The five-step process for obtaining disability benefits from Social Security
When illness or injury prevents someone from working, one option for financial relief may be Social Security Disability Insurance or SSDI. Enacted into law in 1956, SSDI is the federal disability insurance program that is part of the Social Security program.
If they are “disabled” under Social Security rules an eligible person can obtain monthly payments from the federal government and also become eligible for Medicare within two years.
Like Social Security retirement benefits, SSDI is funded through a person’s own payroll deductions. Many people are not aware that their Social Security contributions count toward SSDI qualification, in addition to the retirement program.
First, the claimant must meet certain work history requirements. If they are met, the next issue is whether the claimant meets the SSDI definition of disability, which is unique and different from various more familiar definitions used in workers’ compensation or other disability benefit programs. Essentially, SSDI is available to those persons who develop long-term medical problems that prevent them from working.
Unfortunately, it can often take a long time, months and sometimes years, for the SSDI disability determination to be made. However, denied claims are often reversed on appeal and the person is entitled to a new hearing on his/her eligibility. In response, the SSA instituted two fast-track initiatives (Compassionate Allowances and Quick Disability Determinations) that recognize extremely severe disability much more quickly. In those cases claimants with incapacitating or fatal impairments get the financial benefits they need faster.
If the disability application is not fast tracked, then the administration looks to see if the claimant meets the SSDI definition of disability. To be disabled for purposes of SSDI, a claimant must have a severe medical impairment (physical, mental or any combination) that is expected to last at least one year and that prevents the applicant from working.
The SSA uses a five-step process to determine disability:
First, is the claimant working? A very minimal monthly income is not considered work for purposes of this question. If you are working, then you are not eligible. If not working, then the SSA moves to step two.
Second, is the claimant’s impairment severe? To be severe, the impairment must interfere with basic work activities. If the impairment is not severe, the applicant is not eligible. If it is severe, then the SSA moves to step three.
Third, is the claimant’s medical condition on the SSA’s official listing of medical impairments? This is a list of diseases and injuries (organized by major body systems) so severe that meeting or equaling a diagnosis on the list means the claimant is automatically found disabled. If the condition is severe but does not meet or equal a listing, then the SSA moves to step four.
Fourth, can the claimant return to previous work? If yes, not eligible. If no, go to step five.
Fifth, is there other work the claimant could still perform? At this step, the SSA considers the claimant’s impairments, age, education, transferrable work skills and past work experience. If yes, then not eligible. If no, the claimant will be found disabled and eligible.
Enlisting the assistance of a lawyer in the SSDI application process can make all the difference in a difficult and sometimes long process. After the initial application, there are three levels of appeal within the agency, followed by the option of federal court review. At any of these stages, legal representation can assist with gathering medical evidence for the claim file and communicating with the SSA. An attorney can be especially effective at the administrative hearing stage of appeal.
From offices in Corinth, Pontotoc and Tupelo, Mississippi, the attorneys at Wood & Carlton, P.C., P.C represent SSDI applicants throughout Mississippi and Tennessee.