Social Security Disability Resource Center
What is the criteria for disability? |
Will I Qualify For Disability in NC? |
How long does disability take in NC? |
How to get on disability 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...
As a former disability examiner at North Carolina DDS (Disability determination services, the agency that makes decisions on SSD and SSI claims for the Social Security administration), and as someone involved in the representation of disability claimants, I can state that the road to get on disability benefits is sometimes not an easy one to travel for the following reasons:
A. The process is long. A decision on a disability application in North Carolina is normally made within 3 to 4 months; however, in some cases it can take six months or longer to get a decision.
B. The majority of disability applications in the state are initially denied. Currently, about 33% of all claims are approved at the application level which means that 67% of all claims are denied. For most individuals to be awarded benefits in NC, it will take filing appeals.
Having said this, though, most claimants who refuse to give up on their claims will, statistically, be likely to eventually win their disability benefits.
Typically, the approval--for individuals who have been denied at the application level--will occur at the disability hearing level. This is because the first appeal, the request for reconsideration, has what can only be categorized as an "astronomically high" rate of denial (in NC, reconsiderations have a denial rate of 87%).
As to how get on disability in North Carolina, a claimant will have to prove the following:
1. That they have a severe medical impairment.
The impairment can be mental, or it can be physical. In most cases, a person will list several conditions on a disability application. In fact, it is relatively rare for an individual to list only one medical condition.
And, in truth, it is actually better when a person can list multiple medical conditions. This is because the Social Security administration does not really focus on the specific condition that a person has. The focus will, instead, be on the functional limitations, either of a physical or mental nature, that result from the condition.
So, it is not at all unusual for a person to be approved for disability in North Carolina because they have (for example) carpal tunnel syndrome, depression, back problems, and perhaps even more conditions that, in their totality, result in enough limitations that make it impossible for them to return to work activity (performing either their past work, or performing some type of other work that, were they not disabled, their combination of education and skills would make them eligible to switch to).
2. That their medical impairment is severe enough to have lasted at least one full year.
This is what Social Security refers to as "duration". And on this point, we should clarify something: a person does not have to have been disabled for a full year before they file for disability in North Carolina. They can apply for disability and a disability examiner, or a disability judge, depending on the level of the claim, can review the medical evidence and make a projection as to whether or not the impairment will eventually last a full year, if it has not already.
3. That their condition is severe enough to prevent them from working and earning what Social Security considers to be a substantial and gainful income during this minimum one year period.
Note: this does not mean that a person cannot be working in order to apply for disability in North Carolina. It simply means that if you file for disability, and you are working, your earnings must be under the SGA, or substantial gainful activity income limit that is in effect for the current year.
However, we should stress that if you are working while you file for disability, or if you go back to work while you are receiving disability benefits, you should be very careful not to exceed the SGA limit; otherwise, you may make yourself ineligible to receive disability benefits, and may potentially owe an overpayment to Social Security.
If a person is granted a Social Security Disability award in North Carolina, or an SSI disability award in North Carolina, it will be through one of two ways: The person may be approved by meeting a listing in the Social Security bluebook, or they may be approved by being given what is called a medical vocational allowance.
Meeting a listing means that you have a medical condition that is contained in the Social Security Disability list of impairments, also called the blue book. Satisfying the requirements of the listing is very difficult because the criteria is fairly detailed and most individual's medical records will not contain the information needed to meet the requirements of the listing.
The more common way of being approved for disability is through what is called a medical-locational allowance.
This is where the person's medical records are reviewed to determine what their functional limitations are. The decision is made by the disability examiner, or judge if the case is at the hearing level, to determine whether the individual is capable of doing sedentary, light, medium, or heavy work.
This is called an RFC, or residual functional capacity, rating. This rating is then compared to the claimant's history of past work to determine whether or not they can go back to any of their past jobs that were performed within the 15 year period prior to becoming disabled.
If they are not able to go back to any of the jobs that are part of their past work, then a determination is made as to whether or not they can do some type of other work based on their skills and education.
If a person is found to be unable to do their past work, or any other type of work, they will be granted disability benefits.
This is essentially how the disability system works in North Carolina, and in every other state. How the system becomes very complex, of course, is in the interpretation of the information contained in a person's medical records, as well as the interpretation of their work history.
This probably accounts for why a very high percentage of cases are denied at the disability application and reconsideration appeal levels, while many of those same cases are later approved at the disability hearing level, particularly when a person has a qualified representative who is familiar with how case decisions are made, and how decisions have been improperly been made at the prior levels.
To recap: to get disability benefits awarded in North Carolina, a person's case must satisfy the requirements of the Social Security Administration's disability guidelines.
For the most part, that is a matter of analyzing the individual's evidence--contained in their most recent medical records (including statements from treating physicians) but also contained in their case file, which will provide insight as to why the case was previously denied, as well as any signs of errors in the decision process.
Filing for NC disability benefits
Applying for Disability in North Carolina - How to apply, qualify, and meet filing requirements
Applying for NC disability benefits
More about filing for disability benefits in North Carolina
How to claim disability benefits in North Carolina
What happens on a disability application in North Carolina?
How long will it take to receive NC disability benefits if your application is approved?
Basic questions about disability benefits in North Carolina
How much can you receive in disability backpay in North Carolina?
How far back do you get disability benefits in North Carolina?
Can You Work and Collect Social Security Disability in North Carolina?
How to Get the Status on Your Social Security Disability Claim in North Carolina
How do I get help to win my disability claim in North Carolina?
The disability process in North Carolina
What condition or conditions qualifies for disability in North Carolina?
How long does it take to get through the disability system in North Carolina?
Is it hard to get disability benefits in North Carolina?
What are my chances of being approved for disability benefits in North Carolina?
How long does it take to receive North Carolina disability benefits after you are approved?
Disability determination services in North Carolina
Disability decisions in North Carolina
How long does it take for the disability decision in North Carolina?
How does the North Carolina Social Security Disability determination process work?
Getting disability benefits in North Carolina
Getting denied for disability in North Carolina and filing appeals
What does getting disability benefits in North Carolina involve?
How to get on disability in North Carolina
NC Disability requirements and qualifications
Will I Qualify For Disability Benefits in North Carolina?
What is the criteria for disability benefits in North Carolina?
What are the disability qualifications in North Carolina?
Proving the requirements for disability in North Carolina
How do you meet the Disability qualifications in North Carolina?
SSI and Social Security Disability requirements in North Carolina
How do I Know If I Qualify For Disability in North Carolina?
Winning Disability benefits in NC
How do I win disability benefits in North Carolina?
Improving your chances of getting disability in North Carolina
How to improve the chances of winning a North Carolina disability hearing
Will an attorney or representative help me win North Carolina disability benefits?
Winning disability benefits in North Carolina
Mental Disability benefits in NC
Receiving disability for a mental condition in North Carolina
How do you receive benefits for a mental disability in North Carolina?
Getting approved for mental disability benefits in North Carolina
Disability awards and award notices in North Carolina
Getting a Social Security Disability award in North Carolina
The Social Security Disability award notice process in North Carolina
What affects how much time it takes to get a disability award in North Carolina?
Disability representation in North Carolina
Should I get a disability representative or lawyer in North Carolina?
Who can provide disability representation in North Carolina?
Hiring a Qualified Disability Lawyer in North Carolina
How do Disability Lawyers in North Carolina get paid their fees?
Denied for disability in North Carolina, should I get an attorney or representative?
Disability attorney fees in NC - paying your lawyer or representative
How does a disability lawyer or representative get paid in North Carolina?
How much does the fee cost for a disability attorney in North Carolina?
Do you pay your disability lawyer in North Carolina or does Social Security pay the fee?
Will your North Carolina disability lawyer charge you upfront for taking your case?
Will your NC disability attorney charge you for any expenses other than the main fee?
NC disability hearings
What kind of decision will you get at a disability hearing in North Carolina?
NC disability hearing - how long for a decision?
Do you have to go to a Social Security hearing in North Carolina to get approved for disability?
The disability hearing in North Carolina- things to keep in mind
How do you prepare for a disability hearing in North Carolina?