SOCIAL SECURITY DISABILITY INSURANCE: HOW DOES IT WORK?

If you work and earn wages, you are required to make a mandatory contribution to Social Security.  Your employer is required to match your contribution from each check.

The current rate of contribution is 7.65 percent of wages from the employee, plus 7.65 percent from the employer - for a total of 15.3 percent of your pay.

The federal law requiring these contributions (taxes) is the Federal Insurance Contributions Act (FICA).  On each payroll stub you will see FICA as one of the deduction items.  Your contributions go into a federal government trust fund.

As you work and contribute to FICA, you earn credits toward Social Security disability insurance (SSDI).  You may earn up to 4 quarters per year--one credit for each calendar quarter of work.  Most individuals need at least 20 credits (5 years of work) to earn SSDI coverage.

After you have earned the minimum number of work credits, you may file a claim for a covered disability.  If approved, Social Security will pay a set monthly benefit.  But it isn't quite that simple.

Federal regulations dictate the eligibility requirements to receive SSDI payments.  Here are some of them:

1.  You must have a medically determinable impairment (MDI).  You need medical tests to prove the type, severity and duration of the impairment(s).

2.  Your condition must be so severe to keep you from working for a period of at least 12 straight months OR to end in death.  Shorter term impairments are not covered. There's no "short term" disability benefit. 

3.  You must have medical evidence to prove you are totally disabled according to Social Security rules.   There is no such thing as "partial disability."

Honestly, most disability claims are denied on the grounds that "You are not disabled according to our rules."  On reason for denial that we see a lot is stated this way:

"The evidence shows that you have some limitations and that you are not able to perform your past work.  However, you are able to perform certain types of work."

Simply put, "We think you could do some kind of work, so go find yourself an easier job."

What do you do when you get a denial letter but you know you are not able to work?

You file an appeal.  The first step is to file a written request for "reconsideration."  This will be denied, also, in most cases.  You appeal again, this time asking that your case go before an administrative law judge (ALJ) for a hearing.  The hearing is where you have the best chance to be approved and paid.

The government has made getting Social Security disability benefits difficult.  They purposely make it take a long time.  The appeal process can drag on a year or more. We who are familiar with Social Security disability call it "THE ORDEAL" because it is a purposefully slow, uncomfortable process.

 I often hear the question, "How am I to make ends meet while I am waiting?"  That's a different question altogether.  Your best bet is to get with a good Social Security disability advocate or attorney and dig in for the long haul.  Fortunately, the attorney cannot charge you a fee or any upfront money to handle your case.  He/she is paid AFTER you are paid, and only if you recover past due benefits.

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The Forsythe Firm      Huntsville, AL      PH (256) 799-0297