Social Security Disability

Helping the Individual navigate the complex Social Security Puzzle

 

When a person is dealing with not being able to work, there are many issues going on with them.  First and foremost is how they are going to pay their bills and put food on the table.  Also, dealing with the condition or conditions that makes them disabled is of major concern and an adjustment to how they conduct their lives. 

 

When individuals no longer have the ability to work and support themselves, there are various government programs that can be of assistance.  One of the primary ones is the Social Security Programs offered by the Federal Government.

 

Social Security has two main programs that can assist an individual that is not able to work anymore.  The programs are Social Security Disability Insurance or SSDI and Supplemental Security Income or SSI.  Both programs can help an individual who is not able to work.  Both are different in whom they help, however you can apply and be considered for both at the same time. 

 

Both have different requirements to be considered eligible.  Thus, although you could be approved for both, the requirements are different for each program and only those who have the requirements for both get both. 

 

Supplemental Security Income basically requires that a person is disabled according to Social Security’s definition of disability.  In addition, the person needs to be less than 64 years of age with very limited resources.  SSI is basically a needs based program.   

 

Social Security Disability Insurance or SSD has different requirements that are more difficult to qualify for.  Initially, the person has to be a disabled individual as per social security’s definition of disability.  In addition, as a pre-qualifying matter the individual must have worked recently for an extended period of time paying into the system.  SSDI is insurance for the worker and only payable if you participated in it by working a job that paid into the system.  Also, SSDI has other factors that are considered.  Chief among them is that the individual or claimant can not work at any of their past jobs or any job for that matter. 

 

THE APPLICATION PROCESS AND DO I NEED AN ATTORNEY

 

The application process for both programs is considered rather long and difficult.  Most individuals get their initial application rejected.  The rejection rate of the initial application is approximately 70 percent.  An even larger rejection rate is seen at the second level of review called Reconsideration.   

 

The reasons for such high rejection rates are varied and complex.  Generally, a person without representation often makes mistakes that they are not even conscious they are making.  Timing is also important.  If a potential claimant does not have enough of a treatment history to support the application, often times the application will be rejected.  Indeed, potential claimants are rejected who lack either a sufficient treatment history and or are not currently seeking medical care or interventions.  

 

In order to have success, the application needs certain things and quite simply without them the application will be rejected.  Thus, it is simply smart to have an attorney by your side fighting for your interests.  Attorneys know what the Social Security examiners are looking for and do their best to give your application the supporting reinforcement (via documentation and other methods) it needs to be ultimately approved. 

 

 

 

THE PROCESS USED BY SOCIAL SECURITY TO DECIDE IF YOU QUALIFY FOR BENEFITS AND ARE DISABLED

 

Social Security has a 5 step process that analyzes whether a claimant is disabled.  Within these 5 steps, the ultimate question is answered and that is:

 

 “CAN THE APPLICANT DO ANY WORK AND IF SO DO THESE JOBS EXIST?’ 

 

The following analysis is a breakdown of the Social Security 5 Step process that is used by the Social Security Administration to examine if the applicant is actually disabled. 

 

Step 1.  Is the applicant engaged in Substantial Gainful Activity? 

 

If the applicant Is working and making a certain amount of money, they will be found to be working which the Social Security Administration calls Substantial Gainful Activity. To be considered disabled, you must not be actively engaged in Substantial Gainful Activity. ,

 

Step 2.  Are the applicant’s impairments considered Severe?

 

Is the applicant’s medical condition considered Severe enough to have an impact on their ability to work?  If the claimant’s medical condition or conditions are not considered severe enough to significantly limit the work the claimant could otherwise do, the conditions will be considered Not Severe and the claimants application will be denied. 

 

Step 3.  Does the complained of impairment or impairments meet or equal a listing in the Social Security’s Listing of Impairments? 

 

At the start of the application process when the SSA is reviewing the initial disability application, the SSA will compare your impairments or combination of impairments with their Listing of Impairments.  The Listing of Impairments is a list of impairments that the government has that covers every major system in the body.  The impairments on their list specifies a degree of medical severity that if met by the individual claiming benefits presumes the inability to function enough to perform any type of work.  The Listing of Impairments covers most frequently found impairments that people suffer.  Generally speaking, if the SSA says your impairment or combination of impairments is as severe or can be considered an equal to any impairment on their list, you will be granted benefits. 

 

 

Step 4.  Can you do any of the jobs you had within the last 15 years?

 

If your impairment or combination of impairments do not meet or equal a listing on their listing of impairments, the SSA will consider whether your limitations are severe enough to prevent you from doing any of the jobs you have had for the last 15 years.   To determine how severe your limitations are, the SSA claims examiner will create a Residual Functional Capacity (RFC) rating for the applicant.  If the applicant is shown to not be able to do any of the jobs they held within the previous 15 years, then the analysis moves on to the last step of the analysis. 

 

Step 5.  Can the Applicant do any other jobs that are in the National Economy? 

 

If it can be shown that the applicant can do any other job that is found out there in the national economy, they will be denied benefits from the SSA. It is not important what kind of job it is or if it pays the same as any of their previous jobs.

 

In order to determine whether there are other jobs that the applicant can do, the SSA looks at various factors such as age, education and skills.  The SSA will preform a medical vocational assessment of the applicant.