It Pays to Know the Basics of Social Security Disability

Severe medical conditions that prevent a person from working may lead to financial hardships. Social Security Disability provides monthly benefit payments to help people get through those difficult times.

Navigating the disability benefits application process can be daunting, especially given the complex regulations and procedures confronting applicants. A basic understanding of the Social Security disability programs and how they work may help make the application process less stressful.

The first step is to read this overview of essential things to know before you apply for disability. The next step should be contacting a disability lawyer in New York for advice, guidance, and representation.

What Is SSD?

The Social Security Administration administers two separate programs that pay disability benefits to individuals who are unable to work due to severe medical conditions:

• Social Security Disability Insurance (SSDI): The SSDI program, also known as Social Security Disability or SSD, provides benefits to individuals who worked long enough at jobs or self-employment and paid Social Security taxes on their income.
• Supplemental Security Income (SSI): SSI provides financial assistance to disabled adults and children with limited income and resources. SSI also pays benefits to individuals age 65 and older who are not blind or disabled, provided they meet the income and resource limitations.

Both SSDI and SSI serve as critical lifelines to those living with disabilities by providing them with access to financial support. A key difference between the programs is that applicants for SSI benefits do not require a work history.

SSA Disability Requirements: Work and Medical
Applicants for Social Security Disability benefits must meet strict requirements set by federal law and regulations. These requirements fall into two categories: work and medical.

Each program has distinct non-medical requirements, as detailed below:

•  SSDI: Applicants must have sufficient work credits. Workers earn one credit based on their earnings up to a maximum of four work credits per year. The amount of earnings required for one work credit changes from year to year. Typically, a worker needs 40 credits, with 20 earned in the last 10 years before disability onset, to be approved for the SSDI program. Younger workers may qualify with fewer credits.
• SSI: The SSI program provides benefits to help pay for food, shelter, and other necessities. It does not require a work history. Instead, its non-medical requirements are that applicants have little or no income and that the total value of their resources or assets cannot exceed $2,000 for individuals and $3,000 for couples.

SSI and SSDI have similar medical requirements that must be met, thoughchildren seeking SSI benefits have different medical criteria. It pays to consult an experienced SSI lawyer when there are questions about SSI benefits for children or adults.

The SSA standard used to determine whether a person has a disability requires medical evidence proving each of the following:

• There is a medically determinable physical or mental impairment.
• This impairment must prevent the person from engaging in substantial gainful work activity (SGA).
• The physical or mental impairment must be expected to last for at least 12 months or to result in death.

The medical criteria for approval of a disabled child applying for SSI require proof of a medically determinable physical or mental impairment or impairments that cause marked and severe functional limitations. The impairments must have lasted or be expected to last for at least 12 months or be expected to result in death.

Adults and children who apply for disability benefits through SSI can do so by meeting the requirements for the “blindness” standard. They must have:

• A central visual acuity for distance of 20/200 or less in their better eye using a correcting lens, or
• Visual field limitation in their better eye, such that the widest diameter of the visual field subtends an angle no greater than 20 degrees.

Visual impairment that does not meet the standards for blindness may still meet the disability standard for adults under the SSDI and SSI programs.

If you have questions about the SSD and SSI programs, ask an SSDI attorney at the Law Firm of Nikki L. Prasad, P.C.

Types Of Disabilities Claims for Social Security Disability benefits must document a severe physical or mental health condition. Types of disabilities that could be severe enough to meet the SSD standard include:

• Musculoskeletal disorders, such as curvatures of the skeletal spine, inflammatory arthritis, and non-healing or complex fractures.
• Respiratory disorders, such as asthma, cystic fibrosis, and respiratory failure.
• Special senses and speech disorders, such as statutory blindness, loss of speech, and hearing loss.
• Cardiovascular disorders, such as chronic heart failure, recurrent arrhythmias, and symptomatic congenital heart disease.
• Digestive disorders, such as gastrointestinal hemorrhaging, chronic liver disease, and inflammatory bowel disease.
• Genitourinary disorders, such as chronic kidney disease and complications of chronic kidney disease.
• Hematological disorders, such as sickle cell disease, bone marrow failure, and hemophilia.
• Skin disorders, such as burns, chronic conditions of the skin or mucous membranes, and genetic photosensitivity disorders.
• Endocrine disorders, such as disorders of the pituitary gland, thyroid disorders, and diabetes.
• Congenital disorders affecting multiple body systems, such as Down syndrome.
• Neurological disorders, such as epilepsy, benign brain tumors, ALS, Parkinsonian syndrome, multiple sclerosis, and cerebral palsy.
• Mental disorders, such as depressive and bipolar disorders, schizophrenia, anxiety, and autism spectrum disorder.
• Cancer, including skin cancer, lymphoma, leukemia, breast cancer, and multiple myeloma.
• Immune system disorders, such as lupus, systemic vasculitis, scleroderma, and immune deficiency disorders.

The SSA maintains a comprehensive listing of impairments, commonly known as the “Blue Book,” that contains medical conditions and their symptoms that are considered severe enough to meet the disability standard. Note that a person may be considered disabled under the SSA standard even if they do not meet or equal a listed impairment under the disability evaluation process.

How The SSA Evaluates Disability

The SSA uses a five-step sequential evaluation process to evaluate claims for SSD benefits. Here are the steps:

• Step One – Work Activity: If an applicant is working when they apply for disability benefits, their earnings may not exceed the threshold for SGA. applicant. If they earn more than the SGA threshold, the person is not considered disabled.
• Step Two – Medical Severity: Does the claimant have a physical or mental impairment expected to last for at least 12 months or result in death? Having a condition not severe enough to meet this requirement means the person is not considered disabled.
• Step Three – Listing of Impairments: The SSA maintains a listing of impairments it considers severe and meeting the disability standard. A person’s symptoms must meet or match those of a listed impairment to be disabled according to the SSA standard. If they do, the evaluation process ends; otherwise, it continues to step four.
• Step Four – Past Relevant Work: The ability to do past relevant work means an applicant is not disabled. The process continues to step five if a person cannot do the work they did in the past.
• Step Five – Adjust to Do Other Worko: If a person cannot do past relevant work, do they have the ability, given their residual functional capacity, age, education, and work experience, to adjust to doing other types of work? If they cannot, then they are considered disabled.

A decision that you are not considered disabled can be challenged through an appeals process made up of the following levels:

• Reconsideration
• Hearing with an administrative law judge
• Appeals court review
• Federal court review

A disability lawyer in NY guides you through each level of the appeals process, including helping you to prepare to testify at the hearing level.

Why Legal Help Matters

Receiving the Social Security Disability benefits available to you involves a complex and overwhelming process. More than two-thirds of initial applications are denied, but a disability lawyer in NY can make a difference.

A disability attorney gives you peace knowing your claim for benefits is in the hands of someone who knows the law and federal regulations. That knowledge and experience ensure that your application is accurate, complete, and supported by the medical evidence and other documentation needed for a strong claim.

You have too much at stake to take on the SSD process alone. Take the first step toward improving your chance of success. Contact the Law Firm of Nikki L. Prasad, P.C. for a free consultation today.