Social Security Disability Insurance, a safety net for many US workers
Most people think of retirement benefits when they think of Social Security, but when they pay into the federal Social Security fund through payroll deductions, they also contribute to the disability insurance program. According to the Social Security Administration or SSA, a 20-year-old in the U.S. actually has a three out of 10 chance that he or she will become disabled and unable to work before retirement age.
To provide financial security for the three out of 10 of us who will become unable to work because of disability, the Social Security Disability Insurance program provides monthly support payments to qualified disabled workers. In basic terms, an SSDI applicant must have worked recently enough and in enough quarters over the years to have earned coverage.
SSDI payments can be critical to a disabled person and his or her family since the loss of wages from disability for most families progresses quickly into financial crises. Unfortunately though, applications take three to five months to process, according to the Social Security Administration or SSA, the federal agency that administers the SSDI program.
Seek legal counsel
Many SSDI applications are denied, so it is a good idea to seek the guidance of an experienced attorney to assist with the application. A knowledgeable lawyer will understand what kinds of medical and other evidence the agency will need to see. However, there are several more levels of review and appeal for the denied application, and bringing in legal counsel at whatever stage of the claims process the claimant is can be crucial.
Review and appeal
Here are the review stages available:
- Reconsideration: a review of the initial application by the agency
- Administrative hearing : a hearing before an administrative law judge or ALJ, an SSA employee, at which the claimant will testify and be able to present additional evidence, and at which others may appear like vocational or medical experts
- Appeals Council: a paper review of the record by an SSA panel
- Federal courts: the final decision of the SSA denying an SSDI claim may be appealed to federal district court and further to the U.S. Court of Appeals and the U.S. Supreme Court
If a claimant has an adequate work record, he or she must still meet the federal definition of “disability.” For SSDI purposes, a person is disabled if he or she has a severe medical physical or mental impairment (or combination of impairments) that will prevent him or her from working at least one year, or that will result in death.
The decision process
The SSA uses a five-step process in a disability determination:
- Is the claimant working or making more than an extremely low amount? If yes, the claimant is not disabled. If no, then …
- Is the medical condition severe? If no, the claimant is not disabled. If yes, then …
- Is the medical condition on the official List of Impairments or does it equal a listed impairment? If yes, the claimant is disabled. If no, then …
- Can the claimant return to previous work? If yes, the claimant is not disabled. If no, then …
- Can the claimant do other work considering medical problems, age, education, work experience and skills? If yes, the claimant is not disabled. If no, the claimant is disabled.
Certain family members may also be eligible for benefits based on a qualified recipient’s work record. After two years on SSDI, a claimant is also eligible for Medicare.