Skip to main content

HOW SOCIAL SECURITY IS LIKE ANY OTHER INSURANCE PLAN

 HOW SOCIAL SECURITY DISABILITY IS A TYPE OF INSURANCE POLICY

Individuals are often surprised when I refer to Social Security Disability as "insurance." Yet, the name of the program is "Social Security Disability Insurance," often abbreviated as SSDI.

SSDI is really a disability insurance program provided to workers by the US Government through the Social Security Administration. It was established in 1935 by President Franklin D. Roosevelt during the Great Depression, although today's disability part wasn't added until 1954.

Like all other insurance, SSDI has defined benefits, requires certain qualifications and must be paid for by each individual. The tax which pays for Social Security is called FICA, which stands for the law which mandates the tax: The Federal Insurance Contributions Act. Each worker pays a portion of wages, usually through payroll deduction. (Look at your pay stub and you will see a deduction for FICA; this is the Social Security tax). As long as you pay this tax you have insured status for disability. After you stop working and stop paying FICA your disability coverage will eventually expire, though not immediately. That's why you can "wait too long" to file a new disability claim. Yes, your SSDI benefit does expire after you stop working--no matter how much you've paid into it in years past.

Here's an example I use: You pay your car insurance for 35 years. Miss one or two premium payments and---oops---your insurance is gone!

HOW SSDI IS LIKE ANY OTHER INSURANCE

General Insurance Policy                                 Social Security Disability Insurance

Has a defined benefit                                          Has a defined benefit

Has certain eligibility requirements                 Has certain eligibility requirements

Requires regular payment of premiums          Requires regular payments (FICA)

Will require proof of a a loss                             Will require proof of disability

Has carefully defined terms/conditions            Carefully defined terms/conditions

Is basically a contract with the insured             Is a contract with the Government

May be difficult to collect benefits                    May be difficult to collect benefits

Doesn't cover everyone; only the insured         Doesn't cover everyone; just insureds

May require legal help to get paid                     May require legal help to get paid

Coverage can expire                                           Coverage can expire

You are not required to purchase it                    Workers are required to purchase it

Most workers are not aware that they are purchasing disability insurance through the US Government and the Social Security Administration (SSA) when they take their first job. This is "unseen" insurance and almost every worker in the United States who has a job is enrolled.  It is mandated (required) by the Social Security Act of 1935 and the Federal Insurance Contribution Act (FICA).  It covers only workers and those who have stopped working within about the last 5 years.

So, we now understand that Social Security disability is not some universal thing given to everybody by the US government. It has to be earned and it has to be paid for. An individual must accumulate a certain number of "work credits" or "quarters of coverage" in order to be insured. (Yes, insured is the correct word). So individuals who haven't worked--or who haven't worked recently--may not be "insured" or covered. The general rule of thumb is: You must have worked at least 5 years out of the most recent 10-year period. That rule is a bit different for persons under age 31.

-----------------------------------------

Provided as information only by The Forsythe Firm, disability specialists in Huntsville, Alabama. Let us help you make sense out of Social Security Disability. May we help you with a claim, appeal or hearing? Free consultations at (256) 799-0297. forsythefirm@gmail.com


Comments

Popular posts from this blog

MOST IMPORTANT FACTORS IN A SOCIAL SECURITY DISABILITY CASE

What are the top 3 most important factors in a Social Security disability case? 1.  Medical Evidence. 2.  Medical Evidence 3.  Medical Evidence 4-10     Medical Evidence Federal regulations set the eligibility requirements for Social Security disability (SSDI) benefits.  A claimant must meet these strict legal requirements More than anything else, the claimant's medical evidence will determine the outcome of the claim or appeal.  Without strong objective medical evidence Social Security cannot legally pay you a benefit. Objective Medical Evidence means the result of medical examinations, laboratory tests or imaging studies (X-rays, PT scans, MRI or CT scans). This type of evidence can only be obtained by going to your doctor. There's an old adage that says truthfully:  "The path to Social Security disability benefits runs straight through your doctor's office."  Being approved for an SSDI benefit requires objective medical proof. ...

SOCIAL SECRITY DISABILITY: THE DECISION WRITING PROCESS

  By Charles W. Forsythe - The Forsythe Firm in Huntsville An Administrative Law Judge (ALJ) has made a decision on your Social Security disability appeal hearing. The decision must now be sent to to a process called "Decision Writing" - where an attorney or paralegal will draft the formal binding decision, explaining the judge's legal rationale for the decision and explaining the mandatory 5-Step decision making process. The decision writing process translates a judge's ruling into a formal, legally binding document. It is a vital but time-consuming phase that ensures all medical evidence and vocational factors align with the law. A typical written decision will be 10 to 20 pages, thus very detailed.  It takes time to write one. There are many decisions ahead of yours and usually they are written in the order received. The step-by-step process breaks down as follows: The Judge’s Ruling & Instructions:  Following your hearing, the Administrative Law Judge (ALJ) r...

UNDERSTANDING THE 5-STEP SOCIAL SECURITY DISABILITY PROCESS

Receiving Social Security disability payments depend on one thing:  Proving that you are not able to work. The one and only thing that SSDI pays for is the physical and/or mental inability to work for a period of at least 12 months.  Who decides if you are able to work?  The Social Security Administration (SSA) will decide.--according to their own strict rules and regulations. In reaching that important decision, are you disabled or not, Social Security must use a 5-step examination process.  It's important to understand these 5 sequential steps. STEP 1:  The work Test .  Is the claimant now engaged in Substantial Gainful Activity (SGA)?  If yes, the claim is denied at Step 1.  They look no further.  You cannot be eligible for SSDI benefits if you are working at SGA, regardles of your medical condition.  (In 2026 you are working at SGA if you earn at least $1,690 per month from work or self-employment). STEP 2.  The Medical Requirem...