QUALIFING FOR DISABILITY AND THE SETS OF CRITERIA



Is there a trick to qualifying for disability benefits with social security?



 
No, no matter how many articles you may read that state otherwise, there is no trick to qualifying for disability benefits. The Social Security Disability system is very plain and matter of fact with regard to how an individual may or may not qualify. And basically, the evaluation process for benefits comes down to two different sets of criteria.

1. Medical - Do your medical and/or mental health records indicate that you have one or more severe impairments. To qualify for SSD (Social Security Disability) or SSI (supplemental security income), an individual must have at least one impairment that is considered to be severe.

What is severe, of course, may be a matter of subjective opinion. Obviously, a sprained elbow would not be considered a severe disability, while a respiratory condition or depression could easily be considered a severe impairment. Is the existence of one or more severe impairments enough to qualify a person for disability benefits?



Not necessarily. Not only must a condition be simply "severe", it must be severe enough to prevent an individual from having the ability to engage what the social security administration refers to as substantial and gainful activity. Substantial gainful activity, SGA, is work activity that is performed at a certain monetary level each year.

2. Work Activity - This is the second set of criteria that determines whether or not a person may qualify for disability benefits with the social security administration. If an individual has a severe impairment (or multiple severe impairments) and the impairment is severe enough to prevent the individual from working and earning whatever the SGA earnings limit is for the given, and this situation persists for at least a full calendar year (12 months), then the individual may be considered by the social security administration to be disabled.

On the other hand, if a person has one or two or three severe impairments yet can still engage in work activity and at the same time earn at least whatever the SGA earnings limit is for the given year, then the individual cannot be considered disabled by the social security administration.

SSD and SSI really comes down to the information that is contained in an applicant's medical records, but the determination is also affected by evidence of an applicant's work ability. Of course, evidence of an applicant's ability to work can be inferred by the information contained in an applicant's medical records (for example, the applicant's medical records may directly or indirectly state that the applicant can engage in a full range of daily activities) or can be obtained directly by the mere fact that the applicant is actually engaged in work activity during the time that their disability application or disability appeal is being processed.


About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.







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