To qualify for disability, whether the benefits are Social Security Disability (SSD), Supplemental Security Income (SSI), or both, is not simple. There are many factors involved to proving someone is disabled and a huge amount of regulations, rules, and statutes govern the disability process.
To start, in order to qualify for disability, it is the burden of the applicant to show that he or she is incapable of performing substantial gainful employment. There is also a durational requirement that the condition must have lasted or will last at least 12 months.
“Substantial gainful employment” is a technical term used by Social Security to determine whether a person is entitled to benefits. Every year they recalculate what they consider substantial gainful activity because of changes in the cost of living and other factors. In 2020, for example, substantial gainful activity was defined as earning a gross amount of $1,260.00 per month or more from active employment. If you earn $1,260.00 or more from working, that would indicate you are considered not disabled for that month. In addition, if it is felt that you would be capable of earning more than that amount, they will consider you not to be disabled on an ongoing basis.
These determinations are based on information provided by the claimant and other individuals, medical records, and examinations by a Social Security doctor or psychiatrist.
The specific rules that might apply in any individual case are very complex and no one case is ever like another. Many times our clients stated they should get disability because they know of a relative or other person who receive benefits. While we understand how they could feel that way, it is impossible to compare your claim to anyone else, since each must rise and fall on their own facts and merits and your case is unique to you.
Social Security has developed a five-tiered system to evaluate claims. It involves:
- Considering if you are currently working;
- Determining whether or not you suffer from any severe medical impairments;
- Determining whether you meet any specific rules for disability called the Listing of Impairments;
- An assessment of your residual functional capacity and your ability to do your past work, and;
- An assessment of your residual functional capacity and your ability to adjust to any other work that exists in the United States.
There are literally thousands of pages of rules and regulations concerning various aspects of the Social Security disability process. What this means is that for most people there are no quick answers or easy answers in analyzing any individual claim.
Additionally, a lot of people think that if they have a problem with their current job they can just apply for disability and get on it. Unfortunately, that’s usually not the case.
How To Apply For SSD/SSI
A Social Security Disability or Supplemental Security Income claim is started by filing an initial application. We have found that many of our clients prefer to have us complete the Social Security Disability and/or Supplemental Security Income application for them because it’s a lot easier for them because they get to avoid waiting in line or waiting on the phone to contact the Social Security office. It’s also easier for us because we know the application is completed right when we submit it and we know it was done correctly.
We are very familiar with the SSD and SSI application process and knowledgeable about what to put on the applications and, more importantly, what not to put on the applications and how that can affect your chances of winning your claim. We can usually do these either in person or by telephone for our clients who cannot or do not want to leave their house.
In most jurisdictions, there is a three-tiered process on claims, with the first being administrative–filling in applications and other forms which gives the Social Security Administration the ability to order medical records. Other documents may be submitted to enhance the claim and this is the first step in building a winning claim.
The first two steps are both administrative and the people who make the decisions, who are called adjudicators, are not Social Security Administration employees, but rather employees of the state you live in. If the initial claim is denied, an applicant can appeal and ask for reconsideration. If the reconsideration is denied, an applicant can appeal and ask for a hearing in front of a federal administrative law judge who will decide the claim. If the claim is denied by the administrative law judge, appeals can be taken to the Appeals Council and, if warranted, through the federal court process. Most people would probably do best to have experienced representation negotiating this process, which is far from simple and has many time-sensitive factors involved along the way.
Knowing An Experienced Social Security Lawyer Is Crucial
Drummond Law has successfully handled disability claims for over 40 years and our firm has won over 10,000 cases for our clients. If you would like to discuss your claim with us, just give us a call. Consultations are FREE and fees are only charged if we win your case. Just dial 1-800-842-0426 or contact us online.