Myths and Truths
Myths and Truths of
Social Security Disability (SSD) and Supplemental Security
Income (SSI)
Social Security Disability and Supplemental Security Income are
a confusing pair of programs run by the Federal Government.
These programs exist throughout the United States and Puerto
Rico.
The questions are always the same: who should file and what
program should they file for?
This is a brief overview of the Social Security
Administration's two major Federal programs for people under the
age of 65. Included is SSI which is a "need based" program in
place for non-workers or workers who earned very little while
working, or for those who are no longer insured for SSD benefits.
SSD is for those who worked enough to "insure" themselves for
disability insurance and retirement through work and paying into
FICA. A limited number of people with low earnings, before
they became totally disabled, may file and collect both SSD and
SSI. SSI is a Federal welfare program: SSD is a Federal
insurance program. An individual may be eligible for Federal
adult SSI if they would otherwise be welfare eligible and cannot
work at any job. For SSD, if an individual is not
working for six months and is insured, the only question is whether
they could work. The assets of the individual or any of their
household is not involved. There is also another special
program for severely disabled children called "Child's
SSI".
The basic medical definition of disability applies to both
programs:
20 CFR Section 404.1505: "The law defines disability as the
inability to do any substantial gainful activity (ability to
perform any work and make $800.00 per month) 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 continuos period of not less than 12 continuous
months." To meet this definition, you must have a severe impairment
which makes you unable to do your previous work or any other
work which existed in the national economy.
Each program is a multistep process. First is the initial
application. If denied, a person has 60 days to file for a
Hearing before an Administrative Law Judge. The whole process
usually takes anywhere from 1.5 to 2 years.
The vast majority of
individuals who apply for either or both programs are not
successful at the first levels. However, the odds of
being successful change one the individual has filed for a hearing
and has their matter heard by an Administrative Law Judge
particularly if they have a representative knowledgeable about the
system and how it works.
Things to remember when filing for one or both programs would
include:
- Be sure to include all
impairments as well as subjective complaints such as pain, fatigue,
swelling, stiffness, depression, side-effects to medications, etc.
as well as restrictions sustained sitting, standing, walking,
lifting and carrying and any restrictions in daily activities of
living;
- All information given to
Social Security must be verified by your doctors; and your doctors
must place physical and/or mental restrictions on your ability to
work, daily activities, and must also provide diagnosis with
supporting tests and examination reports;
- Everyone who files has a right
to representation, however a representative is not
required;
- If a person does want
representation, a representative may only charge a fee if you win
and then only up to 25% of past due benefits (for you and your
family) with a total maximum fee of $5,300.00 which is subject to
approval from the Social Security Administration.
Remember, the ultimate question is whether an individual could,
based on objective medical evidence, theoretically do a full-time,
sitting job, not only whether you can do the job(s) you used to
do.
