However, the eligibility requirements for the two programs are different.
The Social Security program pays benefits to disabled or retired workers and their families and to the families of deceased workers. Child's benefits generally may be paid to a dependent unmarried child under age 18, to a child age 18 or older who became disabled before age 22, and to a full-time elementary or secondary school student under age 19. If the parent is alive, he or she must be entitled to retirement or disability benefits. If deceased, the parent must have worked long enough under Social Security for survivor's benefits to be paid on the record.
A child age 18 or older may be entitled to Social Security benefits based on his or her disability when a parent who has worked long enough under the program is entitled or dies. The criteria used to evaluate the disability are the same as those used to evaluate disability in adults. The child must be unable to do any substantial work because of a medical condition that has lasted or is expected either to last at least 12 months or to result in death. (Usually a job that pays $700 or more per month is considered substantial.) The child's disability must have begun before age 22.
The SSI program provides monthly income to people who are age 65 or older, or are blind or disabled, and have limited income and financial resources. Children can qualify if they meet the definition of disability and if the household income of the parents and the child are within the allowed limits.