Social Security disability is an insurance program that is run by the federal government. The federal government created the Social Security Administration to manage this insurance program. Participation in Social Security is mandatory. The way you participate is through Social Security taxes. The fact that this program is mandatory means all who participate or pay taxes on their earned wages are potentially eligible to receive benefits. This includes the most skilled of professions such as doctors, lawyers, and engineers. The way the Social Security Administration determines eligibility is based on two steps. The first being whether you meet the non-medical requirements of disability. The second step determines whether you meet the medical requirements of the program.
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Depending upon the type of program you are applying for will determine the non-medical requirements. There are two types of disability programs. The first is based on the mandatory insurance program. To qualify for this insurance you must have worked and paid taxes on your earnings for the past 5 out of 10 years. In that time you must have earned sufficient quarters of coverage, that being 20 out of the past 40 quarters. A quarter of coverage is earned by paying taxes on $1,320. You are eligible to earn a total of 4 quarters per year. This means if you earn $5,280 in one year you will earn a total of 4 quarters. AS long as you have 5 years of maxing out your quarters of coverage you will have paid enough into the insurance program to have disability insurance coverage.
The other type of program is called Supplemental Security Income or SSI. This program is a financial needs-based program similar to welfare. The non-medical requirements differ from disability insurance in that you do not need to have paid money into the program for disability insurance. The Social Security Administration will consider your current financial situation and income to determine if you meet the financial requirements. Typically higher-skilled professionals will not qualify for this program as their assets will generally far exceed the SSI requirements. Some assets that are considered for SSI qualification include second homes, second vehicles, savings accounts, stocks, bonds, or private disability income. Because of these assets, the more common program that doctors, lawyers, engineers, etc. will be eligible for is the disability insurance program.
After SSA determines whether you meet the non-medical requirements of disability, they will then assess if you meet the medical requirements of the program. Social Security has defined 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.”
SSA assesses this definition utilizing a 5 step analysis. The first step is whether the individual is engaging in substantial gainful activity. Substantial gainful activity is a monthly monetary amount that SSA has determined if someone is able to work and earn over that amount per month then they automatically do not qualify for disability benefits. However, if you are working but earning less than SGA you may still be eligible for the program. The amount of SGA changes every year. In 2018 the monthly SGA amount is $1,180. Keep in mind this amount is gross, meaning before taxes.
If you are earning less than SGA then SSA will consider step 2. Step 2 determines whether you have a medically determinable physical or mental impairment that affects your ability to work. An impairment must have more than a minimal effect on your ability to work to be considered a severe impairment. This threshold or standard is very low. Thus, most people are generally found to meet step 2.
The third step in the analysis considers whether you meet one of social security’s listing of impairments. These listings are impairments SSA has determined are so severe that as long as you have certain medical evidence to support the condition you will be found disabled at step 3. To find out whether your condition(s) meet a listing please visit SSA’s listing website for a list of conditions and the medical evidence required.
It tends to be quite difficult to meet a Listing. Most people will need to proceed to step 4 in the disability analysis. Step 4 considers whether the individual is able to perform their past relevant work. Past relevant work is defined as work you have performed within the past fifteen years. You must have performed this work at SGA levels and also long enough to learn the position. Once SSA determines what work qualifies as past relevant work, they will consider whether you are able to perform this work.
In determining whether or not you are able to perform past relevant work SSA will need to determine what your residual functional capacity is. Residual functional capacity, or RFC, is the most you are physical and/or mentally able to do in spite of your limitations from your impairments. This definition stresses the limitations to be considered are based on the most you can do, not the least you can do. One of the best ways to assess your RFC is through functional evaluations from a medical provider.
If your RFC precludes past relevant work, SSA will then move on to step 5 to determine if there is other work you could do with your limitations. This is where things start to get complicated. SSA not only determines whether you are able to do your past work but also whether you could do any other job in the national economy. That is a lot of jobs and the main reason obtaining disability benefits is so difficult. However, this is one place where the older you are the better. When determining whether there is other work available, SSA will use the medical-vocational guidelines for help. These guidelines are often called GRID Rules. GRID rules can be quite complicated. The general outline is that if you are between the ages of 50 and 54 and are found to be limited to a sedentary position you will be found disabled. IF you are between the ages of 55 and retirement age and are limited to light work you will generally be found disabled. OF course there are more factors that go into determining which GRID Rule applies. The general take away from the GRID Rules is that the older you are the easier it becomes to prove disability. So if you are a highly skilled individual such as a doctor, attorney or engineer, you may be found disabled if you are age 55, found to have the capabilities to perform light work, and unable to perform your past relevant work.
If you believe you may qualify for disability benefits do not hesitate to apply immediately. There is no filing fee to apply so apply today.