HOW DOES SOCIAL SECURITY DISABILITY WORK?

 

How Does Social Security Disability (SSDI) Work?

Think of Social Security as a federal insurance policy issued by the US Government. That's exactly what it is. Participation is mandatory for most workers. Most people aren't allowed to opt out. You pay into Social Security by mandatory payroll deductions called "FICA" on your pay stubs (and your employer matches your contributions). When you have worked long enough to collect the minimum number of "work credits," you become insured against disability, as defined in the regulations. Note: Not everyone is covered by SSDI. Only those who have worked long enough (and recently enough) to be "insured" under the Social Security Act are covered. It's a program for workers.

Once you determine that you have this "insurance," you may file a claim for disability benefits with the Social Security Administration.

Here is what Social Security says about their decision-making:

We consider your medical conditions, age, education, past work experience, and any transferable skills you may have. If you can't do other work, we'll decide you qualify for disability benefits.If you can do other work, we'll decide that you don't have a qualifying disability and your claim will be denied.

A key phrase is "...if you can't do other work..."

For most claimants under age 55, they must prove 2 things: (1) That they cannot perform their past work and (2) There is no other work that they can perform--based strictly on their age, education, past work experience and any transferable skills they have. The argument that no one will hire you won't work.

It would not be enough, for example, for a welder to be unable to perform his job because of back trouble or leg pain. The question becomes: Is there easier work in the US economy that you are able to perform? Perhaps a sedentary or light job, such as small parts inspector, hand packager, or office assistant? If you can do any other full-time work, you are not disabled under Social Security's rules. They make the decision about whether you can do other jobs!

Because the rules are so complex, only an experienced professional is likely to interpret them correctly.

And age is a major consideration. The general rule: The younger you are, the more difficult it may be to get on disability benefits. Claimants over the age of 50 have an advantage. Claimants over age 55 are even better positioned. (Younger individuals might be approved for some very severe impairments).

Q & A

Q. How do I know if I have sufficient work credits to support a claim?

A. Call your local Social Security office and ask. They can check your record in just seconds.

Q. If I don't have enough work credits, is there an appeal I can do?

A. No. Unless your earnings have been wrongly reported, there is no appeal for lack of credits.

Q. What if I worked for 25 years then stopped working for 6 or 8 years? Won't my previous work credits still count?

A. Probably not, but call Social Security to be sure. As the years pass without working, work credits are not kept current and you can lose your "insured status." Think of this as a "deadline" to file for disability befits. Wait too long and you can loose your insured status.

Q. So, it's more difficult for younger workers to get on disability. What kind of things might Social Security approve in a younger individual (under 50)?

A. Social Security might approve a severe, long-term impairment that clearly makes the claimant unable to perform even sedentary or light work on a full-time basis. This condition must have lasted or be expected to last 12 straight months or more, OR to end in death.

Q. My doctor says I can't work and that I should apply for disability? Is this good enough?

A. It may help to support a disability claim; however, doctors cannot make the decision about who is disabled. They can submit medical evidence to be considered.

Q. I pay taxes, so why would I not be automatically covered under Social Security disability?

A. Because Social Security benefits are not paid out of general tax revenues. Benefit dollars come out of the Social Security Trust Fund which is supported by FICA tax on earnings. This is not the same as federal income tax, which does not support Social Security.

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Charles Forsythe is an author and founder of The Forsythe Firm in Huntsville, AL where he works tirelessly to help qualified individuals to get disability benefits. He offers free consultations.