Many people don’t realize that when they pay into the Social Security fund through payroll deductions, they not only invest in future retirement benefits, but also in the Social Security Disability Insurance program.
SSDI benefits are monthly cash payments to people who are unable to work, meet the official definition of disability and who meet the federal government’s other eligibility requirements.
Eligibility requirements are very exact and detailed. In general terms, to be insured under the program and eligible for SSDI payments upon disability, a person must have worked fairly regularly over the years and also relatively recently.
Definition of “Disability”
SSDI uses a specific definition of what it means to be “disabled.” To be disabled for purposes of SSDI, a worker must have a physical or mental medical impairment or combination of impairments that prevents him or her from working and that is expected to last at least one year or end in death.
The Social Security Administration has some expedited procedures for those applicants whose medical conditions are objectively easy to establish and especially severe. Examples are the Compassionate Allowance and Quick Disability
Determination programs that provide faster processing for persons with certain identified devastating medical problems like particular cancers, brain and neurological diseases, mental illnesses, developmental disabilities, heart defects and more.
Most claimants do not qualify for expedited treatment though and the SSA (or one of its state-agency partners the disability determination service or DDS) will apply afive-step process in which it asks:
- Is the claimant either not working or making under a very minimal wage threshold? If no, not disabled. If yes, then
- Is the medical condition severe, meaning it severely affects the claimant’s capacity to do basic work activities and will likely do so for at least a year? If no, not disabled. If yes, then
- Does the claimant’s impairment meet or equal a listed impairment? The official “Listing of Impairments” contains medical conditions so severe they automatically qualify as disabling. If yes, then disabled. If no, then
- Is the claimant able to do previous work? If yes, then not disabled. If no, then
- Is the claimant able to do any other work, considering medical limitations, age, education, past work and skills. If yes, then not disabled. If no, then disabled.
It’s Well Worth Consulting an SSDI Advocate
Federal Social Security law and regulations are some of the most complex to navigate without a knowledgeable, experienced SSDI advocate on your side. Many SSDI applications are denied by the SSA, but later approved at one of three levels of agency review (two of the written record and one at a hearing) or on appeal to federal court.
A disability advocate can assist with getting the medical evidence to support your claim. Sometimes although the SSA is legally required to develop evidence of all medical conditions, including arranging for consultative examinations, the agency can come up short in this regard.
An advocate can be valuable at any step of the process. While even at initial application a disability advocate can be helpful, a claimant whose application has been denied should not hesitate to contact a law firm at any stage of appeal.
While it is positive to have several levels of review, the entire process can take months and sometimes years. Often people struggling with the SSDI application process who are sick or injured and struggling financially because of their inability to work do not consider consulting a disability advocate because of concern over the expense.
However, it is important to understand that federal law actually provides for the payment of fees out of the eventual past-due benefit award and sometimes even by the government, if its position on the application was not substantially justified. So a claimant should not hesitate to talk to a skilled SSDI advocate; it may make all the difference.