The process begins by filling out an application for disability which explains claimant’s impairment(s), treatment sources, and other information that relates to the alleged disability.
Most Social Security disability claims are initially processed through a network of local Social Security Administration. The field office is responsible for verifying non-medical eligibility requirements, which may include age, employment, marital status, or Social Security coverage information.
The field office then sends the case to a DDS (Disability Determination Services) for evaluation of disability. The DDS tries to obtain evidence from the claimant’s own medical sources first. If that evidence is unavailable or insufficient to make a determination, the DDS will arrange for a CE (consultative examination) to obtain the additional information needed. After reviewing the evidence, the DDS makes the initial disability determination.
The DDS returns the case to the field office for appropriate action. If the DDS found that the claimant is disabled, SSA completes any outstanding non-disability development, computes the benefit amount, and begins paying benefits. If the claimant was found not to be disabled, the file is kept in the field office in case the claimant decides to appeal the determination.
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When a person files for Social Security Disability (SSDI), they will need to meet a minimum requirement for for their past earnings. Past earnings are calculated on a quarterly basis. A person meets Quarterly Coverage (QC) when they have earned the required level of wages or earning.
The minimum requirement can change each year. Here is a list of the last few years required levels:
- 2010: $1,120
- 2011: $1,120
- 2012: $1,130
- 2013: $1,160
- 2014: $1,200
- 2015: $1,220
- 2016: $1,260
Always calculate your Quarterly Coverage prior to filing for Social Security Benefits. This will help prevent a denial that could have been avoided.
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To qualify for Social Security Disability Insurance (SSDI) a person must have worked enough and recently recently enough to meet the required Social Security Work Credits. The number of credits required to meet the minimum standard change every year.
Social Security Work Credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year. The number of work credits you need to qualify for disability benefits depends on your age when you become disabled. Generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year you become disabled.
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To meet the definition of disability, the Social Security Administration will determine if the person is not able to engage in any substantial gainful activity (“SGA”) because of a medically-determinable physical or mental impairment(s) that will result in death or for a continuous period of at least twelve months.
Substancial Gainful Employment: significant physical or mental activities or a combination of both. For:
- for pay or profit;
- of a nature generally performed for pay or profit; or
- intended for profit, whether or not a profit is realized.
The Social Security Administration generally uses the earnings guidelines to evaluate whether your work activity is SGA. If your impairment is anything other than blindness, earnings averaging over $1,130 a month (for the year 2016) generally demonstrate SGA. They adjust the amount every year based on increases in the national average wage index.
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People who request social security benefits before they reach the age of retirement may qualify for different kinds of benefits. Although Social Security Disability (SSDI) and Supplemental Security Income (SSI) are terms that are used interchangeably by many people, they are very different benefits.
Supplemental Security Income (SSI) is a benefit based strictly on need. Monthly payments are made to people who have low income and few resources, and who are:
- Age 65 or older;
- Blind; or
Social Security Disability (SSDI) is a benefit paid to people who can’t work because they have a medical condition that is expected to last at least one year or will result in death. There is a strict definition of disability to qualify for Social Security Disability (SSDI). Most workers must meet meet two different earnings tests:
- A recent work test, based on age at the time the person became disabled; and
- A duration of work test to show that the worker has worked long enough under Social Security.
If you have questions regarding Social Security Benefits, make sure you consult with an attorney who is experienced with Social Security claims.
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If you become unable to work, you may be eligible for benefits from the United States government. the two primary types of benefits are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
Social Security Disability Insurance (SSDI) provides benefits to disabled or blind persons who are “insured” by workers’ contributions to the Social Security trust fund. These contributions are based on your earnings (or those of your spouse or parents) as required by the Federal Insurance Contributions Act (FICA). Title II of the Social Security Act authorizes SSDI benefits. Your dependents may also be eligible for benefits from your earnings record.
Supplemental Security Income (SSI) makes cash assistance payments to aged, blind, and disabled persons (including children) who have limited income and resources. The Federal Government funds SSI from general tax revenues. Many states pay a supplemental benefit to persons in addition to their Federal benefits. Some of these states have made arrangements with Federal government to combine their supplemental payment with our Federal SSI payment into one monthly check to you. Other states manage their own programs and make their payments separately. Title XVI of the Social Security Act authorizes SSI benefits.
Many people may apply or be eligible for benefits under both programs.
Daniel L Morris, The Morris Law Firm, firstname.lastname@example.org, (214)357-1782