Many people do not know that this program exists. It is often confused with Social Security retirement benefits or welfare.
Social Security has had a disability element since the 1950’s. There are people who, through no fault of their own, are unable to work due to a physical, mental or a combination of physical and mental conditions. The federal government formed the disability program to provide a safety net of monthly income benefits and medical care to protect these vulnerable members of our society.
Social Security Disability has tougher qualification requirements than most private disability insurance policies. Not only must the claimant be unable to perform the duties of their last job, the claimant must also show that they are unable to perform the jobs they held for the past 15 years. They must also prove that when taking transferable skills into consideration, they are unable to perform any job that exists in the national economy in significant numbers.
For many people who have serious disabilities that prevent them from working, the Social Security Disability program provides a critical safety net of a monthly money benefit and Medicare insurance health coverage.
What does it take to qualify for Social Security Disability?
To qualify for disability benefits, one must prove the following:
1. Not substantially and gainfully employed.
Any work that pays more than $900.00 per month is considered substantial, gainful employment activity. Self-employed people are evaluated under a separate set of criteria.
2. Have a severe impairment.
The claimant must have a medically determinable impairment that results in a reduction in residual functional capacity for work.
3. The severe impairment will last at least 12 months or result in death.
The impairment must have lasted or reasonably be expected to last for at least 12 months or result in death. If the condition is reasonably expected to improve within 12 months, Social Security will usually deny the application.
4. The impairment either meets or equals a medical listing.
There are certain medical conditions that the Social Security Administration considers disabling if they meet or equal a medical listing. In these cases, the claimant is found disabled without further questions.
These conditions include, but are not limited to:
Spinal nerve root compression
Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome
Serious psychiatric problems such as schizophrenia and borderline personality disorders
5. If the impairment does not meet a medical listing then the claimant must be unable to perform past relevant work AND unable to perform other types of generally available work.
Social Security looks at the jobs a claimant has performed over the past 15 years. This is called past relevant work. If the SSA determines that the claimant can perform a job they held 15 years ago, then the claimant will be found not to be disabled. Many people believe that all that is required is inability to perform their last job. This is clearly not the standard.
If the SSA determined that the claimant is unable to perform any of their past relevant work, the SSA then determines if the claimant can perform other jobs generally available in the national economy that are compatible with the claimant’s residual functional capacity and transferable skills. To answer this question, the SSA uses a complex set of guidelines called the medical-vocational guidelines.
If the claim is heard before an Administrative Law Judge (ALJ), the ALJ may call a medical or vocational expert or both to testify at the hearing. The ability to cross examine these experts is critical in winning the hearing.
In addition to meeting the disability qualifications, one must either meet the additional requirements of the Social Security Disability Insurance program (SSDI) or the Supplementary Security Income program (SSI).