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How - and When - to File a Social Security Disability Claim

money pic.jpgWhen a person can't work for at least 12 months due to a medical condition, or worse, or when that condition ends in death, there may be financial recourse for her/him or certain members of the family from Social Security disability benefits. To qualify for these benefits you must 1) have worked in jobs covered by the Social Security law and 2) have a medical condition that meets Social Security' s definition of disability. This is how you can met both requirements.

Work Requirement

According to the Social Security Administration ("SSA"), a person claiming benefits must have worked long and recently enough to qualify for disability benefits. In other words, a person must have worked at a job where they paid FICA taxes from their wages. The SSA decides if a person has worked long enough based on how many "Social Security work credits" they have. Social Security work credits are based on your total yearly wages - or income from self-employment. An individual can earn a maximum of 4 credits per year. The amount needed for a credit varies from year to year. In 2016, an individual earns one credit for each $1,260 of wages they earned. So once you earn $5,040 in that year, you get 4 credits. The number of work credits someone needs to qualify for disability benefits depends on the age when they become disabled. Generally, 40 credits will be enough, 20 of which must have been earned in the last 10 years ending with the year you become disabled. However, younger workers may qualify with fewer credits.

Disability

The SSA defines "disability" as an inability to engage in any substantial gainful activity due to a medically determined physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. Generally, the SSA will consider you "disabled" if you can meet the following conditions: 1) you are unable to do the work that you did prior to the condition; 2) the impairment prevents you from doing any other kind of substantial gainful work in the national economy; AND 3) the disability has lasted or is expected to last for at least one year - or to result in death.

According to federal regulations, the SSA does a five-step inquiry to decide if an applicant is eligible for Social Security benefits: first, SSA asks whether the applicant is working, second, SSA decides if the applicant has a severe impairment that presents significant limitations to the applicant's ability to do basic work activities, third, if the applicant's impairment is found on the administration's list of impairments (the list can be found at https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm), the applicant is automatically eligible for SSDI benefits without further inquiry into work ability.

But if you do not have an impairment found in step three, then the SSA checks into whether the applicant is able to perform past relevant work and, if not, whether the applicant is able to perform other jobs that exist in significant numbers in the national economy. During this inquiry, the SSA considers different vocational factors, which include the individual's education and past work experience to see if the person is capable of performing other jobs that are in abundance in the national economy.

In the case of Barnhart v. Thomas, the US Supreme Court said that individuals are not eligible for Social Security disability just because their previous job no longer exists in meaningful numbers in the national economy and they are still able to perform that job. In that case, Pauline Thomas was recently fired as an elevator operator due to most elevators becoming automated. She applied for Social Security disability benefits because she could not do other work. The SSA rejected her claim because she was still able to perform the duties of her former position as an elevator operator. The fact that it was nearly impossible to find such a position, the SSA held, did not entitle her to benefits. Ultimately, the Supreme Court upheld the SSA's decision. Fair? Of course not.


It's important to figure out if you've worked long enough and whether your disability is severe enough before you apply for Social Security disability benefits. Like in all situations, the only way to prove disability or injury is through medical reports. If you are denied Social Security disability benefits for any reason by a SSA bureaucrat, you have the right to appeal the decision. Your request must be in writing and delivered to any Social Security office within 60 days of the date you receive the letter containing our decision. Omar Bareentto is a 2016 Rutgers School of Law graduate and a former contributor to the Rutgers Business Law Review. He collaborated with me on this blog. 

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