The majority of Americans don’t plan for what could happen if they become disabled. However, the likelihood is stronger than most people realize. According to the Social Security Administration, before reaching retirement age, a 20-year-old worker has a 1-in-4 chance of becoming disabled.
Social Security has a number of benefits available to adults who are unable to work because of a medical condition that is predicted to last at least one year or is terminal. There are no benefits for conditions resulting in partial disability. There are benefits for children with disabilities as well, and in some cases, for family members of the person affected. Disabilities that are eligible for benefits can be either physical or mental.
How Is Disability Defined?
The Social Security Administration defines disability as the inability to do a “substantial gainful activity,” or SGA. SGA requires significant physical or mental activities, or a combination of both, while working either part-time or full-time. Generally, if an individual earns more than $1,620 per month (unless they are blind), they are considered to be performing SGA. In order to meet the definition of being disabled, your medical conditions must prevent you from performing work activities. “Gainful” means that the work can be done for pay or profit.
There are two types of Social Security disability benefits: Supplementary Security Income and Social Security Disability Insurance.
What Kind of Medical Conditions Cause Disability?
Physical and/or mental medical conditions that prevent a person from working at their former job, or a job with different requirements, for at least a year can be eligible for Social Security disability payments.
Some of the most common impairments that can result in receiving Social Security disability benefits include:
- Musculoskeletal Disorders (non-healing fractures, amputation)
- Mood Disorders (depression, bipolar disorder)
- Nervous System and Sense Organ Disorders (epilepsy, multiple sclerosis)
- Intellectual Disabilities (Down syndrome, fetal alcohol syndrome)
- Circulatory System Disorders (chronic heart failure, congenital heart disease)
- Schizophrenic and Other Psychotic Disorders (schizophrenia, delusional disorder)
- Other Mental Disorders (obsessive-compulsive disorder, eating disorders)
- Injuries (bone, muscle, and nerve injuries)
- Organic Mental Disorders (dementia, Alzheimer’s disease)
- Neoplasms (tumors)
Although these categories list the most common reasons beneficiaries receive Social Security disability payments, there are more than 200 conditions that can qualify. Some severe conditions allow for fast-tracked payments for people who suffer from cancers, amyotrophic lateral sclerosis (ALS), and early-onset Alzheimer’s disease, for example.
Social Security Disability Insurance
Eligibility for Social Security benefits is determined by how long an employee has worked and paid Social Security taxes. The amount of taxes paid is measured by credits, up to a maximum of four credits a year. In 2022, a worker must earn $6040 total in one year in order to earn four credits. Social Security taxes can be awarded after a worker earns at least 40 credits. However, the number of credits does not affect the amount of the benefit a recipient or their family receives. If you have more than 40 credits for example, the amount of the benefit does not increase.
In order to be eligible for Social Security Disability Insurance, the recipient has to pass a recent work test to make sure they have accumulated enough credits before they became disabled.
- Before age 24: A recipient may qualify if they have six credits earned in the 3-year period ending when their disability starts.
- Age 24 to 31: A recipient may qualify if they have credit for working half the time between age 21 and the time their disability began.
- Age 31 or older: A recipient must have at least 20 credits in the 10-year period immediately before their disability began.
Family Benefits for SSDI
Certain family members of disabled workers can also receive money from Social Security. This includes the recipient’s spouse, divorced spouse, or children, and adult children disabled before the age of 22. Each family member who applies may be eligible for a monthly benefit of up to 50% of the amount of the original recipient. The total limit awarded to a recipient and their family is about 150-180% of the original recipient’s benefit.
Spouses are eligible for benefits if they are 62 or older (unless they collect a higher Social Security benefit based on their record of work) and based on how many months remain before their full retirement age.
If the spouse is caring for the recipient’s child under the age of 16 or an adult child who became disabled before age 22, they may be eligible for benefits.
An ex-spouse may be eligible for benefits if they were married to the recipient for at least 10 years, are at least 62 years old, are unmarried, and are not eligible for an equal or greater Social Security payment based on their own or someone else’s work record.
Children of disabled workers may also be eligible, including biological, adopted and stepchildren, and dependent grandchildren. The child must be unmarried, under the age of 18, be 18-19 years old and a full-time student up to grade 12, or an adult child with a disability that started before age 22.
If a worker dies, their disabled spouse or surviving divorced spouse may be eligible for a widow or widower’s benefit if they are between 50 and 60 years old and their disability started before or within seven years of the worker’s death.
Benefits for Disabled Children
Children with disabilities who were receiving Social Security benefits as a minor child on a parent’s record may qualify to continue those benefits after the age of 18.
An adult with a disability that began before the age of 22 may receive benefits if their parent is deceased, or their living parent is receiving retirement or disability benefits. It is still considered a child’s benefit since it is based on the parent’s Social Security record.
A Disabled Adult Child (DAC) can be an adopted child, or, in some cases, a stepchild, grandchild, or step-grandchild may be eligible for benefits under the parent’s Social Security record.
They must be unmarried, be age 18 or older, have a qualified disability that started before age 22, and meet the definition of disability for adults. The DAC does not need to have any work record, but they must not have substantial work earnings.
The Application Process for Social Security Disability
Applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) can be a complicated and time-consuming process. That’s why we want to share some of the steps involved to help you avoid delays or mistakes that can lead to a denial.
Overview of the Application Process
To apply for SSDI or SSI, be sure to gather all relevant medical records, employment history, and other documentation that proves your disability prevents you from returning to work. Including every single limitation that keeps you from doing your job will improve your chances of an approval. The application can be submitted online, by phone, or in person at a Social Security office.
What’s the First Step When Applying for Social Security Disability Benefits?
Applying for Social Security disability can be a complex and confusing process. If you are dealing with your own recent illness or injury, or that of a family member, you are already under considerable stress and financial hardship. In spite of your best efforts, your application may have omissions and mistakes, which may lead to your benefits being denied.
If you have already applied and been turned down for benefits, facing an appeals process may be intimidating. Your next step should be to consult a professional legal team who are experts in the Social Security disability benefits system and will help you get the benefits you and your family deserve. Contact us today for a free initial consultation.
Common Mistakes to Avoid
It’s common for applicants to make errors, causing delays or denials. Those errors include incomplete paperwork, missing medical documentation, or failing to respond to requests for more information. Being organized from the start is key to a much smoother process.
Appealing a Denied SSDI or SSI Claim
If your initial claim for SSDI or SSI is denied, don’t be discouraged. Many applications are rejected upon first try. That’s frustrating, but fortunately, you have the right to appeal. Understanding the Social Security appeals process is crucial for improving your chances of success.
The Social Security Appeals Process
First, you can request a reconsideration of your application, where your claim will be reviewed again. If denied, you can request a hearing before an Administrative Law Judge (ALJ). Then, if your ALJ hearing results in yet another denial, your case can go to the Appeals Council, and eventually to Federal Court if needed.
What to Expect at Each Level of Appeal
It’s important to note that the amount of scrutiny increases at each level. Being thorough is critical at every stage of the application process, but there’s truly no room for error once you’re appealing denials. Here’s what you can expect at each level:
During reconsideration, another official reviews your claim.
If you move on to an ALJ hearing, you will present your case to a judge, providing new medical evidence.
After the hearing, the Appeals Council will review the judge’s decision. If necessary, your case may go before a federal judge.
Tips for Improving Your Chances on Appeal
Here are a few ways to strengthen your appeal:
- Gather additional medical evidence.
- Be sure to correct any errors in your initial application.
- Seriously consider getting a lawyer involved to review your case. It can make all the difference during the appeals process.
How a Social Security Disability Lawyer Can Help
To say that the complexities of applying for SSDI or SSI are overwhelming is an understatement. The high rate of initial denials makes this process extra challenging and frustrating. This is where a Social Security Disability lawyer can make a critical difference.
Increasing Your Chances of Approval
An experienced Iowa SSD lawyer understands the intricacies of Social Security law and can anticipate every next step and expectation to build a compelling case. They can make sure your application is meticulous and that all necessary documentation is included. Having a lawyer guide you from the beginning improves your chances of being approved at the initial stage, but if you’ve been denied already, it’s not too late.
What to Expect from a Social Security Disability Lawyer
When you work with a Social Security Disability lawyer, they will:
- Guide you through every step of the process. This includes completing your application, gathering necessary medical records, and representing you during appeals.
- They will also communicate directly with the Social Security Administration on your behalf.
- Having an advocate during this process will reduce stress and improve your chances of a favorable outcome.
Your claim should be handled by someone who knows the process inside and out. Besides, the benefits you are applying for are YOUR benefits, and a lawyer will give you the best chance at securing what should be yours in the first place.
Consulting a Lawyer for Your Social Security Disability Application
Navigating the Social Security Disability system is incredibly complex, confusing, and intimidating. There is a lot at stake when you apply for SSI or Social Security Disability Insurance for yourself or your family.
If your application has any errors or is missing any information, you can be denied benefits you are eligible for. If you have applied previously and been denied, there is an appeals process that you don’t have to go through alone. You should always seek expert legal advice so that you receive the benefits you deserve.
At Mueller, Schmidt, Mulholland & Cooling, our experienced team is here to help. Contact us today for a free initial consultation.