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How Social Security Disability Benefits Are Awarded: A Primer

The Social Security Disability (SSD) program is operated by the Social Security Administration, better known for its retirement program that covers a majority of Americans. However, it also administers the disability insurance program that pays workers whose disabilities prevent them from doing their jobs.

In order to obtain disability benefits from the SSD program, a worker must have paid into the system for the required number of quarters, which varies according to the age of the applicant. In addition, he or she must be able to answer the following three questions correctly:

  • Are you able to do the work you did before you became disabled?
  • Even if you are no longer able to do the work you did before you became disabled, can you do other types of work?
  • Is your disability expected to last more than one year?

In order to be eligible to receive disability benefits, you must be unable to do the work you did before and unable to do other types of work. Your disability must be expected to last more than one year, as determined by your doctor. If you cannot answer these questions as required by SSD, you are probably ineligible for benefits.

These are the essentials. However, as with any type of social service program, there are many factors that come into play when answering the three basic questions. Some are listed here:

Working while receiving SSD: You really can't work when receiving or applying for SSD benefits. The program allows recipients to receive only a small amount of work income before the amount of benefit is reduced, and the full amount is barely enough to live on in any event. Unlike some private disability insurance and veterans' disability insurance beneficiaries, an SSD recipient cannot be partly disabled. Either you cannot work or you are essentially ineligible for SSD.

Disability must be severe: The disability must be severe enough to hinder you in performing the essential functions of the job. It is seldom enough to be a little slower or to require accommodation, such as a seat or stool if you cannot stand for long periods of time.

Presumptive conditions: There is a list of disabilities - injuries, conditions and illnesses - that automatically make an applicant eligible for SSD. When applicants do not have one of the conditions on the list, known as presumptive conditions, the SSA will dig further to determine the extent of the disability and its impact on the ability to work.

Not unemployment: If an applicant is qualified for some type of work according to the SSA but cannot find that kind of job, he or she is still ineligible for SSD benefits. The Social Security Administration emphasizes that its program is not unemployment-related. Nevertheless, workers over age 50 are treated differently by the determination process and are more likely to be granted disability benefits as they approach retirement age.

These are the basics of how the Social Security Administration determines eligibility for SSD benefits. However, there are so many other variables that it is important to consult an experienced and knowledgeable advocate when submitting a claim or an appeal. The people at Binder & Binder®, America's most successful Social Security Disability advocates, can help you. Call them from anywhere in the United States and find out what they can do.

Source: Motley Fool, "Disability Benefits: How Social Security Decides If You Deserve Them," by Dan Caplinger, Jul. 13, 2014.

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