About the Social Security Disability (SSDI) and Supplemental Security Income (SSI) Process
Social Security Disability (SSDI)
There are many factors that can determine the payment of SSDI benefits. EAG will take you through the process and explain the guidelines in a way that is easy to grasp and understand. Below, we have prepared an outline of the various factors that are considered by SSA in order determine your eligibility for Social Security Benefits. Please review the materials below then contact EAG to schedule your FREE legal consultation:
Disability in General
"Disability," under the SSA regulations, is based on your inability to work. You must prove the complete inability to sustain Substantial Gainful Work Activity - which is work earning at least $1,040 per monthfor non-blind individuals or $1,740 for blind individuals. You are considered “disabled” if you cannot do the work you did before, you cannot adjust to any other work because of medical conditions, and your disability has/will last more than one year.
To qualify for Social Security Disability (SSDI) payments, you must have enough “quarters of coverage” from past work activity. This means that you must have worked long enough in the past to have paid into Social Security to be eligible for benefits presently. If you have not worked long enough in the past in order to be considered for SSDI, you may still qualify for SSI (see below for SSI criteria).
Proof of Disability
In order to prove your disability claim, there needs to be clear objective medical evidence of the existence of your disabling impairment(s). After that is established, the SSA considers how severely your medically determinable impairment(s) impacts your ability to perform work related activities on a day-to-day basis.
In making this assessment, the SSA considers many factors including:
- Your medical records
- Any opinions provided by your physicians
- The results of any medical exams to which SSA sends you
- Your statements throughout the application process
- Your sworn testimony (if a hearing is held)
- And any expert medical and/or vocational opinions that the SSA obtains
How SSDI Claims Are Evaluated:
The Social Security Administration outlines a 5-step evaluation process to determine whether or not a person is disabled. The 5-step process is as follows:
Step 1: Are You Working?
According to the SSA, working is defined as performing “substantial gainful activity" (as defined above).
Step 2: Is Your Condition Severe?
Is your medical condition severe enough to cause an impact on your ability to perform basic work related activities? In addition, your impairment must last or be expected to last for a period of no less than 12 months.
Step 3: Does Your Condition Meet the Requirements of a Social Security “Listing?”
The Social Security Administration has identified numerous medical impairments that will be deemed “disabling” if you meet the medical criteria outlined by the regulations. These are called “Listings.” If, based upon your objective medical evidence alone, your condition meets the requirements of one of these “Listings,” you will be considered disabled without further inquiry into your vocational, educational, or noted skill sets. The SSA may consider the opinion of a medical expert in reaching this conclusion. If your condition does not meet or is not medically equivalent to the requirements of a “Listing,” the SSA will continue to step 4 of the sequential evaluation.
Step 4: Can You Do The Work You Did Previously?
This requirement explores your ability to perform the type of work you have done over the past 15 years. If you are found to be able to perform any of the previous positions which you had in the last 15 years, you will not receive benefits. If you are found to be unable to perform any of your past relevant work, the SSA will continue to step 5 of the sequential evaluation.
Step 5: Can You Do Any Other Type Of Work?
Once it is determined that you cannot perform the work that you did in the last 15 years, the SSA considers whether your condition precludes you from performing any other work that exists in significant numbers in the national economy. In addition to your medical and/or psychological limitations, SSA will take into account your age, your education, any work skills you may have acquired from your past jobs, and whether those skills can be applied to other work. The SSA may consider evidence from a vocational expert in reaching a decision whether you can perform either your past work or any other work.
If the SSA determines you cannot perform any of your past relevant work, and you cannot sustain any other work on a full-time basis as a result of your medically determinable impairments, you will be awarded benefits.
The SSDI Claims Process:
EAG will guide you through every step of the claims process. Although the process can be lengthy, due to the high volume of claims that SSA receives, EAG has an exceptional track record for achieving benefits for our clients early in the process. Please see the outline and timeframes below then contact us for answers to any and all questions:
- Initial Claim (3 to 9 months for decision);
- If denied, Reconsideration (3 to 9 months for decision);
- If denied, Request for Hearing before Administrative Law Judge (12 to 18 months until a hearing is scheduled);
- If denied following a Hearing, Request for Review by Appeals Council (12-24 months).
SSI Process & Evaluation
The 5-step process for SSI is identical to the process for determining SSDI, and proving disability under this program is the same. There are, however, some key differences between these programs.
One is that SSI is generally a lower monetary amount than SSDI and this amount can be offset by household income or personal assets. SSI pays $710 per month for an eligible individual. Any countable income or personal assets determines, and possibly reduces, the monthly payment accordingly. Additionally SSI only pays retroactively to the date of the application as opposed to the date you became disabled.
Another difference is that eligibility for this benefit does not require any quarters of coverage from past work. Move over, in order to qualify, you must have less than $2,000 of assets ($3,000 per couple). If your assets exceed those limits, you are disqualified from receiving this benefit.
Finally, while SSDI eligibility provides health coverage under Medicare, SSI results in eligibility for Medicaid.
Our legal professionals are standing by to give you an accurate overview of your qualifications.