In order to qualify for Social Security disability benefits, you must be found “disabled” under Social Security’s definitions.
By law, Social Security has a very strict definition of who is considered disabled. Most applications are initially denied.
To be found disabled:
•You must have a severe impairment;
•You must be unable to do substantial work because of your medical condition(s); and
•Your medical condition(s) must have lasted, or be expected to last, at least one year, or expected to result in death.
Some applicants have medical conditions that are so severe that their conditions obviously meet disability standards. To quickly identify and help these individuals, Social Security has a list of Compassionate Allowances, or conditions that that will qualify for benefits based on evaluation of minimal, official medical records. There are also 14 categories of “listed impairments,” which describe specific medical criteria for various impairments that will essentially result in an automatic disability determination, without the need to consider age, education, or work experience. Most types of illnesses, however, can vary from minor to severe. This makes defining disability tricky, as it depends on how badly the illness or disease has affected you.
When To Apply for Social Security Disability
As a general rule, you should apply sooner rather than later. You can file for Social Security disability benefits on the very same day that you become disabled. Many individuals make the mistake of waiting months or even years after becoming disabled before filing a Social Security disability claim. However, there is no reason to file a Social Security disability claim if you only have a minor illness or one that is unlikely to last at least one year. But, an individual who suffers serious illness or injury and expects to be out of work for a year or longer should not delay in filing a claim for Social Security disability benefits.
- I am 60% disabled. Do I get 60% of my Social Security disability benefits?
No. There are no percentages of disability in the Social Security disability determination. For purposes of Social Security disability benefits, you are either disabled or not disabled according to the strict Social Security standards. Thus, Social Security only pays for total disability; no benefits are payable for partial or short-term disability.
- I have several health problems, but no single one disables me on its own. It is the combination that disables me. Can I get Social Security disability benefits?
Social Security will review the combination of impairments that an individual suffers in determining disability. Many claimants for Social Security disability benefits have more than one health problem and the combined effects of all of the health problems must be considered.
- I got hurt in an automobile accident. I am disabled now, but I expect that I will be able to return to work after I recover. Should I file for Social Security disability benefits?
If you expect to be out of work for a year or more on account of illness or injury, you can file for Social Security disability benefits. If you are later able to return to work, you can notify Social Security of this development, cease benefits and return to gainful employment.
- I am disabled because of a mental illness. Can mental illness serve as the basis for a Social Security disability claim?
Yes. Both mental and physical impairments must be considered by Social Security in evaluating disability claims.
- Can people suffering from alcoholism or drug addiction get Social Security disability benefits for their addiction?
Realistically, alcohol or drug abuse in a client’s medical records is considered by attorneys to be the ‘kiss of death’.
Congress prohibits Social Security from paying disability benefits on the basis of alcoholism or drug addiction alone. However, just like anyone else, people suffering from alcoholism or drug addiction can have heart attacks, get cancer or get sick in other ways. Those who become disabled apart or in addition to alcoholism or drug addiction can be eligible for Social Security disability benefits, so long as their alcoholism or drug addiction is not a material contributing factor to their disability. In other words, you had better be in recovery, and your credibility will be scrutinized. You must show the judge your inability to work is not self-imposed due to drug or alcohol addiction.
Employment, Disabled Children & Work History Issues
- My daughter has never been able to work because she has been disabled from birth by cerebral palsy. Can she get disability benefits from Social Security?
Possibly. If the child is under 18 and you have limited income and resources, the child may qualify for SSI benefits. If the child is older than 18, she may be able to qualify for SSI disability benefits without regard of the income of her parents. If either of her parents are drawing Social Security benefits of some type or are deceased, and the child’s disability began before age 22, the child may be eligible for disabled adult child benefits.
- I used to work, but lately I have been staying home taking care of the kids. I recently became sick. Can I get Social Security disability benefits?
Possibly. If you worked five out of the last 10 years before becoming disabled, you may have enough earnings to qualify for Social Security disability benefits. For individuals age 31 or under, the requirements are a little different, since such individuals have not had an opportunity to work for a long period of time. Unless a person has been staying home and taking care of his or her children for quite a long time, it is very possible that they will qualify for Social Security disability benefits based upon his or her own earnings. A homemaker, depending on his or her financial situation, may qualify for SSI regardless of his or her work history.
- I am disabled, but I have never worked. Can I get Social Security disability benefits?
If you have very limited income and resources, you may qualify for SSI benefits, even if you have never worked before. It is also possible to qualify for disabled adult child benefits on a parent’s work history if you became disabled before age 22, or for disabled widow’s or widower’s benefits on the earnings record of a late husband or wife. Contact a Social Security attorney to review the facts in your specific case.
- I am a widow. I have not worked for many years, but I am disabled. Can I get Social Security disability benefits?
If you are age 50 or older and became disabled within seven years of your husband’s or wife’s death, or within seven years after you last drew mother’s or father’s benefits from Social Security, you may be eligible for disabled widow’s or widower’s benefits. If you are age 65 or older, even without a disability, and have very limited income and resources, you may be eligible for SSI benefits.
- I got hurt on the job and I’m drawing workers’ compensation benefits. Can I get both workers’ compensation and Social Security disability benefits?
Yes, you can receive both at the same time. However, depending on which State you live in, either your workers’ compensation or your Social Security disability benefits will be reduced so that the total amount of the combined benefits do not exceed 80 percent of your average earnings before you became disabled. You do not have to wait until the workers’ compensation ends. It is best to file the Social Security disability claim as soon as possible because otherwise there may be a gap between the time the workers’ compensation ends and the Social Security disability benefits begin.
- I am still on sick leave from my employer. Can I file for Social Security disability now or do I have to wait until the sick leave is exhausted?
You do not have to wait until the sick leave is exhausted. You should file for Social Security disability benefits now, if you believe that you will be out of work for at least one year.
- I am disabled, but I have sufficient amount money in the bank for now. Do I have to wait until this money is gone before I apply for Social Security disability benefits?
No. If you have worked in recent years or if you are applying for disabled widow’s or widower’s benefits or disabled adult child benefits, it does not matter how much money you have in the bank. There is no reason to wait to file for Social Security disability benefits.
- Can I receive Social Security disability benefits in addition to Medicare and/or Medicaid?
Everyone found disabled under the SSDI program is also eligible for Medicare after a 29-month waiting period (two years plus the five month mandatory waiting period). During this waiting period for Medicare, an individual may be eligible for health insurance through a former employer. The employer should be contacted for information about health insurance coverage.
Typically, a SSI recipient is entitled to Medicaid. In most States, if you are approved for SSI, you are automatically approved for Medicaid. In other States, you must apply and establish eligibility for Medicaid separately at your local Medicaid office. Information on SSI and Medicaid in your State is available online. It is possible to get both Medicare and Medicaid if you have a low income and limited resources.