If you become disabled before you can retire from work, you may be eligible for disability benefits under the Social Security Act. Under that Act, a worker who is found to be blind or disabled is entitled to Social Security disability insurance (SSDI) benefits.
Qualifications for SSDI Benefits
To qualify for disability benefits, you must:
- be younger than full retirement age
- have insured status for disability, which means that you have earned enough money in the required number of years before the disability began
- have a qualifying disability, and
- file an application for benefits.
Determination of Disability
The Social Security Administration (SSA) defines disability as the inability to do one's previous job or any other substantial amount of work due to a severe physical or mental impairment. The impairment must be diagnosed and documented by a doctor and must last or be expected to last for at least 12 months (or to end in death).
The SSA uses a five-step evaluation system for determining whether a worker is disabled. The major questions to be answered, in order, are the following:
- Step One: Is the person currently working and engaged in "substantial gainful activity"? If the answer is yes, the person is not considered disabled, regardless of medical condition. If the answer is no, go to Step Two.
- Step Two: Does the person have a severe medical impairment or combination of impairments that can be expected to last for a continuing period of one year or result in death, and which significantly limits the ability to do basic work activity? If the answer is no, the person is not disabled. If the answer is yes, go to Step Three.
- Step Three: Is the impairment (or combination of impairments) the same as or equal to an impairment found in Social Security's Listing of Impairments? If the answer is yes, the impairment is automatically presumed to be so severe that the applicant would not be able to do gainful activity, and the person is considered disabled. If the answer is no, go to Step Four.
- Step Four: What is the person's ''residual functional capacity''? Does the person retain sufficient mental and physical capacity to meet the demands of the person's former work? If the answer is yes, the person is not disabled. If the answer is no, go to Step Five.
- Step Five: Does the person have sufficient residual functional capacity, when considered with the person's age, education, and work experience, to be able to undertake other work activity that is less physically or mentally demanding?
In steps one through four, the burden to prove a disability is on the applicant, but the burden shifts to the government at step five. This means that, at step five, Social Security must show that there are jobs that the applicant can do despite his or her limitations.
Amount of Social Security Disability BenefitsIf you are approved for benefits, you will not receive benefits for the first five months following the onset date of your disability. Starting in the sixth month, your monthly benefit will be equal to your primary insurance amount, which is the same amount you would receive at full retirement age. If you are receiving or have received workers' comp for your injury or illness, however, your disability benefits may be limited by a worker's compensation "offset." Your combined Social Security and workers' comp benefits cannot exceed 80% of your pre-disability earnings.
Termination of Monthly Benefits
If you are granted disability insurance benefits, you must report to the SSA any changes in your medical condition, as well as any return to or increase in work, or an increase in your earnings, as these may affect your continuing eligibility. The SSA also conducts periodic reviews to determine one's continuing eligibility for disability benefits.
Questions for Your Attorney
- Does my medical impairment match any conditions in the Listing of Impairments?
- How likely am I to be approved for Social Security disability benefits?
- What can I do to help my chances of getting benefits?