Social Security Disability (SSDI)(Title II)
When someone becomes disabled and cannot work, the most common form of Social Security benefits that someone may qualify for is Social Security Disability. This program is designed for a worker who has become injured and can no longer work.
Often you will hear people refer to Social Security Disability as Title II. The reason behind this is due to the Social Security Act of 1935 where Title II of the Act gave benefits to disabled workers. The Social Security Act was passed by Congress during the first term of President Franklin E. Roosevelt. President Roosevelt signed this Act on August 14, 1953.
Social Security Disability (SSDI) is awarded to people who have generally worked for five of the past ten years and have paid a Social Security tax on their income. The work requirement can be waived for applicants under age 22. It is a federally run benefits program that provides aid to people who are unable to achieve substantial gainful employment due to a permanent disabling condition.
Do you qualify for SSDI?
- First, you must have worked in a job that is covered by Social Security. If FICA/social security taxes were not deducted from your paycheck, then your job may not have been covered by Social Security. If, however, you were an independent contractor and paid in these taxes when you filed your 1099, then your earnings would still be covered.
- Second, you must have earned enough work credits in order to qualify for Social Security Disability benefits. Typically, you must have a total of 40 work credits and 20 of those credits must have been earned within the 10 years prior to your injury or illness that caused you to become disabled. Therefore, you must have a fairly consistent work history and must have paid Social Security tax for a combined five of the ten years prior to your becoming disabled. (These rules differ if you become disabled prior to reaching age 22.)
- Third, in order to qualify for SSDI, you must suffer from a medical condition that meets Social Security's definition of disability. Typically Social Security defines a qualifying medical condition as a permanent condition that prevents you from working. In other words, your disability must have lasted, or be expected to last, a minimum of twelve months and you must be unable to earn an income greater than the "substantial gainful activity" amount that is regulated by Congress and readdressed annually. (The substantial gainful activity amount was $1010 per month, gross, in 2012)
Once you meet all of the qualifications for SSDI, one would think that all they would have to do is apply and they automatically get awarded these benefits. However, that is not exactly how the process works. Often times, Social Security will deny you benefits for multiple reasons. Below is a list of reasons why someone may be denied SSDI:
- Too Much Income. If you are working and earning more than the substantial gainful activity (SGA) amount, Social Security will assume that you are "working" and therefore not disabled. If you can work, then logically Social Security will assume you are not disabled. You cannot work (defined as earning more than the SGA amount) and be disabled at the same time.
- Your medically disabling condition is not expected to last 12 months. In order for Social Security to consider a medical condition disabling, that condition must last at least 12 months. Therefore, even a severe injury may not qualify a person for Social Security benefits. This seems to be a very common issue for clients of the Sellers Law Firm. Fortunately, the attorneys of the Sellers Law Firm have experience in overcoming this obstacle for most clients.
- The Social Security Administration cannot find you. In order for a claim to be determined, SSA will want you to complete many forms, interview you in person or by telephone, and perhaps see a doctor that they refer you to. If they cannot reach you, they cannot pay you. Fortunately, with an experienced attorney, Social Security will rely on the attorney to stay in contact with the client; which, will reduce the amount of contact Social Security must have with you. However, you must remember to stay in contact with your attorney!
- You refuse to cooperate with the Social Security Administration. This is perhaps the second leading cause for denial of SSDI benefits. Social Security will want to verify every piece of information you provide to them. This includes employment records, medical records, and perhaps independent medical opinions provided by a doctor that they send you to. If Social Security cannot contact you, which means they cannot verify a piece of information, you will be denied for failure to cooperate. Fortunately, we can and will gather the information needed by Social Security and provide that information to them. Therefore, the chance of being denied by Social Security for failure to cooperate is substantially reduced simply by having an attorney.
- Non-Compliance. This is a very difficult hurdle for many people attempting to get any type of Social Security benefits. Non-Compliance can encompass many things. However, the most common issue for a Social Security claimant is failure to follow prescribed therapy. If a doctor prescribes you medication, you are expected to take that medication. If you are prescribed counseling sessions on a regular basis, you are expected to attend these sessions. We recognize there are many reasons why someone may not be compliant with medical treatment. Primarily, Non-Compliance is due to financial barriers. If you have no medical insurance, it may be extremely costly for you to attend doctor appointments or to have your prescriptions filled. There are ways to overcome this barrier to benefits and we have the knowledge and experience to do so.
- DA&A (Drug Addiction and Alcohol). If you are a drug addict or an active alcoholic and your drug or alcohol use is a direct contributor to your disability, you will not be eligible for Social Security benefits. If, however, even if you quit using drugs or stopped drinking, your medical condition would still be disabling, then Social Security must find that your addiction and abuse is non-material to your disability. Each case involving DA&A is different and must be discussed on an individual basis.
- Pending Felony, Confined to Prison, or Injury Sustained During the Commission of a Felony. If you are in prison, you may not draw Social Security benefits. If your medical condition that disables you was acquired during the commission of a felony, you may not draw Social Security benefits. And if you have a current warrant for a felony that is currently pending, you may not be eligible for Social Security benefits.