You may have heard about the Social Security Disability program in the past. Maybe a friend or family member has received those benefits, but what are disability benefits? Social Security Disability is a government-run program set in place to help individuals who are unable to work due to a physical and/or psychological condition. When you work, you pay disability taxes on your earned income. Those taxes that you pay go towards disability insurance coverage which is managed by the Federal Government. This program is mandatory, unlike private disability insurance programs. Like any insurance program, you need to have the coverage to receive a benefit. In this instance, for you to have disability insurance coverage from the Federal Government you must have worked 5 out of the past 10
If you do not have disability insurance coverage, you may qualify for the second type of disability. This program is called Supplemental Security Income, or SSI. The SSI program is a financial needs-based program. To qualify for this program you need to provide proof that your total income and assets are less than $2,000 a month if you are a single individual.
While both programs have different technical requirements, what they have in common is that they both require a finding of disability as defined by the Social Security Act. Whichever program you apply for, the Social Security Administration will evaluate your claim for disability the same way using a five-step sequential evaluation:
Step 1: Determining if you are performing a substantial gainful activity.
Contrary to what you may have heard or assumed, you are able to work while applying for Social Security Disability benefits. The first step in the disability analysis is whether the work you are performing rises to what Social Security has termed “substantial gainful activity”. Substantial gainful activity (SGA) is any work that you perform where your earnings gross a certain amount per month. This amount changes every year. In 2016, the SGA amount is $1,130. What this means is that if you are working and grossing more than $1,130 per month, then you will be denied disability benefits at Step 1 in the analysis. If you are not working, or you are earning less than SGA, then we move on to Step 2 in the analysis. One thing to keep in mind is that if you are only applying for the SSI program and you are working, whatever benefit you receive from SSI will be reduced by the exact amount you are earning. This reduction is not the same for the disability insurance program.
Step 2: Is your impairment severe?
At Step 2, SSA will consider the severity of your medical conditions. While they analyze them individually, a determination of disability is made up of all of your conditions put together. A condition is deemed severe if it has more than a minimal impact on your basic work-related activities. This standard is relatively low. Most often, if your conditions interfere in some way with your ability to work, Social Security will find that you meet the severity requirement at Step 2. It should be noted that if you are not receiving any medical treatment for your conditions, it will be hard to prove your conditions are severe. As long as SSA makes a finding of severity on at least one condition, then social security will move on to step 3.
Step 3: Does your condition meet a Listing?
Social Security has come up with a list of conditions that are so severe that they automatically mean you are disabled. To meet a Social Security listing, you will need to show medical evidence supporting not only your diagnosis but also your limitations. There are 14 Listings that cover multiple body systems. They are broken down by group such as neurological or mental disorders. If you are found to meet or equal a listing, then the analysis stops right there and you will be paid disability benefits. However, if your conditions do not meet or equal a Listing then Social Security will move on to Step 4.
Step 4: What is your residual functional capacity and can you perform your past relevant work?
At this Step, Social Security will review your medical records to determine what your residual functional capacity is. Your residual functional capacity (RFC) is an assessment of your symptoms and limitations. This assessment considers your maximum activity level and whether at your best if you would be able to perform the job duties of your past work. Your past relevant work includes any work you have performed in the past fifteen years, as long as you worked at the job long enough to learn it and you earned SGA level earnings. If Social Security determines based on your RFC that you could perform any of your previous jobs, you will not be found disabled. In the event Social Security finds you are not able to perform any of your past jobs given your limitations, then SSA will move on to the final step in the disability analysis.
Step 5: Can you adjust to other work?
At the final step, Social Security will sue the same RFC they determined in Step 4. Only they will compare your RFC to every job in the national economy. SSA determines if given your conditions, you will be able to adjust to any other type of work in the national economy. This includes job you have never performed and probably have never heard of. If SSA finds you are not able to adjust to other work, then you will be found disabled. However, if you are found able to perform other work in spite of your limitations, SSA will not find you disabled. Because this is the final step in the analysis if you are found not to be disabled, then the process is over.
Determining whether you qualify for Social Security Disability benefits can be quite confusing. First, you need to determine if you meet the technical requirements for either the disability insurance program or the SSI program. If you are deemed to technically qualify, only then will SSA determine if you meet the definition of disability. If you are unsure if you are disabled, or even if you technically qualify, call us at LaBovick Law Group for a free consultation. We will quickly determine what/if any program you may qualify for.