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What are the disability qualifications in North Carolina?

Note: The SSDI, SSI disability system is federal and nationally standardized, though there are state differences in approval rates, wait times, the number of appeals available--as of the time of this writing--and even the name given to the stage disability agency (DDS, or the Bureau or Division of Disability Determination). Now, to answer the question...

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.

This is why the Social Security evaluation process is focus is 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.

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.

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.

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