What is the Application Process for Social Security Disability and SSI?
How do you Win Benefits under Social Security Disability or SSI?
If I am determined disabled, how far back will Social Security pay benefits?
How do you prove your disability case if you have a mental condition?
What Can I Do to Improve My Chances of Winning Disability Benefits
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
How to File for Disability - Tips for Filing
If You Get Approved For SSDI Will You Also Get Medicare?
How much does a Social Security disability attorney get paid?
Social Security Disability SSI Criteria and the Evaluation Process
How long does it take to be approved for SSI or Social Security disability?
What do you Need to Prove to Qualify for Disability Benefits?
Social Security Disability SSI and Fibromyalgia
Social Security Disability SSI and Degenerative Disc Disease
Can I Qualify For Disability and Receive Benefits based on Depression?
Answers to questions about SSD and SSI disability
What Disabilities Qualify for SSI and Social Security Disability Benefits?
Social Security Disability Status
Social Security Disability Tips — how a claim gets worked on
Social Security Disability, SSI Disability - Terms, Definitions, Concepts
What makes a person eligible to receive disability benefits?
How to prove you are disabled
and win disability benefits
Continued from: Part I: What makes you eligible for Social Security Disability or SSI?
After all the various types of evidence have been gathered on a social security disability or SSI disability case by a disability examiner, how is the decision made? Or, perhaps a better way to put it is to ask "How does a person qualify for disability benefits and what makes them eligible?". We can answer the question in two parts.
How does a person qualify for disability
There are two ways in which an individual will qualify for disability benefits in either the SSD or SSI disability program. The first method is by having a condition that is listed in the social security administration blue book (the social security list of impairments) and also meeting the severity requirements of the listing for that condition. Satisfying a listing can be difficult and most conditions are not listed in the blue book.
An example of a condition that is listed in the blue book is asthma. Qualifying for disability under the asthma listing requires being able to show documented medical evidence that the condition has, first of all, been diagnosed, but, further, that the individual has chronic asthmatic bronchitis of a certain severity level or that the individual has suffered a certain number of asthma attacks within a designated time frame.
One difficulty of satisfying the asthma listing is that for an attack to be countable it needs to have been documented by a physician. However, most people do not rush off to the hospital each time an asthma attack occurs. This can make satisfying the asthma listing difficult. But asthma is, by far, not the only listing in the blue book that is difficult to satisfy for whatever reasons. Many of the conditions in the Social Security list of impairments will be very difficult to meet due to the documentation requirements.
Added to that difficulty, though is the fact that most medical conditions are not listed. Conditions like fibromylagia and carpal tunnel syndrome, while being fairly common, are not given listings.
Fortunately, there is another means of receiving a disability award. This is by being given what is called a medical vocational allowance. This is a type of approval that requires a disability examiner to review a claimant's medical records and determine how they are functionally limited by giving them a rating (e.g. are they capable of heavy, medium, light, or sedentary work, or are they capable of performing what social security refers to as SSRTs, which are simple, routine, repetitive tasks).
This rating of a person's limitations is compared to the type of work they have done and this allows the disability examiner to decide whether or not they are capable of engaging in work activity.
The great majority of all approved cases are approved on the basis of a medical vocational allowance being made. And since this allowance (approval) is both medical and vocational in nature, claimants should try to provide as much information, at time of filing for disability, with regard to where they have been treated and where they have worked.
The work history, in particular, should be well documented. It is generally unwise to simply list one's past places of employment. Instead, a claimant should also supply an accurate job title along with a detailed description of the duties involved for each job. This is because the disability examiner will rely on a resource published by the department of labor known as the DOT, or dictionary of occupational titles.
Jobs that are identified in the DOT supply information about the mental and physical requirements of jobs, as well as the skills that are held by individuals who have performed these jobs. Properly identifying the claimant's jobs in the DOT can determine whether or not the disability examiner will consider the claimant as capable of returning to their past work, or even being able to do some new type of work based on their training.
So, obviously, it is clearly in the claimant's best interests to provide enough detailed information about their work history so that their jobs can be properly identified. Because it can make a difference as to the outcome of a case.
What makes a person eligible for disability benefits?
Simply put, a person is eligible to receive disability benefits if they satisfy the definition of disability used by the social security administration. The way that SSA views disability is different from private disability insurance companies and very different from the military in the sense that it is not enough for a person to be disabled to the extent that they can no longer do their last job. Their condition must be severe enough that the limitations that are imposed by their condition, or conditions, rule out the ability to do any kind of work while earning a substantial and gainful income.
The catch phrase in the last sentence, of course, is substantial and gainful income. What that basically means is that a person may be still work and be considered disabled by SSA if they are not able to work and earn a certain amount of gross income each month. That amount is the SGA limit (see the definition of: SGA, or substantial gainful activity ).
Here is a condensed form of the definition of disability. If a person's case satisfies this standard of disability, they may be approved for benefits.
1. The individual's condition must be severe, versus a simple non-severe impairment that has no substantial impact in terms of reducing their ability to engage in normal daily activities.
2. The condition cannot be temporary. Instead, it must last a minimum of 12 months (additional information: Can you get temporary Social Security disability or SSI benefits ? ).
3. The condition must result in functional limitations, of a physical or mental nature, or both, that make it impossible for the individual to work and earn a substantial and gainful income. And this inability to work at this earnings level must persist for at least one full year.
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SSD and SSI are Federal Programs
The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states:
Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Recent approval and denial statistics for various states can be viewed here:
Social Security Disability, SSI Approval and Denial Statistics by state
Special Section: Disability Lawyers and unnecessary claim denials