SOCIAL SECURITY DISABILITY PROCESS
What is Disability in Regards to Social Security?:
The inability to engage in any substantial gainful activity by reason of any medically determinable mental or physical impairment expected to last at least 12 consecutive months or results in death
Types of Social Security Disability:
- Social Security Disability Insurance (SSDI)
- For those people who have earned enough social security work credits and are medically disabled
- Supplemental Security Income (SSI)
- For those people below the age of 18 or those who do not have the required work credits to qualify for SSDI
When to Apply for Benefits:
- A person should apply as soon as they become disabled. The disability determination process is a long and drawn out process and waiting just prolongs a determination being made.
How to Apply for Benefits:
- Call your local field office and schedule an appointment to meet with someone to go through the application process
- Directly go to your local field office and wait in line to speak to someone about your claim
- File the application online at https://secure.ssa.gov/iClaim/dib
- At the moment, this is only for those who are applying for SSDI
- Call our office to setup an appointment to discuss your claim.
Process to Determine Eligibility:
- Are you currently working and if so, at what financial level?
- The cutoff point for a person to be working and not be considered disabled is called the Substantial Gainful Activity (SGA) level. Substantial Gainful Activity is work which brings in over a certain dollar amount per month. In 2019, the SGA level is $1,220 per month for non-blind SSDI or SSI applicants. The SGA level for statutorily blind applicants is set at $2,040 per month for SSDI. SGA does not apply for those individuals seeking SSI benefits. A more in depth year by year determination for Substantial Gainful Activity can be found at: https://www.ssa.gov/oact/cola/sga.html. If a person is making at or above the SGA level, then the claim will be denied.
- A lower earnings does not mean that an applicant will be exempt from this stage of the determination process however. Social Security will take a look at a person’s per month earnings as well as the details of the job they are performing and make a determination on whether or not the applicant could potentially work more to get to the SGA level. An example of this is someone working part time but Social Security makes the determination that a person could potentially work full time and make at or above the SGA level. If this is the case, then a person will be deemed ineligible for disability benefits.
- Social Security Disability does not take into consideration non-work sources of income. These can include but are not limited to interest, investments, or gifts.
- Are your impairments severe?
- Social Security must determine that a person has a medically disabling condition, whether that is mental or physical, and must be severe enough to interfere with basic day to day work activity. If a person does not meet this requirement, then they will be denied benefits.
- A person’s condition must last or expected to last a minimum of 12 consecutive months or to end in death. Social Security does not award benefits to what they consider partial impairments or those that last less than 12 months. A person who is medically disabled for only 11 months and 15 days will be found ineligible to receive benefits.
- Does your impairment meet a disability listing?
- Social Security Disability has compiled an extensive list of disabling conditions and criteria that must be met to be considered disabled under their rulings. These are called the Adult and Child Listings which can be found at https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm.
- Should a person be found to meet one or more of these listings, then they can be approved at this stage. If a person does not meet a listing, then Social Security will move onto the next step of the determination process.
- Can you perform your Past Relevant Work?
- Social Security will now look at an applicant’s Past Relevant Work (PRW). This means that Social Security makes the determination if there are any relevant job skills from the past 15 years, before the applicant alleges they became disabled, which can be transferred to other work in the same general industry. If an applicant retains both the physical and mental capacity to perform such work, then they are found ineligible for benefits. If it is determined that a person does not have skills that allow them to work in a similar job market or they do not have any PRW history, then Social Security moves onto the last and final step of the initial determination process.
- Can you perform any work?
- Social Security now takes a look at the alleged medical conditions and determines if there is any form of work in the job market that a person can do. If an applicant is found to be able to perform some form of work, then they are denied. If no such work exists, then the applicant will be found disabled. Unfortunately, just because Social Security finds that a person can performs some form of work, does not mean that they have to find you a job in that profession. They take a look at the Local, State, and National averages for the potential jobs to make a better determination on if this is a feasible job in the current market.
Do not worry if you are denied. There are many people just like you who are denied disability benefits and there is still more that can be done to become qualified for disability benefits.
Should an applicant’s case be denied based on a non-medical reason, they are eligible to file for what is called Reconsideration of the Claim. This informs Social Security that the applicant wants them to re-examine the case if there was an error along the determination process which resulted in the denial of the claim.
If an applicant was denied based off of medical evidence, he/she can Appeal the case and Request to go before an Administrative Law Judge. Here, the applicant can present their argument to a judge and explain why they should be found disabled under Social Security’s rules.
Schedule an appointment to come in and talk to us at no charge
Contact the social security disability advocates at Mark W. Smith & Associates, Attorneys at Law by simply calling our Metairie or New Orleans office at 504-224-8388 and speak with Mark Smith II, or contact us online. We look forward to helping you.
We accept all claims cases on a contingency basis and there is no fee unless your claim is approved for payments.