Frequently Asked Questions
Disability benefits
Disability is something most people do not like to think about. But the
chances that you will become disabled probably are greater than you realize.
Studies show that a 20-year-old worker has a 3 in 10 chance of becoming disabled
before reaching retirement age.
This website provides basic information on Social Security disability benefits
and is not intended to answer all questions. For specific information about your
situation, you should talk with Melvin E. Irvin.
Who can get Social Security disability benefits?
Social Security pays benefits to people who cannot work because they have a
medical condition that is expected to last at least one year or result in death.
Federal law requires this very strict definition of disability. While some
programs give money to people with partial disability or short-term disability,
Social Security does not.
Certain family members of disabled workers also can receive money from Social
Security.
How do I meet the earnings requirement for disability benefits?
In general, to get disability benefits, you must meet two different earnings
tests:
1.A “recent work” test based on your age at the time you became disabled; and
2.A “duration of work” test to show that you worked long enough under Social
Security.
Certain blind workers have to meet only the “duration of work” test.
How do I apply for disability benefits?
Simply contact us and we'll help you get started.
When should I apply and what information do I need?
You should apply for disability benefits as soon as you become disabled. It
can take a long time to process an application for disability benefits (three to
five months). To apply for disability benefits, you will need to first complete
an application for Social Security Benefits and the Disability Report.
We'll help you with that.
The information we need includes:
•Your Social Security number;
•Your birth or baptismal certificate;
•Names, addresses and phone numbers of the doctors, caseworkers, hospitals and
clinics that took care of you and dates of your visits;
•Names and dosage of all the medicine you take;
•Medical records from your doctors, therapists, hospitals, clinics and
caseworkers that you already have in your possession;
•Laboratory and test results;
•A summary of where you worked and the kind of work you did; and
•A copy of your most recent W-2 Form (Wage and Tax Statement) or, if you are
self-employed, your federal tax return for the past year.
In addition to the basic application for disability benefits, there are other
forms you will need to fill out. One form collects information about your
medical condition and how it affects your ability to work. Other forms give
doctors, hospitals and other health care professionals who have treated you
permission to send us information about your medical condition.
Do not delay applying for benefits if you cannot get all of this information
together quickly. We will help you get it.
Who decides if I am disabled?
The
SSA will review your application to make sure you meet some basic requirements
for disability benefits. They will check whether you worked enough years to
qualify. Also, they will evaluate any current work activities. If you meet these
requirements, they will send your application to the Disability Determination
Services office in your state.
This state agency completes the disability decision. Doctors and disability
specialists in the state agency ask your doctors for information about your
condition. They will consider all the facts in your case. They will use the
medical evidence from your doctors and hospitals, clinics or institutions where
you have been treated and all other information. They will ask your doctors:
• What your medical condition is;
• When your medical condition began;
• How your medical condition limits your activities;
• What the medical tests have shown; and
• What treatment you have received.
They also will ask the doctors for information about your ability to do
work-related activities, such as walking, sitting, lifting, carrying and
remembering instructions. Your doctors are not asked to decide if you are
disabled.
The state agency staff may need more medical information before they can decide
if you are disabled. If more information is not available from your current
medical sources, the state agency may ask you to go for a special examination.
We prefer to ask your own doctor, but sometimes the exam may have to be done by
someone else. Social Security will pay for the exam and for some of the
related travel costs.
How Does the SSA make the decision?
They use a five-step process to decide if you are disabled.
1. Are you working?
If you are working and your earnings average more than a certain amount each
month, we generally will not consider you disabled. The amount changes each
year.
If you are not working, or your monthly earnings average the current amount or
less, the state agency then looks at your medical condition.
2. Is your medical condition “severe”?
For the state agency to decide that you are disabled, your medical condition
must significantly limit your ability to do basic work activities—such as
walking, sitting and remembering—for at least one year. If your medical
condition is not that severe, the state agency will not consider you disabled.
If your condition is that severe, the state agency goes on to step three.
3. Is your medical condition on the List of Impairments?
The state agency has a List of Impairments that describes medical conditions
that are considered so severe that they automatically mean that you are disabled
as defined by law. If your condition (or combination of medical conditions) is
not on this list, the state agency looks to see if your condition is as severe
as a condition that is on the list. If the severity of your medical condition
meets or equals that of a listed impairment, the state agency will decide that
you are disabled. If it does not, the state agency goes on to step four.
4. Can you do the work you did before?
At this step, the state agency decides if your medical condition prevents
you from being able to do the work you did before. If it does not, the state
agency will decide that you are not disabled. If it does, the state agency goes
on to step five.
5. Can you do any other type of work?
If you cannot do the work you did in the past, the state agency looks to see
if you would be able to do other work. It evaluates your medical condition, your
age, education, past work experience and any skills you may have that could be
used to do other work. If you cannot do other work, the state agency will decide
that you are disabled. If you can do other work, the state agency will decide
that you are not disabled.
Special rules for blind people
There are a number of other special rules for people who are blind.
We will tell you the decision
When the state agency reaches a decision on your case, we will send you a
letter. If your application is approved, the letter will show the amount of your
benefit and when your payments start. If your application is not approved, the
letter will explain why and tell you how to appeal the decision if you do not
agree with it.
What if I disagree?
If you disagree with a decision made on your claim, you can appeal it. The
steps you can take are explained in The Appeals Process (Publication No.
05-10041), which is available from Social Security.
You have the right to be represented by an attorney or other qualified person of
your choice when you do business with Social Security. That's where
we come in.
What happens when my claim is finally approved?
If your application is approved, your first Social Security disability
benefits will be paid for the sixth full month after the date your disability
began.
Here is an example: If the state agency decides your disability began on January
15, your first disability benefit will be paid for the month of July. Social
Security benefits are paid in the month following the month for which they are
due, so you will receive your July benefit in August.
You also will receive What You Need To Know When You Get Disability Benefits
(Publication No. 05-10153), which gives you important information about your
benefits and tells you what changes you must report to us.
How much will my benefits be?
The amount of your monthly disability benefit is based on your average
lifetime earnings. The Social Security Statement that you receive each year
displays your lifetime earnings and provides an estimate of your disability
benefit. It also includes estimates of retirement and survivors benefits that
you or your family may be eligible to receive in the future.
Can my family get benefits?
Certain members of your family may qualify for benefits based on your work. They include:
• Your spouse, if he or she is 62 or older;
• Your spouse, at any age if he or she is caring for a child of yours who
is younger than age 16 or disabled;
• Your unmarried child, including an adopted child, or, in some cases, a
stepchild or grandchild. The child must be under age 18 or under age 19 if in
elementary or secondary school full time; and
• Your unmarried child, age 18 or older, if he or she has a disability
that started before age 22. (The child’s disability also must meet the
definition of disability for adults.)
NOTE:
In some situations, a divorced spouse may qualify for benefits based on your
earnings if he or she was married to you for at least 10 years, is not currently
married and is at least age 62. The money paid to a divorced spouse does not
reduce your benefit or any benefits due to your current spouse or children.
How do other payments affect my benefits?
If you are getting other government benefits, the amount of your Social
Security disability benefits may be affected.
When do I get Medicare?
You will get Medicare coverage automatically after you have received disability benefits for two years.
Can I go back to work?
After you start receiving disability benefits, you may want to try working again. There are special rules that help you keep your cash benefits and Medicare while you test your ability to work. We call these rules “work incentives” or “employment support” programs.
The Ticket to Work Program
Under this program, Social Security and Supplemental Security Income disability beneficiaries can get help with training and other services they need to go to work at no cost to them. Most beneficiaries will receive a “ticket” that they can take to a provider of their choice who can offer the kind of services they need.