Social Security Disability

An Overview of Social Security Disability

Disabling physical or mental health conditions do not care about someone’s plans to work until reaching retirement age. If you are unable to work because of a disability, Social Security Disability benefits offer the financial stability that allows you to focus on your health instead of how to pay bills.

The regulations, procedures, and medical requirements of the initial application process can be overwhelming. Knowing how the system works before you apply for disability can make the process far less intimidating and confusing.

Get knowledgeable advice and skillful representation throughout the disability claims process from James Mitchell Brown. An Ohio disability lawyer with decades of experience representing Social Security Disability claimants nationwide, let James Mitchell Brown be the one you rely on to guide your claim for disability benefits through the application and appeals process.

What is Social Security Disability

Social Security Disability Insurance and Supplemental Security Income are two benefit programs managed by the Social Security Administration. The SSDI program provides monthly disability benefits to individuals who paid Social Security taxes while employed or self-employment.

The SSI program pays benefits to individuals age 65 and older and to disabled or blind children or adults. SSI, unlike SSDI, is a means-based program intended to provide financial assistance for people to afford shelter, food, and clothing.

SSI and SSDI function as essential sources of assistance to individuals with disabilities who are unable to work. SSDI recipients receive coverage for medical expenses through Medicare. Medicaid may be available to those approved for SSI benefits.

SSA Disability Work & Medical Requirements

The requirements applicants must meet to be approved for SSDI and SSI can be broken down into two primary components: Work and medical. However, a person’s income and resources become factors when they apply for benefits under the SSI program.

Medical requirements for SSDI and SSI disability

The SSA uses a specific definition of disability to evaluate claims when people apply for SSDI or SSI. Adults applying for disability benefits must prove the following:

• An inability to do substantial gainful activity (SGA).
• The inability to do SGA is caused by a medically determinable physical or mental impairment.
• The impairment or impairments must be expected to cause death or be expected to last for at least 12 months.

Applications for SSI benefits submitted on behalf of a child must document a medically determinable physical or mental impairment causing marked and severe function limitations. The impairment or impairments must be expected to result in death or to last for at least 12 months.

Meeting the medical requirements can be challenging. Medical records containing findings of physical examinations, lab results, and diagnostic imaging reports.

The SSA defines blindness as central visual acuity of 20/200 or worse, as corrected, in the better eye, or a visual field limited to 20 degrees or less. A visual impairment may meet the SSA disability definition without meeting the standard for blindness.

Working with Social Security Disability lawyer James Mitchell Brown provides you with unsurpassed representation and guidance from a renowned disability lawyer. You’ll appreciate the empathy and compassion he and his team show as they guide you through the challenges of the Social Security disability process.

Types of disability benefits

Monthly payments are not the only disability benefits available through the SSDI and SSI programs. Applicants approved for SSDI benefits also receive Medicare coverage after receiving monthly benefit payments for 24 months.

SSI beneficiaries in most states receive medical coverage through Medicaid upon approval of their SSI claim. However, not all states treat an SSI application as a Medicaid application. An SSI lawyer can advise you about the process and whether you need to separately apply for Medicaid coverage in your state.

Certain members of an SSDI recipient’s family may be entitled to family benefits. Family members include the following:

• Spouse and former spouse
• Children
• Grandchildren

Conditions may apply. For example, a spouse must be at least 62 years old unless they are caring for a child younger than 16 or a child with a disability. Family benefits can be as much as 50% of the disabled worker’s benefits. The SSDI recipient’s benefits are not affected by the payment of family benefits.

How the SSA Evaluates Disability

The evaluation process for disability applications begins at an SSA local field office. It undergoes a review to determine whether it meets the non-medical requirements for SSDI or SSI. applications for disability benefits.

The next stage of the Social Security Disability evaluation process takes place at a Disability Determination Services office. DDS offices are state agencies funded by the federal government.

DDS examiners use a five-step sequential evaluation process to review medical evidence and determine whether a person meets the SSA’s disability standard. Steps in the evaluation process include:

• Step One: Is an applicant capable of doing substantial gainful activity? If you apply for disability while working, a disability examiner determines whether it shows you have the ability to do SGA. Earning more than the SGA monthly earnings threshold means you have the ability to work and are not disabled within the SSA definition.
• Step Two: Is the medical impairment severe? Do you have a physical or mental impairment severe enough to result in death or that is expected to last for at least 12 months? The SSA does not pay benefits for short-term disability.
• Step Three: Does the condition meet or is it functionally equal to a listed impairment? The SSA listing of impairments, commonly called the “Blue Book,” contains medical conditions the SSA considers severe enough to meet its disability standard. Conditions that do not match a condition may be approved by producing symptoms and limitations functionally equivalent to a listed impairment. Meeting or equaling a listing generally indicates the person is disabled under the SSA definition. However, the evaluation process continues for those individuals who do not.
• Step Four: Does the condition prevent you from doing past relevant work? Disability examiners use a person’s residual functional capacity (RFC), the activities a person’s disabling medical condition allows them to perform. If RFC allows an individual to do work they did within the past five years, they are not disabled.
• Step Five: Could an individual make the adjustment to do other types of work? A person who cannot do past work may, given their RFC, education, experience, and age, be able to adjust to other types of work available in the national economy.

Medical documentation, including medical records and statements from your healthcare providers, are essential in the evaluation process. Your SSDI and SSI lawyer will gather and submit evidence that supports your claim, including:

• Examination findings.
• Physician’s notes
• Treatment summaries
• Hospital records
• Diagnostic testing results
• Specialist findings and statements
• Mental health evaluations

Failing to follow the treatment plan or take medications prescribed by your doctors could lead to a denial of an otherwise valid claim for disability benefits.

Why Legal Help Matters

Applying for disability benefits through SSDI or SSI can be a confusing and challenging process. Missing or insufficient medical documentation, applications with missing or inconsistent information, and a failure to follow SSA rules can result in a claim for benefits being denied.

Working with James Mitchell Brown gives you an experienced disability lawyer with unsurpassed knowledge of the SSA rules and procedures. He ensures that your application meets SSA guidelines and has the evidence to prove your claim. You have too much at stake to take on the Social Security Disability system without representation from a skilled disability attorney. Contact James Mitchell Brown for a free consultation.