You may have heard about the Social Security Disability program in the past or you know a family member, neighbor, or friend that is receiving those benefits. But what really are those benefits? And should you apply for them?
Social Security Disability is a federally run disability insurance program. This program provides individual health and monthly monetary benefits if they are unable to work due to physical and/or mental conditions. This program is mandatory, and funded from the taxes you have paid into the social security system. Not everyone has disability insurance coverage. Only individuals who have paid social security taxes from their earned income will be eligible for this program. Generally, you must have paid taxes into social security for the past 5 out of 10 years to be eligible for this coverage. Also, you must prove you became disabled within 5 years of the last date you paid social security taxes.
If you have worked long enough and have paid your taxes every year, you may be eligible for this program.
Below is a list of the top three reasons to apply for these benefits.
You suffer from a condition which prevents you from working 8 hours a day, 5 days a week.
If you are struggling to fulfill a full work week then this may be the right program for you. Most people who apply for these benefits are not able to work in any capacity. The first step in determining eligibility for disability benefits is whether you are earning substantial gainful activity. If you are not working then you will easily pass this step in the process. Generally, the day you stopped working full-time will be used as your disability date. But if you were laid off a year prior and then suffered a severe motor vehicle accident leaving you paralyzed last month, your disability date will more than likely be the date of the injury. Determining your disability date can certainly be confusing and is something that is best left to legal counsel.
In terms of part-time work, you may still qualify for the disability program. As long as your part-time work does not constitute substantial gainful activity, you will be able to proceed with the disability process. SGA is a monetary amount that changes each year. In the year 2016, this amount was $1,090. Meaning, if you are working but earn less than $1,090 per month in gross you will move on to step 2 in the disability process.
Keep in mind, the reason you are working part-time must be related to a severe physical and/or mental condition, as mentioned above. Your reasoning for part-time work cannot be based on the fact that you cannot find a full-time job, or that you want to only work part-time. The hours must be restricted by your functional limitations.
You suffer from a severe physical and/or mental condition.
The second consideration in the social security disability process is whether you suffer from a severe physical and or mental condition. Severity is defined as having more than a minimal impact upon your ability to work 8 hours a day 5 days per week. What this means is that just being diagnosed with a condition is not sufficient to prove severity. You need to show that your diagnosis comes with functional limitations.
The Social Security program considers not only physical conditions but also mental conditions when making their determination. If you find that you are struggling to complete an 8-hour workday due to a medical condition, you may want to apply for disability benefits. Some of the most common conditions include:
- Auto-Immune Disorders (i.e. rheumatoid arthritis, Crohn’s disease, lupus)
- Back Pain
- Mental illness (i.e. bipolar disorder, anxiety, depression, schizophrenia, and PTSD
- Chronic Pain (i.e. fibromyalgia, chronic fatigue syndrome, chronic pain syndrome)
- Digestive Disorders (i.e. inflammatory bowel syndrome)
- Heart Conditions (i.e coronary artery disease, congestive heart failure, arrhythmias)
- Neurological Disorders (i.e. brain injury, narcolepsy, seizure disorder, MS, stroke)
- Orthopedic Conditions (i.e. osteoarthritis, carpal tunnel syndrome)
- Respiratory illness (i.e. asthma, COPD, emphysema)
It is important when proving severity that you are seeking treatment from a medical doctor on a regular basis. And that doctor is documenting in the treatment notes not only your conditions but also the limitations and symptoms you suffer from those conditions. This will be the basis of the evidence used to prove the severity of your conditions. Make sure you are treating with a provider who is an MD, DO, PhD or PsyD. These providers’ opinions will hold the most weight when determining severity. Unfortunately, nurse practitioners, physical therapists, chiropractors, and even mental health counselors are not afforded as much weight in terms of their opinions, when compared to a medical doctor.
Another thing to keep in mind, when you are treating your doctor, ask if they think you should apply for disability benefits. If your doctor believes you should apply for the program then more than likely you will qualify. This would be a good indication of disability.
Your disabling condition is expected to last for 12 months or end in death
Social Security Disability Insurance requires an individual to be unable to work for at least 12 months. Or, their condition is expected to end in death. This is a very important distinction to make when comparing this federal program to private disability insurance programs. The Social Security program requires an expectation of being out for 12 months while short-term private programs may reimburse you for being out as short as 1 day or 3 months. If you are expected to be out for a significant period of time the social security disability program is probably the right fit for you.
These are just the top three reasons to apply for social security disability benefits. As you can tell after reading this information, the program is complicated. To determine if this is really the right fit for you, call me at LaBovick Law Group. I will discuss your situation and determine your eligibility for this program.