Social Security Disability

By: LawInfo

As of December 2014, nearly 9 million disabled workers were eligible for SSDI benefits. The Social Security Disability Insurance program was formalized in 1956 after more than two decades of discussion at the federal level. Although the program is designed to provide financial security to those who can no longer work due to disability, access to these benefits is restricted. The program is meant to provide a modest amount of support for those who have participated in a substantial amount of work during their lives. Appropriate contributions must have been made toward Social Security programs through tax withholding. However, disability has been strictly defined to ensure that those obtaining these benefits are truly incapable of performing gainful work.

Who Can Apply for Disability Benefits?

Because SSDI eligibility is dependent on one's work history, it’s one of the first issues evaluated. Up to four Social Security work credits can be earned annually based on wages. An individual must have earned a minimum number of credits based on their age, and the number of credits in the previous 10 years must be substantial. Additionally, an applicant's impairments must be severe enough to prevent them from performing their previous work and adapting to other types of work. A disabling condition must be expected to last for at least one year, but typically, benefits are aimed at those who are deemed permanently disabled.

The Disability Determination Process

The Social Security Administration uses a five-step process for evaluating a disability claim. These steps assess the following issues in order:

  • The working status of the applicant
  • The severity of medical conditions
  • Meeting or equaling a medical condition as defined by the SSA
  • The ability to do one's previous work
  • The ability to adapt to different work

These issues are evaluated based on medical evidence provided by an applicant or by their health care providers. Additionally, information about the impact of a condition can be provided to explain issues such as limited mobility, pain, fatigue, and other physical or mental challenges. The SSA may use third-party information to expand its understanding of an applicant's condition as well. In some cases, there may be requests for claimants to attend consultative exams to augment the medical information in the record.

Common Reasons for Denial

Aside from lacking the minimum required work credits or having a condition that isn’t considered a disability, there are multiple reasons that a claim for SSDI benefits can be denied. These can involve a lack of evidence, application errors or any combination of the following:

  • Making too much money
  • Not following doctors’ orders
  • Lacking treatment records
  • Having a disability caused in relation to a criminal conviction
  • Being unavailable for contact

Dealing with Denials

Although the statistics can vary from year to year, approval rates for Social Security Disability Insurance tend to be much lower than the denial rates. Around two-thirds of claims result in denials. After an initial denial, an applicant has the opportunity to appeal through the reconsideration process or by way of a hearing. This can vary by state. There are also upper-level reviews available if necessary.

The information on this page is meant to provide a general overview of the law. The laws in your state and/or city may deviate significantly from those described here. If you have specific questions related to your situation you should speak with a local attorney.

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