One of the first questions I usually hear from a new Social Security Disability client goes something like this. The answer, like so much in life, is complicated. Sometimes it is because the neighbor, friend, guy down the street got away with something. More often it is not that the other guy doesn’t deserve benefits, it’s that you are being treated unfairly.
You purchase a Social Security Disability benefit with a portion of your Social Security tax taken from your check each pay period. If you are disabled and no longer able to work, you are entitled to this benefit.
Social Security goes through several steps in evaluating your claim. They first determine whether you paid enough into the system to qualify. If so, they look to see if you currently engage in “substantial gainful activity”. If you are working and making more than $1310 per month you may be considered engaging in substantial gainful activity. The rate is a little higher if your disability is based on blindness. If you are engaging in substantial gainful activity, it does not matter how ill or disabled you are, you will be denied benefits. This rule can create great hardship as it requires you to quit working before applying for benefits. Further Social Security does not give benefits until five months after you qualify. When you combine these two rules you see that you must be prepared to live without income for at least five months prior to receiving your first check.
If you get through these first two test, then Social Security will actually start looking at your ability to work. If you meet any of a series of “listings” you qualify. There are listing for a number of health conditions such as heart ailments, lung conditions and back injuries. These listing are difficult to meet. It is not enough to have a heart ailment, lung condition or back injury. There are very specific, very stringent, requirements for each listing. These listings are difficult to understand if you don’t have experience dealing with Social Security regulations.
The next step, assuming you didn’t meet a listing, depends on your age. For younger individuals, defined as someone under fifty years of age, it is tough. If you are able to do even sedentary work, you will not be considered disabled. If you are over fifty, cannot do your past work and are limited to sedentary work you should qualify. If you are fifty-five or older, cannot do your past work and are limited to light work you will probably qualify. I use the words “should” and “probably” because there are some additional qualifiers that can interfere with you obtaining your benefits. For example, if you have skills that are transferable to other, less physically demanding, occupations this will be used against you.
This is an overly simplified outline of what you are facing when you try to obtain Social Security Disability benefits. The rules themselves take up hundreds of pages. They are complicated and, on occasion, complete and utter nonsense. You do not need a lawyer to apply for benefits. But if you are turned down on your initial application it is usually a good idea to at least speak with someone used to dealing with this complicated mess.