What are the disability requirements for filing a claim in Texas?
Both Social Security Disability and SSI disability are federal programs administered by the Social Security Administration. Therefore, filing for SSDI or SSI benefits in Texas will be remarkably similar to what a person encounters in any other state.
There are different types of "requirements" concerning the SSDI (Social Security Disability Insurance) and SSI (supplemental security income) programs. On this page, we will divide them into easily understandable categories.
The first type of requirements are basic application requirements. And by this we mean the requirements for which a person can simply be allowed to file a disability claim. These requirments also fall under the category of non-medical requirements.
Common questions about filing for disability in Texas
Application requirements in Texas
To be eligible to file for SSI disability, you must be a U.S. citizen or permanent resident of the United States. SSI is a need-based program. It provides disability benefits to individuals who may never have worked (including minor-age childen), or who have not worked for long enough that they may no longer be covered for SSDI, meaning they have lost their insured status.
Because SSI is need-based, a requirement for filing for SSI is that a person must not have more than a certain amount in countable assets. For SSI, the limit on how much you can have in assets is currently $2000. See: What are countable assets for SSI?
To be eligible to file for SSDI, you must also be a U.S. citizen or permanent resident of the United States. But you must also be insured for SSDI as a result of work credits earned through work quarters.
SSDI is for individuals who have worked long enough to be covered by the program, though it should be noted that many people were once covered for SSDI but lost this coverage after not being in the work force for a long period of time.
SSDI does not have any restriction on how much a person can have in assets. It is simply not an issue.
However, both SSDI and SSI do limit how much a person can work and earn and still be considered eligible to receive disability benefits. This is because neither program assumes that a disabled person cannot work at all. Instead, both programs assume that while a person may be able to engage in some amount of work activity, their physical or mental condition simply prevents them from being able to work and earn a substantial income.
Both a person's assets and current income will be evaluated before any real work is done on a disability case. If a person is found to have too much in assets or earnings, the claim will never make it onto the desk of a disability examiners, examiners being the case processing specialists that make decisions on SSDI and SSI claims for the Social Security Administration. Instead, it will receive what is known as a technical denial.
Medical eligibility Requirements and proving disability
To be eligible to receive disability benefits in Texas, an individual must prove that their case satisfies the Social Security definition of disability. The definition states that one must have a medically determinable severe impairment.
What does this mean? It means, first of all, that the impairment must be considered severe versus non-severe. A broken bone will typically be considered severe (though in very few instances will this result in an approval) while a sprain or laceration will typically be considered non-severe. To use other examples, simple headaches may be considered non-severe while migraines or cluster headaches may be considered severe.
Whether or not a condition is severe will be assessed by the disability examiner working on the case. If a claimant only has non-severe conditions, the case will be denied on the basis of NSI, or non-severe impairment. However, this does not happen often because most people do file claims based on verifiable severe conditions.
How severe must a condition be? The definition of disability also states that the disabling condition must last at least one full year. This is the benchmark that is used. However, it does not mean that a person must wait to be out of work or disabled for a year before applying. It means that the medical evidence must indicate that the condition will be disabling for at least one full year. If the condition will improve to less than an disabling state within a year, then the claim will be denied on the basis of duration.
The definition of disability also states that condition must be severe enough--in the limitations that it imposes--that the individual will be prevented from being able to engage in work activity at a level that earns them a certain minimum income, referred to as substantial and gainful employment. Of course, this inability to work and earn this minimum level of income must exist for at least one full year.
Finally, on the issue of severity, the SSA definition of disability states that the condition must be severe enough that it may possibly result in death.
Now, how does the Social Security Adminisration's definition of disability actually get used to make decisions on disability cases. The page following this one explains that.
Qualifying and Eligility for Disability in Texas.
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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