Before submitting a disability claim to the Social Security
Administration (SSA), it is very important to understand how a
determination is made on your case. Realizing there are key fundamental
aspects to every disability submission is critical to whether or not a
person will be successful.
While there are many sub-parts to these
categories and the issues can become quite complex, this should provide
a basic understanding to help you navigate the SSA disability system.
Determine Whether or Not You Are Legally Disabled:
First,
it is important to understand how SSA determines legal disability. In
order to be disabled because of a mental or physical condition, one must
not be able to do the work he or she did before and is unable to adjust
to some other type of work. Further, this impairment must be expected
to last for at least one year or result in death.
Again, as stated
above, this definition can become more complex as you start considering
your condition, but what is most important is to ask yourself:
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Can I still do the work I did before?
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Am I physically or mentally able I do another job instead?
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Is my disability likely to last for one year or more or result in my death?
If you can affirmatively answer "no" to the first two
questions and "yes" to the third, then you are likely well on your way
to at least having a credible claim.
Determine What Type of Benefits I Need:
If
you have successfully passed the first hurdle, then understanding your
own financial situation and your work history is very important at this
stage. Here, you need to determine whether you are eligible for
Supplemental Security Income (SSI) or Social Security Disability
Insurance (SSDI) or both. Because this part of determining whether you
are legally disabled and what benefits you may qualify for is terribly
complicated, SSA provides step-by-step instructions on their website and
a benefits calculator to make this easier.
Remember this, SSI is based on need.
Once
again, there are many requirements in order to qualify, but you must be
determined to be disabled and not make more than $721.00 per month for
an individual and no more than $1,082.00 for couples. However, please
understand there are exceptions here, such as SSA may only count some of
your income towards your limit, and you also may be able to set aside
some of your income if you are enrolled in the PASS (Plan to Achieve
Self Support) program, or if you receive state supplements.
Basically,
if you can remember or understand nothing more about SSI, understand
that it is intended for those with very low income and those who have
little or no liquid assets.
Social Security Disability Insurance (SSDI) is based on the amount of work credits you have earned.
There
are different requirements for various age groups, but generally you
need 40 credits, 20 of which were earned in the last 10 years before you
stopped working. Again, this is very complicated to many people, but
you earn credits by working. SSA determines that $1,200 equals one
credit and a person is allowed a maximum of up to four credits per year.
Therefore,
in determining the amount of income your household brings in each month
and the amount of assets you have on hand and the amount of time you
have worked, will determine whether you qualify for either SSI or SSDI
benefits or both.
Criteria That is Used to Determine Whether You Are Disabled:
Finally,
you need to understand how Social Security is going to determine
whether your physical or mental condition keeps you from working.
If
you don't take anything else from this article, it is important that
you understand the importance of documenting your condition. Social
Security states explicitly on its own website that medical evidence is
the "cornerstone" of a disability determination. Every person who files
for disability is responsible for providing medical evidence showing
that he or she has an impairment and the severity of that impairment.
While SSA does help claimants with collecting their medical records,
ultimately it is up to the person filing for disability to see that SSA
can make a determination with an adequate amount of medical evidence.
Therefore,
as you go to the doctor, make it a point to tell your physician you are
attempting to file a claim for disability. Ask your doctor to not just
write shorthand about your condition, but to spell it out in his or her
notes because those will be reviewed. SSA understands you have a
physical or mental condition, but your doctor stating you are disabled
is not sufficient. That is a legal determination that is made by SSA and
not your doctor. He or she needs to explain that you cannot sit for
long periods of time, walk more than 20 yards before sitting to rest,
get along with others, follow directions, etc. This is what helps SSA
determine whether or not you are disabled.
Social Security will
also look at other evidence to determine if you are disabled. This
"other evidence" helps to show the extent of the individual's condition
and his or her ability to work in a business setting. Such evidence may
be allowed to come from spouses, employers, friends, other family, etc.
If
Social Security is not content with your medical records or has a
difficult time obtaining them, then you may be asked to go through a
Consultative Examination. This may be done by your own doctor or through
one SSA designates. Here, there will be a report made about your
condition and any results the physician feels is relevant for SSA to
make a determination.
Lastly, you need to consider what evidence
you have in regards to your condition which shows that you are unable to
work. Social Security here will look at a number of factors such as:
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Your daily activities;
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The frequency of your symptoms and their intensity;
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Medication and its side-effects; and
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Any measures you have taken to relieve your condition.
Here, probably the most important thing is that you
continue to see a doctor, even if it is only once every six months. Many
people often find it difficult to keep up with their treatment because
they are no longer working. They can no longer afford private care
because they no longer have insurance. However, if you truly are
disabled, it is imperative to stay under the care of a physician, even
if it falls under indigent care.
Further, you must always be a
good patient and do as your physician prescribes. Social Security will
usually not consider your case if you can't even follow instructions
from you own doctor in trying to better your condition. Remember,
medical evidence is the cornerstone to making a determination as to
whether you are disabled. A note from your physician stating that you
are not following his recommendations will assuredly make it that much
more difficult to be successful in your claim.
