You may know “someone on disability,” but what does that mean?
Many people may not be aware that the Social Security Administration (“SSA”) oversees a program for individuals who are unable to work due to medical impairments. The program is a lifeline for those who are unable to work, mostly through no fault of their own.
This includes people who have physical impairments such as a back injury as well as mental impairments like Post Traumatic Stress Disorder (PTSD). At the same time, it doesn’t matter whether your impairment, whether mental or physical, happened at the job. It also doesn’t matter whether your impairment happened suddenly or was something that happened over time.
In reality, “Social Security Disability” includes two separate programs: Social Security Disability Insurance (“SSDI”), and its sister program Supplemental Security Income (“SSI”). They are federal programs created to help those in need and who qualify. When someone can’t work, that person still needs a roof over their head and food on the table. These programs are meant to give these injured individuals enough money to provide for their basic needs. Just like Medicare retirement benefits, you receive a monthly payment to pay for your rent and groceries. It might also allow you access to Medicare or Medicaid (Mass Health) to pay for your medical treatment.
If you have been unable to work for one year, or have a medical impairment or impairments that are expected to last for more than one (1) year, you may be eligible. Unlike Workers Compensation plans, your impairments do not have to be work-related.
In order to qualify, you need to establish that your injuries/impairments make you unable to work. This is usually done through the medical records of your doctors. Your doctors evaluate you,, diagnose you, and recommend treatment plans. The Social Security Administration then looks at those records as evidence of your doctors’ opinions. It then makes a decision based on those opinions.
In order to be awarded benefits, SSA applies a 5-Step Sequential Analysis to your claim.
At step one, you must establish you are not currently engaging in Substantial Gainful Employment. This means that you’re not working or have not been making more than about $1200 per month within the past year.
At step two, you must establish your impairment(s) will last or are expected to last at least 12 months. Many people assume that Social Security Disability benefits are only for permanent injuries. This is not necessarily the case.
At step three, SSA must consider whether your impairment(s) “meet or equal” what is known as a “Listing.” These listings include not only your injury, but also your age. Some are tough arguments to make, but depending on the nature and severity of your impairments, they may be available to you. If you are found to meet or equal a Listing, the analysis goes no further, and you are awarded benefits.
At step four, you must establish that you are unable to perform your past work. So, if you have a history of construction work, you have to show that you can’t do that anymore. At this step, it doesn’t matter if you can’t do a desk job, as you have no history of doing that
At step five, you must establish that your impairments are such that you cannot perform any jobs in the national economy. The SSA will look at your injury, your job history, your education, and your age to determine if there are any jobs for you to do. For example, the older you are, the easier this step is because there are different rules for claimant’s who have reached the age of 50, and even easier rules for those reaching age 55 or higher.
This is a very simplified overview of SSDI/SSI. Applying can be complicated, but an experienced attorney can help you navigate that process. At Marcotte Law, we know the system and can help you develop your claim to its fullest potential.