Claiming Social Security can be a long process, but it’s one that can leave you with life-saving benefits that let you live with dignity even after suffering an injury or developing a condition that leaves you unable to work. Social Security Disability Benefits can be difficult to get, and it’s common for applicants to be rejected the first time around.
Whether you’ve already tried to apply or are preparing for your very first application, there’s one question you’ll need to have a solid answer to. When can you claim Social Security? Find out what lets you qualify, and discover exactly how the Social Security Administration determines disability status and the benefits to provide.
Far too often, disabled people aren’t sure whether or not they even qualify for benefits. That uncertainty can stop them from applying in the first place. In other cases, the first denial can stop applicants dead in their tracks and make them abandon the endeavor entirely, simply accepting that they don’t actually qualify. It’s important to remember that the SSA isn’t perfect. Their people can make mistakes, and you could be entitled to benefits by their own standards even if they deny your claim at first. Don’t let the initial denial discourage you from continuing to pursue benefits
To begin, you’ll need to understand exactly what qualifies one for Social Security Disability benefits. The first step is working in jobs that are covered by Social Security. Fortunately, this includes the vast majority of jobs on the market. Specifically, more than 90% of workers in the country work jobs that are covered, but it’s important to recognize the exceptions. Some government municipal employees, for example, aren’t covered by Social Security and are instead covered by pension plans maintained by their state. Additionally, government employees that were hired before the year 1984 are covered by a pension as well.
There is one industry that uniquely isn’t covered by Social Security, the rail industry. Railroad employees have their own unique pension system that operates outside of the Social Security Administration. This strange exception has been in place since the 30s and the Social Security law has never been amended to account for them. Additionally, foreign nationals that work in the US for the government of their home country or any international organization aren’t covered. If you’re a US citizen who works in a foreign embassy in the US, however, you are covered by Social Security.
Definition of Disability
The second major aspect to qualification is meeting the specific definition of disabled according to the SSA. This is a five-step process evaluated by the SSA staff to determine whether or not an applicant qualifies as legally disabled. Only after completing this process can you qualify for disability benefits. Keep in mind that during this portion of the process many claims are denied. This is often due to a lack of supporting evidence. A disabled person who doesn’t adequately demonstrate their disability will not be legally considered disabled.
The first step to the process is determining whether or not the applicant is working. If you’re able to work and make more than a certain amount each month, you’re not considered legally disabled. Rest assured that the amount in question is generally enough to live comfortably rendering disability benefits useless in the first place. Additionally, this amount changes each year, so you’ll want to check the latest annual update to see the exact amount. If you’re not working or don’t reach the specified amount in income, the process moves on to step two.
The second step’s goal is to determine whether or not your condition is actually severe. Severity is determined by judging your ability to do basic work activities. While every job has different activities, the general abilities being measured at this level are the ability to lift objects, stand, walk, sit for long periods of time, remembering and recalling information, and other basics. Additionally, if your disability prevents you from performing these basic activities, you must establish that it has for at least 12 months, starting from the onset of the disability.
Should your condition be considered severe, the SSA will move to the third step. This is the portion of the evaluation where your condition is compared to the list of impairments. If you have any of the impairments on the list, you’ll automatically move to the fourth stage of the process. There are quite a few impairments and conditions on the list that the SSA considers to inherently render a person unable to do gainful activity regardless of their age, education, or experience working. Within the list of impairments, you’ll also find the necessary requirements to demonstrate each condition.
If you don’t have any of the impairments on the SSA’s list, don’t worry. That doesn’t automatically mean that you’re disqualified from benefits. When you don’t have any of the listed conditions, you’ll have to demonstrate that your condition is medically equivalent to one of the listed conditions. Medical equivalency, in this case, means that your condition is as severe with a similar duration to one of the listed impairments. While there’s obviously no standard for the exact evidence you’d need to prove that, a Social Security disability lawyer can help you gather what is required.
Step four questions whether or not you can do the work you did prior to the onset of your disability. This question is fairly basic as it simply determines whether there’s any reason you should stop working the job you already have. If you can still do your old job, the SSA will render you disqualified at this step. Should your old job no longer be within your capabilities, you’ll move on to the fifth and final step.
The last step of the evaluation determines whether or not you could do any other work. For example, your disability may prevent you from doing a physically demanding job, but you may still be able to do a desk job that you’re qualified for. If there are no alternatives and you’re simply unable to work, the SSA will consider you to be disabled and eligible for benefits. Think about the answers they may come to if they investigate your case. Is there any other work you may be able to do? If not, don’t hesitate to file an application for disability. Remember, the list of impairments isn’t strictly limited to physical disabilities. Many neurological and mental disorders are included.
When it comes to applying for disability, you’ll also need to have the appropriate work credits. Work credits are obtained by working a certain number of hours. The exact number required changes by year, however, so you’ll need to see what the exact requirement is based on the SSA’s latest update. For example, you’ll earn a singular credit in the year 2020 by earning $1,410 in wages or self-employment income. Keep in mind that only four credits can be earned each year, so reaching $5,640 in income in 2020 means you’ve already reached the maximum four credits for the year.
The amount of credits needed to qualify for disability depends on how old you are and whether or not you’ve been working continuously. To take an extreme example, a person who became disabled on the job before the age of 28 typically only needs 1.5 years worth of work credits to qualify. Someone becoming disabled at age 50, however, will need seven years worth of work credits to qualify. While developing a disability that prevents you from working can entitle you to benefits, you’ll still need a continuous history of work to get future payments in many cases.
While the vast majority of disability cases involve disabled people meeting the standard requirements, there are some special qualifications that could indicate that it’s time for you to apply for benefits. Blind people or people with low vision are exempt from most of the more rigorous requirements making it relatively easy to get benefits. Similarly, workers with disabled children often have an easier time getting benefits than the average disabled worker.
In addition to the visually impaired and those with disabled children, widows and widowers and veterans have special circumstances. Veterans are entitled to a vast array of benefits, especially if they were wounded during their service. Widows and widowers can also be entitled to benefits that their deceased disabled spouse was receiving or could have received.
After a Denial
If your claim has been denied, don’t give up. You can still claim Social Security benefits by making an appeal. In fact, there’s quite a long process to go through. Moving forward with the appeal is quite simple. All you have to do is go through the relevant process on the SSA website. Keep in mind, however, that the average person won’t be adept at navigating the process, so it’s best to have a lawyer by your side if you don’t already.
The first step to making an appeal is requesting a reconsideration. There are essentially two kinds of reconsiderations you can file, a medical reconsideration and a non-medical reconsideration. As the name suggests, a medical reconsideration is a demand for reconsideration based on denial for not qualifying as disabled. During a non-medical reconsideration, someone who didn’t take part in the first determination will look through the evidence again to see if you medically qualify as disabled. Additionally, you can submit new evidence to help your case at this stage in the process.
A non-medical determination is one in which you were denied for another reason. In this case, you may qualify as disabled, but your income, resources, and living arrangements could render you unqualified. The actual process of this kind of reconsideration is the same as it would be for a medical consideration. The only difference is that the reviewer will be looking at different kinds of evidence.
Administrative Law Judge Hearing
If the reconsideration doesn’t go your way, you can request a hearing in front of an administrative law judge. This hearing typically goes by fairly fast, often taking no more than an hour in total, and it’s typically located within 75 miles of your home, but often closer. It’s best to have a lawyer with you at this point if you don’t already. While these hearings are far more informal than a typical court hearing, a lawyer will still know the process inside, what evidence to present, and how best to present it.
Review by the Appeals Council
Should the administrative law judge not rule in your favor, you can request a review by the Appeals Council. Note that they will not validate your claim. This step is solely to determine whether or not the administrative law judge’s ruling was valid. Should they determine that it was valid, your case will still be denied. Should they determine that the ruling was invalid, they will return it to a different administrative law judge to try step three again.
Even after going through the Appeals Council, you can still claim Social Security by filing a civil suit in a federal district court. This is the last and final step before having to start the process over. Given the formal nature of a federal court, you will need to have a lawyer by your side. This is a civil action, so you’ll have to deal with a filing fee as well. This is the last stage of appeal, so if you don’t get approved at this level, you’ll need to reevaluate your application and submit a new one.
File Your Disability Claim
When it’s time to file a Disability Claim, don’t move forward without help from a lawyer. At Joel Thrift Law, you can enjoy committed representation and years of expertise to help you throughout the entire process and get you the compensation you deserve. Contact us today for a free consultation whether you want detailed assistance or just need to ask a simple question.