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Why Can’t I Receive Disability Benefits?

The Social Security Disability program is a federally run insurance program. This program requires individuals who work to pay taxes upon their earned income, part of which goes towards disability insurance. This is a mandatory insurance program. Meaning, you do not have an option to pay for this insurance or not. While you are required to pay taxes from your earned income into the social security disability insurance program, that does not mean you will automatically qualify for disability benefits. First, you must have paid enough into the system to have this type of insurance coverage. The general rule of thumb is you must have paid taxes on more than $5,000 of earned income each year for the past 5 out of ten years. This threshold may sound low but beware. People generally do not have problems initially obtaining this insurance coverage. The problem comes from proving you are disabled prior to your insurance expiring. The disability insurance program acts like insurance. Meaning, you pay a premium for coverage. Once you stop paying a premium you only have insurance coverage for a certain amount of time. For disability, that coverage lasts for approximately five years from when you stop paying into the disability insurance program through taxes. So if you want to obtain disability benefits from the federal government you must first make sure you have paid enough into the system to have coverage. Second, you must make sure you claim your benefits prior to your insurance expiring.

If it has been determined that you have disability coverage, then your next step would be to prove you meet social security’s medical definition of disability. Oftentimes this is a very difficult task. Social Security will not pay you benefits simply because you lost your job or cannot find work. You must suffer a physical or psychological condition that prevents you from working. The Social Security Act defines disability as; “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”

Let’s break this definition down. The first consideration is whether you are able to engage in the substantial gainful activity (SGA). Meaning, if you are able to earn more than a certain monthly amount you will ordinarily be considered to be engaging in SGA. The amount of SGA depends on the nature of the individual’s disability. If you are blind, your SGA amount is $1,820. For individuals who are not blind, the monthly amount is $1,130. These amounts change every year. In 2017, the non-blind amount is increasing to $1,170. Now that you know what SGA is we can discuss the rules. If you earn more than SGA per month you automatically do not qualify for social security disability benefits. This is because Social Security has determined SGA to be the threshold for eligibility in this type of program. What all of this means is that you are able to work and still apply for disability benefits as long as your net income per month is lower than the SGA amount. That’s great right? Well, SGA is only the first consideration in whether you are disabled or not.

The second consideration is whether you suffer from a severe impairment which prevents you from earning more than SGA. You will not be found disabled simply because you are paid a rate less than SGA. You must show the reason you are not paid more than SGA is due to a medical condition. This condition may be physical or mental, or both. You must prove to the Social Security Administration that not only do you suffer from certain conditions but that those conditions meet the definition of disability. To do that, you will need medical evidence from your doctors. If you do not have any medical treatment you will be unable to prove your disability. Most people struggle with this aspect of the disability program. If you are not working then you most likely do not have health insurance and therefore are unable to see the doctor. But if you are unable to see a doctor then how are you going to prove you are disabled? It is a catch 22 situation. The best advice I can give is to find a free clinic in your area. A helpful website for that is called Needy Meds. Another option is to inquire whether your county provides health insurance. Many states and counties provide this benefit for individuals with a low income.

If you do have medical treatment and evidence to support your disability then social security will determine what your residual functional capacity is. Meaning, what is the most you are physical or psychologically able to do in spite of your medical conditions. Once your residual functional capacity is determined, social security will look at whether you are able to complete the work you have performed in the past fifteen years. They will take your limitations and match them up with the job descriptions of your past work to see if you could still perform this work. For example, you suffer from carpal tunnel syndrome in both of your hands which prevents you from typing on a keyboard more than 1 hour per day. Your past work was as a legal assistant. A job as a legal assistant generally requires a significant amount of typing throughout the day. Thus, you would be determined to be unable to perform your past work as a legal assistant.

If social security determines you cannot perform your past work, they will consider whether there are any other jobs available which you may perform in spite of your limitations. In doing so, social security will seek advice from a vocational expert who is generally familiar with the dictionary of occupational titles. The dictionary of occupational titles is published by the department of labor and includes job titles and descriptions for all of the jobs available in the United States economy. The vocational expert will use your residual functional capacity to rule out available jobs. If it is determined there is no other work you are able to perform in spite of your limitations you will be found disabled.

If this whole process sounds confusing and daunting, you are not alone. Obtaining social security disability benefits is not an easy process. While you are required to pay taxes into the disability program, you are not entitled to receive monetary benefits unless you meet the strict criteria social security has set forth for disability. Your best bet in obtaining these benefits is to consult an experienced disability attorney who knows the ropes and the best way to obtain benefits for you.

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