Understanding the way this insurance works is important to enable the individual to get the most out of their claim. This type of insurance is commonly referred to as SSDI or SSD. This program enables individuals to receive benefits if they should be disabled prior to reaching the age of retirement. SSD is also called workers disability because the individuals who apply are unable to work. These individuals can obtain an application by visiting the Social Security office, going online to www.ssa.gov or by retaining the services of an attorney for assistance during the process.
In order for an individual to qualify for this program, they must have paid taxes for social security through their job for a specific number of years. These taxes are called FICA. If the person has not worked for a long enough period of time prior to becoming disabled, has low assets and a low income, they can apply for SSI or Supplemental Security Income instead of SSD. To qualify, the individual must have earned a specific number of work credits. A maximum of four credits can be earned each year the individual has worked.
The Eligibility Requirements for SSD
The number of work credits each individual must have to qualify for SSD is dependent on their ages at the time the impairments occurred. A good example is an individual who became impaired at the age of fifty. This person must have worked for a minimum of seven years. Five of these years must have been during the past ten years. If the individual does not meet this requirement, they must have 28 work credits for their status to be considered eligible for approval.
The individual must have a medical condition meeting the SSA’s office definition of being disabled. SSD benefits are only available to individuals with long-term and severe impairments and total disabilities. The definition of severe is any condition that interferes with the basic activities a person is expected to perform at work. Long-term is defined as any condition expected to last a minimum of one year. According to the Social Security Administration, the definition of total disability is an individual unable to perform SGA or substantial gainful activity for a minimum of one year.
If the individual is working and their income exceeds a specific amount, the SSA will determine the individual is able to perform SGA. This means their disability will not be considered serious enough for their status to receive an approval for disability insurance. In 2018, if the individual is blind, the amount is $1,970 per month. If the individual is disabled, the amount is $1,180. There is additional information regarding the medical qualifications for SSD benefits available at www.ssa.gov.
The Approval for SSD Benefits
Once the individual has received their approval for SSD benefits, they must be disabled for a total of five complete months prior to receiving any benefits. This is due to the five month mandatory waiting period of the Social Security office. If the individual receives their approval right away, they are still required to wait the five month period prior to receiving their first check. A good example is an individual who has recently had a liver transplant. This person is still required to wait the five months.
The chances are good it will take approximately six months to one year for the individual to be approved. This usually requires a minimum of one level of appeal. In this case, once the individual has been approved, they would receive back pay for their impairment. This would begin the sixth month after they became disabled. This is referred to as the onset date. Once the individual receives their back pay, they will receive an SSD check every month. If the income of the household exceeds a specific amount, the individual will be responsible for paying taxes on their benefits.
The members of the family may be eligible to receive a partial benefit each month. Benefits may be provided for the dependents of the individual. The individual is able to receive their SSD benefits for as long as they are unable to work due to their medical condition. A CDR review will be performed by the SSA on the individual’s file to determine if there has been any improvement in the condition. This review is performed every one to three years.
When the Benefits are Denied
The majority of initial applications for SSD are denied. This decision can be appealed within sixty days of when the denial letter was received by the individual. In most states, the appeal process begins with a Request for Consideration. This is when a different examiner reviews the claim. If the SSDI application is denied a second time, another appeal can be made. This involves a request for a hearing with an administrative law judge working for the SSA.