This guide explains what Social Security benefits are and whether or not you may qualify for them.
What are Social Security Disability benefits?
Social Security Disability benefits refer to two kinds of financial benefits that may be available to disabled individuals: Social Security Disability benefits and Supplemental Security Income Benefits. "Social Security Disability benefits" and "Supplemental Security Income Benefits" are the terms used to describe the monthly payments that the Federal Government makes to qualified disabled individuals. The goal of these benefits is simple: to offer financial support and assistance to those individuals who are no longer able to work due to a disability.
As we will explain in this guide, to qualify for Social Security Disability benefits or Supplemental Security Income, you must meet very specific requirements related to your medical conditions and your employment or financial situation.
What is the Social Security Administration?
The Social Security Administration is the national government agency that is in charge of overseeing and managing our country's Social Security programs. This includes determining who is eligible to receive benefits and how much the monthly benefit will be.
If you are applying for Social Security Disability benefits or Supplemental Security Income, then it is the Social Security Administration that will handle your claim, process your documentation and, potentially, pay you your benefits.
How Do I Contact the Social Security Administration?
The Social Security Administration has offices in cities across the United States. These local offices are the first point of contact for individuals who seek the Social Security Administration's services. If you are interested in visiting a Social Security Administration office, there are locations in Iowa at the following addresses:
If you do not live in Iowa or are unsure which office you should contact, you may look up the Social Security office that serves your area online at: https://secure.ssa.gov/ICON/main.jsp
In addition to the local Social Security offices, there is also a national toll-free number for contacting the Social Security Administration: (800) 772-1213.
Do I qualify for benefits?
Who can receive disability benefits?
For you to qualify for Social Security Disability benefits or Supplemental Security Income Benefits, you must meet some very specific legal requirements. The requirements are different for each of these two types of benefits and we explain these requirements below.
In order to qualify for Social Security Disability benefits...
If you are seeking Social Security Disability benefits, you need to meet two basic requirements:
Requirement #1: You must be disabled.
It is important to understand that the Social Security Administration has its own definition of what "disabled" means. You must meet Social Security's definition of disabled. We explain in more detail what it means to be "disabled" on pages 15-16.
Requirement #2: You must have worked long enough and recently enough to qualify for Social Security Disability benefits.
The Social Security Disability Program is like an insurance policy. Just like you pay a premium for your car insurance, if you have been working, you have also been paying a portion of your salary to the Social Security Administration in the form of taxes. That money helps to fund the Social Security Disability Program. Then, if you become disabled, you are able to collect money from the Social Security Disability Program, similar to how a person collects money from an insurance policy after an accident. The law says that you can only get disability benefits if you have paid enough money into the system while you were working and at least some of that work was performed recently.
To know if you worked long enough, a good rule of thumb to follow is: "Have you worked a total of 10 full years in your lifetime?" If you are younger than 31, you may qualify with fewer years of work.
To know if your work was recent enough, a good rule of thumb to follow is: "Have you worked within the last five years prior to becoming disabled?"
If you answered "yes" to both of these questions, you very likely meet this requirement. However, the easiest way to determine for sure if you satisfy this requirement is to review your "Social Security Statement" online by creating a free account with the Social Security Administration by going to the following website: https://www.ssa.gov/myaccount/.
You can also contact the Social Security Administration and request that they send you a copy of your "Social Security Statement" by calling toll-free at (800) 772-1213. When you receive this information, it will tell you whether you qualify for Social Security Disability benefits.
In order to qualify for Supplemental Security Income...
If you do not have a recent or long enough work history to qualify for Social Security Disability benefits, you may still qualify for Supplemental Security Income. Again, you need to meet two basic requirements:
Requirement #1: You must be disabled.
Once again, remember that you must meet Social Security's definition of disabled.
Requirement #2: You must have significant financial need.
Supplemental Security Income is intended to provide some minimum financial benefit to individuals who have severe financial need.
What does it mean to be "disabled"?
As we just explained, whether you are trying to get Social Security Disability benefits or Supplemental Security Income, you must always prove that you meet Social Security's definition of 'disabled.' So what does this mean?
It is important to understand that the Federal Government and the Social Security Administration have their own definition of what "disabled" means. Because of this, many applicants become frustrated or upset when the Social Security Administration denies them disability benefits because they don't meet the very strict definition of "disabled."
For instance, the fact that you are currently not working does not, by itself, make you disabled. Similarly, just because a doctor says you cannot go back to work does not, by itself, make you disabled. You may have a very serious medical condition that limits your lifestyle and still not qualify as 'disabled' according to the Social Security Administration. This guide will help explain what the Social Security Administration means when it says "disabled."
When the Social Security Administration says you must be "disabled" to get benefits, they are saying that you must have a severe medical impairment - or maybe multiple impairments - that prevent you from doing the type of work you used to do and that also prevent you from being able to perform a new type of job.
That may seem straightforward enough, but what exactly does it mean for your specific situation? Well, in every single Social Security Disability claim, the Social Security Administration uses the same five questions to decide whether or not the claimant meets this very specific definition of "disabled."
Question 1: Are you working?
Remember, Social Security benefits are intended for individuals who cannot work due to disability. This means that one of the requirements for being considered "disabled" according to the Social Security Administration is that you are not participating in what the Social Security Administration calls "substantial gainful activity." In general, the Social Security Administration will look to see if you are earning any income and how much. Income you get but did not have to work for - such as FMLA, short-term disability or sick leave - does not count.
In 2016, if you earned more than $1,130 per month from working, then the Social Security Administration will conclude that you do not meet its definition of "disabled" and will not even investigate your medical conditions.
Question 2: Do you have a "severe" medical impairment?
At this step, the Social Security Administration begins looking at your medical records to determine if you have a "severe" medical impairment.
Social Security is trying to address a couple of big picture issues here. First, they want to know if your impairments are supported by medical evidence - for example, test results or a doctor's examination of symptoms. Second, Social Security will determine whether your impairment is expected to last more than one year or if it is likely to result in death.
Is your impairment listed in Social Security Law?
Question 3: Is your impairment listed in Social Security Law?
The Social Security Administration keeps a list of certain severe conditions that automatically qualify a person as disabled. This list is found in Social Security Law. If you have one of these conditions, then the Social Security Administration will conclude that you are disabled without looking at your work experience.
Keep in mind that this list is very detailed and usually requires both a specific medical diagnosis in addition to specific symptoms, exam findings or test results. Even if you don't meet all the requirements for one of these "listed conditions," the Social Security Administration may decide that your condition is similar enough to one of the listed conditions to qualify you as disabled.
If your medical records show that you meet the requirements for a listed condition, you will automatically be found disabled. If you do not meet a listed condition, then the Social Security Administration will look at how your condition affects your ability to work.
Question 4: Can you do any of your previous types of work?
At this point, the Social Security Administration is trying to determine if you can return to any type of work that you have done within the last 15 years. To do this, the Social Security Administration will first identify - based on your medical records, doctor's opinions, and questionnaires that you fill out - what restrictions or limitations you have because of your medical impairment. They will then compare those restrictions to the physical and mental requirements of jobs you have had in the last 15 years to see if you would still be able to perform any of those jobs.
If Social Security finds that - even with your limitations - you would be able to perform work that you have done in the last 15 years, then you will not be found disabled. If, however, Social Security finds that your limitations meant that you could not return to any of your past work, then they will examine your ability to adjust to new work.
Question 5: Can you adjust to any other type of work?
Even if you cannot return to your past work, the Social Security Administration will still ask if there is some other type of less-demanding or less-strenuous work that you would be able to do given what your physical or mental limitations are.
There is no limit to the types of jobs Social Security will consider at this point. However, when trying to answer this question, the Social Security Administration will consider how old you are, your education level, what your past work experience has been, and what skills you have that would enable you to move into a different type of work.
If the Social Security Administration finds that you cannot adjust to any other type of work for which you are otherwise qualified, then you will be found disabled. If, however, Social Security is able to identify even one other type of job you could do - even if you have never done that job before - then you will not be found disabled.
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