There are two programs that provide disability benefits for people with medical conditions that prevent them from working; Social Security Disability (SSD) and Supplemental Security Income (SSI). Both of these programs require that disabled individuals prove, by their medical records, the extent of their disability.
Social Security defines disability as “the inability to engage in substantial gainful activity, by reason of medically determinable physical or mental impairment(s) which can be expected to last for a continuous period of not less than 12 months".
So to be proven disabled you must show that:
The older you are, especially over age 50, the less education you have, the more physical your work has been, and the less transferable your work skills, the easier it is for you to obtain benefits. With certain problems, however, it doesn't matter how old you are. For example, if you suffer from depression to such an extent that it interferes with your ability to work, your age is not relevant. But you're really the only one who knows how disabled you are, and if you feel that you can't work because of a medical condition then you should apply for disability benefits.
In addition to the medical requirements, you also have to show that you've worked five of the last 10 years before your became disabled in order to qualify for SSD benefits. For example, if you were 31 when your disability began, the work requirement is reduced. Another example, if you became disabled before age 23 you would need 6 quarters of coverage or a year and a half of work. A quarter of coverage is equal to earnings of $1,120.00 for 2010. If you were disabled before age 31, you only need to have accumulated half the number of quarters between the ages of 21and the age you first became disabled, but not less than 6 quarters.
The amount of your Social Security disability benefits will be based upon your earnings records. This amount is generally the same as that which you would have received at your normal retirement age based upon your work history. However, Social Security disability benefits may be reduced if you have received workers’ compensation benefits or certain types of pensions.
Family members who are dependents of an individual entitled to Social Security disability benefits may also be eligible for monthly benefits. The maximum amount that a family can receive is approximately 150% of the Primary Insurance Amount (PIA). Children are eligible for these benefits if they’re 18 or younger or 19 and still in high school. Disabled children who are over 19 years of age may still be eligible for benefits under their parents’ account.
There is a waiting period of five calendar months from the date of onset before benefits are payable, and benefits are retroactive one-year from the date of application. If you apply for your benefits before the five month waiting period is completed and are awarded benefits, your benefits will not start until after the five-month period has expired. Recipients of Social Security disability benefits will be eligible for Medicare after they have received disability benefits for two years, or if they are over age 65. Medicare premiums are automatically deducted from your monthly benefits.
Some individuals may be entitled to both SSD and SSI benefits. When Social Security disability benefits are less than the amount of the Federal monthly SSI benefit, the claimant can apply for SSI to increase the total amount of their benefits up to the level that would otherwise be paid by SSI. In these cases, household income and resources are taken into account to determine whether SSI is payable.
When should you apply for benefits? If medical evidence exists that shows that your disability will continue for at least 12 months, you can apply immediately. If the evidence concerning how long disability will continue is unclear, it might make sense for you to apply as soon as the evidence becomes available that you will be out of work for more than one year.
If your disability is properly documented, your benefits may be approved at the initial level. It can be helpful to have an attorney review your application and help you gather the medical documentation necessary to prove your claim. The medical information must clearly indicate that your disabling conditions keep you from working. Unfortunately, however, most claims are still denied at the initial level. There is a long administrative process that follows an initial denial and it is important for you to have an attorney who primarily deals with the Social Security Administration to assist you with your appeal.
Generally speaking, there is no fee in disability cases unless you are successful in your claim. The Social Security Administration requires that they approve all fees which are generally calculated at 25% of back to benefits not to exceed $6000, unless your claim has to be decided at a stage beyond the hearing level. Fortunately, however, most of the claims that we handle are favorably decided at the hearing level or below.
