Social Security Disability Benefits

September 28, 2011

Hubert Humphrey observed that “The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadows of life, the sick, the needy and the handicapped.” According to the Social Security Administration, the Social Security Act aims to provide for the material needs of individuals and families, protect aged and disabled persons against the expenses of illnesses that may otherwise use up their savings, keep families together, and give children the chance to grow up healthy and secure. These programs,

designed to make all of us feel and be more socially secure, include both federal and state benefits commonly known as Social Security retirement or disability benefits, and Supplemental Security income (SSi), as well as Medicare, Medicaid, and all the public assistance or human services programs sometimes known as Welfare.

Some of the programs are need-based or means-tested, meaning that you must have low income and assets to qualify. Entitlement to other programs, notably Social Security retirement and disability benefits, is earned through Federal insurance Contributions Act (FiCA) paycheck contributions. The worker may think of it as paying an insurance premium on a policy that will entitle her to future benefits, even though today’s workers are paying for today’s beneficiaries.

The eligibility criteria for the means-tested programs vary; sometimes income guidelines are tied to the Federal Poverty Level. To be eligible for Supplemental Security income disability benefits, for example, you are allowed to have no more than $2,000 in assets, not counting your home and car, and any income (over a minimal, specified amount) will reduce the benefit, depending on whether the income is earned or unearned. To give people receiving public benefits the incentive to return to work, earned income is often treated more kindly than unearned income when it comes to calculating benefits, and various trial work periods allow disabled people to venture back into the workforce as soon as they can.

To attain insured status or become vested in the Social Security system, a worker must generally have worked 20 out of the last 40 quarters, or 5 of the last 10 years. Quarters of coverage are now known as credits, but whatever the updated term may be, you may want to know, at any given point in your life, whether you are insured or not. As you plan your future (or reflect on your past) as a stay-at-home parent or homemaker, keep in mind that over time, a number of zero years can reduce the amount of retirement benefits available on your own work record (as opposed to that of your wage-earning spouse, or divorced spouse).

While the means-tested Supplemental Security income benefit for noninsured disabled and elderly people is in the neighborhood of $552/month, the Social Security retirement or disability benefit may be higher, as high as $1,700/month or so, plus auxiliary benefits for dependent children, depending on how much the worker earned and contributed to the system during her working years. Various offsets may apply (workers’ compensation, veterans’ benefits), to preserve the notion that working should always be more financially attractive than drawing disability benefits. If the Social Security amount is less than the Supplemental Security income amount, the individual may be eligible for both concurrent benefits.

Perhaps two of the most unsettling aspects of the Social Security benefits system are that disability coverage does not last forever, and that not every disabled person is entitled to government benefits. First, women and others who work in the home should be aware that Social Security Disability Insurance coverage does not typically last more than 5 years after a period of steady work, called your date last insured or DLI. So the mother of the 6-year-old who seriously injures herself in a household or car accident is not likely to be eligible for Social Security disability benefits, no matter how much she contributed to the Social Security system before trading her career in the paid workforce for her unpaid position raising a family. And we all know how much it costs to try to pay someone to do everything a mom does. She is irreplaceable and her work invaluable.

Second, not every disabled person is entitled to government benefits. A claimant may be entitled to disability benefits under one, both, or neither of two different programs: Social Security Disability Insurance and Supplemental Security Income (Supplemental Security income). What this means is that some very disabled people, often women who have not worked much outside the home over the years, will not be entitled to any government benefit because they have neither earned the right to draw Social Security benefits on their own work record nor are they impoverished enough to be eligible for Supplemental Security income.

The Social Security Administration’s assessment of disability, considered by many to incorporate quite a rigorous standard, is the same for both programs and turns on a five-step sequential evaluation. The only people who get Social Security Disability or Supplemental Security income are those found to be totally and permanently disabled. Claimants do not get more money the more disabled they are. To be disabled, a claimant must (a) not be working at an income level known as substantial gainful activity (self-employment is a special case with rules that look at how much time the claimant puts in and how much money the claimant takes out, and how other unimpaired people in that business fare); (b) suffer from a severe medically determinable impairment that lasts at least 12 months; (c) either meet a listed impairment or suffer from an impairment so severe that it (d) prevents return to past relevant work performed in the last 15 years and (e) prevents entry into other jobs existing in significant numbers in the national economy. For this final criterion,
Social Security needs only to prove that the jobs exist somewhere in the United States—it is not a matter of whether there are openings, whether you can get hired, pass the physical exam, or whether you can reach any such jobs by car or bus from where you live.

Social Security’s Listing of Impairments covers Musculoskeletal, Respiratory, Cardiovascular, Neurological, Digestive, Genito-Urinary, Hemic and Lymphatic, Endocrine, Multiple Body, and Immune Systems, as well as Special Senses and Speech, Skin, Mental Disorders, and Neoplastic Malignant Diseases. A person who meets a listing—for example, a person who has not just one but two amputated limbs, or a 5 ft. 4 in. woman whose gastrointestinal disorder has shrunk her to less than 91 pounds—should qualify instantly for benefits.

The combination of a person’s physical and mental impairments may not be listing-level, but may nevertheless be severe enough to reduce the claimant’s capacity so much that she cannot sustain full-time employment. The Social Security rules do reflect the basic idea that the older a worker gets, the less we demand, both physically and mentally, of her. Age is key, particularly the 50 th and 55th birthdays, unless someone has skills that can be used at a sedentary, desk-type job. Some people are chagrined to learn that Social Security does not cover skilled workers with professional or technical expertise just because they can no longer perform their job as doctor or plumber. A 44-year-old brain surgeon who loses only one hand or one eye may have to prove not only that she can no longer perform surgery, but also that she cannot do a stint as the minimum-wage worker at the circular desk in the middle of the shopping mall who points people in the direction of the shoe store.

Certain other Social Security benefits are part of the safety net woven by the workers. For example, Surviving Spouse benefits are available to widows over 60, or 50 and disabled. In certain limited circumstances, a remarried woman can keep receiving widow’s benefits on her deceased husband’s earnings record. Older women receiving benefits should always explore the financial implications of remarriage, no matter which time around it is. Disabled Adult Child (DAC) benefits are available to developmentally disabled adult children whose parents retire, become disabled, or die. An interesting sidelight: a DAC may not marry and maintain benefits, unless she marries another DAC. Child’s Supplemental Security income is available to help support severely disabled children, but only if their parents have very little in the way of income and assets. Social Security provides no automatic family benefit to full-time wage-earners with some savings who happen to have a disabled minor child or spouse.

Nationally, about 50% of claimants who apply for Social Security disability benefits are eventually granted benefits. In some regions, it can take over a year, sometimes two, to obtain benefits under this system. If a claimant chooses to hire a lawyer, consider that legal fees are highly regulated to protect vulnerable and often desperate claimants from unscrupulous lawyers. If the case goes all the way to federal court, sometimes the U.S. government will be required to pay the claimant’s legal bill under the Equal Access to Justice Act (EAJA), a law intended to help individual citizens fight city hall. If you are receiving private long-term disability (LTD) benefits, do not lightly abandon your SSD claim even if you see no immediate dollar benefit, because Medicare eligibility (after 2 years on SSD) and your retirement benefits can be affected by the decisions you make now.

See Also: Disability, Medicaid, Medicare

Suggested Reading

  • House Ways and Means Committee. The 2000 green book: Background material and data on programs within the jurisdiction of the Committee on Ways and Means (17th ed.).
  • Social Security Administration. (2001). Social Security handbook (14th ed.).
  • Social Security Administration (2003). Social Security: What every Woman should know (SSA Publ. No. 05-10127, ICN 480667).
  • Treanor, J. R. (2002). 2002 Mercer guide to Social Security and Medicare (30th ed.). New York: William Mercer.

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