What are the Disability Qualifications in North Carolina
Author: Tim Moore, Accredited Disability Representative and former NC Disability Examiner. For a free case evaluation, complete the form at the bottom of the page.
How to get Disability in NC
This may be the most thorough guide to getting disability in North Carolina you will find, partly because I am an Accredited Dsiability Representative, but also because I am a former disability examiner who has been writing about the sytem for approximately 20 years.
To get disability disability benefits in the SSD or SSI program in North Carolina, you must first file a claim. You have several options for doing this including the SSA 1-800 line, filing online, or visiting a local field office. However, our advice is to avoid the toll free line or the online application process, because they carry problems with them.
Our office has found that the most efficient way to start your claim is to contact a local Social Security office and get an appointment set for a disability application interview to be done by phone. This allows you to avoid going there physically and makes the process less stressful. It also allows you to gather your information at home regarding your medical treatment sources and past jobs so you can have it ready when the interview begins.
If you have representation before you apply
If you have a representative, such as our office, they can call Social Security and get the appointment scheduled for you. When the appointment is made, Social Security will typically call you and text you the appointment date and time as well. If you have representation at this point, your representative will receive copies of everything SSA sends you and if you are denied they will be in a position to immediately file an appeal on your behalf.
Maximizing your chance of getting approved on the application
Most individuals are denied on their disability application in North Carolina. This is not abnormal. But it does mean that appeals will need to be filed and usually a hearing before an administrative law judge will be needed. The hearing level is where we do the bulk of our work, getting statements from your doctors, recent medical records, and analyzing your work history to prepare for the hearing, at which a vocational jobs expert may be present by the request of the judge. However, we attempt to learn as much about your case at the beginning, i.e. your medical conditions, how they affect you, and who has treated you, in order to present as complete a picture as possible in the hopes that you might be awarded disability at the first step, the disability application, which would allow you to skip appeals and get your benefits going considerably faster.
How do you meet the qualifications for disability in NC?
To meet the qualifications for disability in North Carolina, a person filing a claim, under either the Social Security Disability or SSI program, must prove–largely through the information contained in their medical records, but also through their vocational history–the following:
1. That their condition is severe.
2. That their condition has lasted (or can be projected to last) for a period of not less than one year.
3. That during this minimum one year period, they have not been able to, as a result of their condition (or conditions which is usually the case), work and earn what Social Security considers to be a substantial and gainful income.
As you can see, the fundamental issue for Social Security Disability and SSI claims is whether or not a person can work; in fact, the issue is really not even whether a person can work, but whether they can work AND earn a substantial income.
Social Security considers your medical conditions and work history
This is why the Social Security evaluation process is focused not just on a person’s medical records, but also on their work history. And this is why a disability examiner may contact you to clarify information regarding the jobs you have worked in the past, as well as the duties of those jobs.
As far as the individual items above are concerned, Item 1 is relatively easy to prove, as Social Security can distinguish between what is, and what is not, a severe impairment.
Nonetheless, there is room for some subjectivity here. For example, a sprain of the wrist would not be considered a severe impairment, while “headaches” or “abdominal pain” may very well be since they may easily be indicative of a much larger medical problem.
Items two and three are also fairly clear cut as they will be plainly verified by the individual’s medical records and work history.
All three of these disability qualifications are part of the Social Security Administration’s unique definition of disability, Which applies to both the SSD and the SSI disability program.
However, we should also clarify several other facts regarding the two disability programs.
Short-term disability is not an option
The Social Security Administration does not offer any type of short-term disability benefit. In other words, to qualify for disability benefits, your condition must be, for lack of a better phrase, “long-term”.
When we say long-term, however, do we also mean that your condition must be considered permanent, in order for you to meet the requirements for disability?
The answer is yes and no. When a person is approved to receive disability benefits under SSD, or SSI, or under both programs in the form of a concurrent claim, the assumption is that their state of disability will be long-standing.
In fact, this is why the process of qualifying for disability requires that a person must have a disabling condition for a minimum period of one full year before they can be determined to be eligible to receive ongoing disability benefits.
You must be completely disabled, but not necessarily permanently disabled
Having said this, though, this does not necessarily mean that Social Security automatically concludes that a person’s disability will be absolutely permanent.
For any individual that is awarded benefits, Social Security maintains the assumption that their condition may “potentially” improve. This is why, after disability benefits are awarded, a person’s case will be set up for periodic reviews. The purpose of a review is to determine whether or not medical improvement has taken place.
Can you lose your benefits after you get them?
If medical improvement occurs, there is the possibility that an individual’s disability benefits will be discontinued. However, it is somewhat rare for a person’s disability benefits to be stopped, simply because, for most individuals, the medical evidence will not indicate that their condition has gotten better. Therefore, for this reason, there is usually little reason to fear a continuing disability review.
How often do reviews of your case happen? They can occur as little as one year after your case been approved; however, some cases are set to be reviewed every seven years. Having said this, though, sometimes reviews can take much longer than this simply because Social Security is perpetually behind on cases.
To reiterate, Social Security does not provide short-term disability benefits.
For Social Security and SSI you must be 100% disabled
Social Security also does not provide percentage-based disability benefits. For example, unlike veterans disability benefits, a person cannot receive a 30% disability benefit, or a 60% disability benefit. For Social Security purposes, a person either meets the qualifications for disability, or they do not.
The process of evaluating a disability claim, under Social Security regulations and guidelines, is fairly simple in concept. A person’s medical records will be evaluated, and whatever functional limitations they have as result of their medical condition, or conditions, will be determined.
How NC disability claims are decided
These limitations will be compared to the requirements of the jobs they have held in the past to determine if they can go back to one of their past jobs, or if they cannot do any of their past work at all.
If a claimant cannot do their past work, then the next question to resolve is whether or not they can transfer their education, work skills, and job experience to some type of other work, essentially some type of job they’ve never done before. If the answer to this question is no, as well, meaning that they cannot be expected to do some type of other work, then they will be given a disability award.
So, to sum up, receiving disability under SSD or SSI is based on your inability to do A) any of the jobs you’ve done before, and B) any other type of work that you might have been able to switch to if you were not disabled.