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Disability
I. Eligibility For Benefits
From Disability Insurance Trust Fund (DI).
A worker must be unable to work because they have a medical condition expected to last at least one year or result in death.
The SSDI will make monthly payments to disabled workers, their spouses and children, and Medicare health insurance after two years of disability benefits.
The work requirements and the medical requirements.
There are two different earning tests, which depend on the worker’s age at the onset of the disability.
First, the disabled worker must have enough substantial lifetime work to be insured. Second, they must also meet the criteria for recent work in covered employment before the onset of the disability.
It requires that the worker has from 1 1/2 to 10 years of work paying into Social Security and it is measured by quarters of coverage (QC).
Note: Disability benefits are generally the same 40 credits as are required for retirement benefits.
They are qualified if they have credit for working 1/2 of the time between age 21 and when they became disabled.
20 QCs, or five years of qualified works.
22 QCs, or 5.5 years of qualified works.
24 QCs, or 6 years of qualified works.
40 QCs, or 10 years of qualified works.
Social Security Administration.
“The inability to engage in any Substantial Gainful Activity by reason of any medically determinable physical or mental impairment which can be expected to result in death, or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
Lifting, standing, walking, sitting, and remembering for at least 12 months.
Only 1/3 of the initial claims were approved.
II. Application And DeterminationOf Benefits
It usually takes three to five months to process the application.
The SSA reviews applications to determine if the basic requirements have been met and if a worker has enough employment to qualify for benefits.
The application will be forwarded to the worker’s state Disability Determination Services office where the initial disability determination decision is made for SSA.
The decision is based on the medical evidence provided by the worker and discussion with the worker’s doctors, including information about the ability to do work-related activities.
- Working.
- The severity of the medical condition.
- Meeting the lists of impairment(s).
- Perform previous work.
- Other work.
If the applicant is working and their monthly earnings average more than a certain amount each month.
The medical condition must significantly limit the worker’s ability to do basic works for at least 12 months.
The state agency will decide at this point that the worker has a qualifying disability.
The SSA will evaluate if the worker’s skills would allow them to perform other work despite their impairments.
Note: If the worker can not perform other works, the workers are determined to be disabled.
It will send a letter to the worker or the applicant.
The amount of benefit and the start date of payment.
The letter will explain why and explain how to appeal the determination.
The computation is similar to retirement benefits at FRA.
It begins only after a five-month waiting period.
Note: The first disability payment will be paid for the entire sixth month after the disability begins.
The worker was disabled for at least 18 months before filing a claim.
Workers become eligible for Medicare after they have been entitled to disability payments for 24 months.
III. Working and Other Benefits
The work incentives allow recipients to test their ability to work while still receiving monthly Social Security disability benefits.
The beneficiaries are required to report any paid work, no matter how small, changes in job duties and when starting or stopping work.
The SSA does not consider work performed during this trial period as showing that the disability has ended until the work has been performed in at least 9 months(not necessarily consecutive) in a rolling 60-month period.
This is another Social Security work incentive that provides beneficiaries with help to obtain training and other services they need to go back to work at no cost to them.
Pensions from non-covered work, workers’ compensation, or other public benefits.
Note: Windfall Elimination Provision (WEP) and Government Pension Offset (GPO) also applied to disability benefits similar to retirement benefits.
The total amount can not exceed 80% of the worker’s average current earnings before becoming disabled.
Private pensions or insurance benefits.
Veterans Administration benefits.
State and local government benefits (if Social Security FICA payroll taxes were paid).
Supplemental Social Security Income (SSI) benefits.
IV. Family Disability Benefits
If they either 1). have a child under the age of 16 or a disabled child in their care.
or
2). They are at least 62 years old.
If he or she married the disabled worker for at least 10 years, is not currently married, and is at least 62 years old.
To be eligible, the child must be unmarried and under the age of 18.
or
If the child is still in high school, he or she is eligible until graduate or two months after turning age 19, whichever comes first.
or
If children over the age of 18 and disabled before the age of 22.
It is 85% of the disabled worker’s average indexed monthly earnings (AIME). However, it can not be less than the worker’s PIA, or more than 150% of the worker’s PIA.
Each can receive up to 50% of the worker’s disability rate.
