How
is disability defined?
Disability is defined as the
inability to perform substantial gainful activity resulting from
a medically determinable impairment which has lasted or is expected
to last for twelve months or more. There must be medical evidence
of a condition that prevents you from doing most types of work.
When the Social Security Administration evaluates a disability
claim, it also considers your age, education, and previous work
experience.
Some handicaps and diseases are
so serious that Social Security automatically treats them as
disabilities. Examples are severe epilepsy and loss of vision
and hearing. These are included in an impairments list at the
Social Security Administration. If workers do not have a listed
impairment, they can still prove that they have a disability.
They must show that their condition or disease is the medical
equivalent of a listed impairment. The condition or disease must
be equal in severity and duration to a listed one. First, of
course, the applicant must be disabled to the extent that he
or she cannot do any job, not only the job previously performed.
Secondly, the applicant must have security coverage. The person
must have paid into Social Security, either through employment
or self-employment, long enough and recently enough to have coverage
for disability purposes. If the applicant does not have Social
Security coverage and is disabled he or she may still qualify
for help under the “SSI” or Supplemental Security Income
program. The “SSI” program is also administered by
the Social Security Administration. Financial help is available
for disabled persons who have had very little income and very
little property. Your local Social Security office has additional
benefit information and literature. State and County welfare
offices may also have information.
How
do I apply for benefits?
You should apply for disability
benefits as soon as you become disabled. Generally, applications
should be made by mail or in person. Call the social security
office to see what arrangements can be made. If a disabled person
cannot handle his or her own affairs, the application can be
completed by a spouse, parent, relative, friend, or legal guardian.
If a physical or mental disability is expected to last at least
twelve months or to result in death, apply for benefits without
delay to allow for processing and verification. Benefits are
generally not available until after five full months of disability.
You will need to give the Social Security Administration the
names, addresses, and telephone numbers of doctors, hospitals,
and clinics that have treated you for the disability and the
approximate dates of treatment. An easy way to provide this information
is to supply copies of your medical bills.
You will have to tell Social
Security what your illness or injury is, when the illness started
or the injury was sustained, how it keeps you from working, and
the date you stopped working. Be prepared to tell the Social
Security office the restrictions your doctor has placed on you
and the names and dosages of medication you are currently taking.
Your local Social Security office can provide additional information.
What
if my disability claim is denied?
Persons who apply for Social
Security disability benefits are often discouraged because the
applications are denied in the initial stages. Denials at the
first two levels for consideration are not unusual.
Initial administrative-level
determinations are made by claims examiners based only upon written
records. Favorable decisions at these initial levels are common
only for the most obvious cases. The Social Security Administration
has its own review system and judges. An applicant for disability
benefits is entitled to a hearing before a Social Security Administrative
Law Judge. If an application is denied and the individual still
believes he or she is truly disabled, the case should be appealed.
Hearings before a judge can often be requested by mail by following
directions in the denial notice.
If you are still not satisfied
after the Administrative Law Judge makes a decision, you can
request a review by the Appeals Council. The Appeals Council
will hear your case only if it wants to. If it refuses to hear
your case or hears your case and rules against you, you can then
file suit in Federal Court. Generally, for every stage, you have
only sixty days to appeal each action to the next stage, and
appeals to Social Security usually must be made on a required
form, available at your local social security office.
Appealing denials of a social
security claim often requires the assistance of an attorney experienced
in this area of the law.
Supplemental
Security Income (SSI)
The Social Security Administration
has a program that makes monthly payments to people in financial
need who are disabled, blind or sixty-five years or older called
Supplemental Security Income (SSI). It is financed through general
funds of the U.S. Treasury rather than from Social Security taxes.
Medical requirements to receive SSI disability checks are the
same as for Social Security. However, there are certain differences
between the programs. For example, no work credits are needed
for SSI, but there are limits on assets and income. People who
attempt to work while still disabled are not subject to the test
for substantial, gainful work. Also, they are allowed certain
additional work-related deductions in determining entitlement
to payments. Some disabled and blind beneficiaries may also receive
Social Security disability benefits. In these cases, the amount
of SSI checks will be lower. Although SSI is administered through
the Social Security Administration, it is considerably different
from retirement, disability, and survivors’ benefits. For
example, your eligibility for SSI isn’t based on whether
you’ve earned a certain number of quarters of coverage.
You can be eligible for SSI benefits even if you’ve never
worked.
Disabled
Child’s Benefits
A child’s benefits stop
the month before the child reaches age eighteen, unless the child
remains unmarried and either disabled or is a full-time elementary
or secondary school student. A child can receive benefits until
age nineteen if he or she continues to be a full-time elementary
or secondary school student. When a student’s nineteenth
birthday occurs during a school term, benefits can be continued
up to two months to allow completion of the term. A disabled
child can continue to receive benefits after age eighteen if
he or she has a physical or mental condition which prevents substantial
gainful work and which is expected the last at least a year.
As with a spouse, their benefits
will be about one-half that of the workers’ benefits. This
also covers stepchildren, adopted children, and under certain
cases of dependency, grandchildren.
I cannot
work anymore. Can I apply for benefits?
If you have worked for five out
of the last ten years and can no longer work at any job, you
have the right to file for disability benefits. If you are found
to be disabled, you will get a monthly check. The amount you
receive each month is determined by how much you earned while
you worked. Your minor children and spouse may also get monthly
checks. You may also qualify for Medicare coverage.
You do not have to be disabled
for the rest of your working years to receive benefits. If you
are unable to work twelve months or more, then recover and return
to work, you may be eligible to receive benefits for the months
you were unable to work.
Information about
benefits or applying for benefits is available from the Social
Security Administration. |
