ARE SOCIAL SECURITY DISABILITY BENEFITS THE RIGHT CALL FOR YOU?
Having all your ducks in a row before you apply for benefits will streamline the process and increase your odds of getting your claim approved. For those who are considering applying for Social Security Disability benefits, there are several factors to think about before you file.
#1-IF YOU ARE STILL WORKING FULL-TIME, SOCIAL SECURITY WON’T EVEN CONSIDER YOUR HEALTH PROBLEMS. YOU MUST HAVE EITHER STOPPED WORKING ALTOGETHER, OR AT LEAST CUT DOWN YOUR HOURS/INCOME BEFORE SOCIAL SECURITY WILL EVEN CONSIDER YOUR CASE.
This may seem like a no-brainer, but we often have people contact our office about applying for disability benefits even though they are still working full-time. If you apply for benefits while working full-time, you will be denied automatically without any further consideration into your claim. And make no mistake—Social Security will know if you are working.
If you are still employed at a full-time job you are struggling to perform while considering applying for benefits, you face one of the biggest dilemmas of the entire process straight out of the gate: Do I continue working at this job even though my medical conditions make it very difficult, and maybe even dangerous, for me to do so? Am I at risk for doing further damage to my body by continuing to work a job that is too strenuous for me? Should I up and quit this job to pursue benefits knowing it might take a long time to get a check and with no guarantee that I will even get a check in the first place? We regularly talk to people in this difficult situation and we sympathize. Losing an income is tough for anyone. The vast majority of Americans are only a few missed paychecks away from being in real financial trouble. Before you make this call, take stock of your situation. Do you have a spouse who is working? Do you have other sources of income, such as rental property, you can rely on? Do you have family or friends who might be willing to help you out while you are going through the process? Does your current job offer short-term or long-term disability benefits that you might qualify for? While everyone’s situation is different, these are some of the things you should consider before you take the leap of quitting a full-time job to pursue benefits. But keep in mind that if you take that leap, it could be one or two years (even longer in some cases) before you see a payment from Social Security, so plan accordingly as best as you can.
If going the Johnny Paycheck route and quitting your job outright is just not an option financially, you can work part-time and still apply for benefits as long as you keep your income below a certain amount. Social Security sets this amount, and it typically increases a little each year as the cost of living goes up. In 2020, you can make up to $1,260 per month in gross income (meaning that’s the amount of your pay before taxes and other things are deducted from your paycheck) and still be eligible to apply for benefits. Social Security calls anything more than $1,260 per month “SGA”—substantial gainful activity. So, as long as you make below SGA, you can keep working as you apply for benefits.
Working a part-time job as you seek benefits has its pros and cons. The obvious pro is that you can continue to earn money to pay for important things such as bills and food. The con is that Social Security may deem your health problems to be less credible if you are working part-time: “If Mr. X can work 30 hours a week, he should be able to work 40.” Our office has various ways of addressing the stigma of a part-time job that will be covered in another blog post. For now, it’s just something to keep in mind as you wrestle with these decisions.
#2-YOU MUST MEET THE NON-MEDICAL REQUIREMENTS FOR ELIGIBILITY.
Even if you’ve stopped working, Social Security will check and see if you meet the non-medical requirements for benefits before they move on to looking at your health problems, so this is another hurdle that you have to clear. For the most common Social Security benefits, SSDI (“Social Security Disability Insurance”), you must have a certain amount of work credits in order to qualify. As you work and pay in taxes, you earn work credits that go toward your eligibility. As a general rule, you should qualify for benefits if you’ve worked and paid into the program (through taxes) for five out of the last ten years. If you haven’t worked anywhere in a long time, you might not qualify for this program. Given that there is an expiration date on your ability to draw these benefits, you should apply sooner rather than later after you stop working so you won’t risk losing your eligibility.
Social Security has abbreviations for everything. They call the last day you can prove that you are disabled and still qualify for benefits your Date Last Insured, or DLI for short. Say, for example, you have a DLI of 12/31/22. That means that as long as you are able to establish that you became disabled before 12/31/22, you can draw benefits until you get better or reach retirement age. You can find out your DLI by calling your local Social Security field office or online by setting up an account on www.ssa.gov/myaccount/.
If you don’t have enough work credits to qualify for SSDI, you might be eligible for SSI (“Supplemental Security Income”) benefits. SSI is for disabled people who are very low income and very few assets. The income limits for this program are strict.
There is some overlap between SSI and SSDI, so you should apply for both kinds of benefits. Unfortunately, there are some people who do not qualify for either program. That’s why it’s prudent to check and see if you are eligible on the front end of the process, especially before you consider quitting your job.
#3-YOU MUST HAVE AT LEAST ONE SEVERE IMPAIRMENT THAT PREVENTS YOU FROM WORKING.
While most people who are applying for Social Security Disability benefits have a number of different health problems, the rules require that you have at least one impairment that is “severe”—meaning it limits your ability to perform the duties of your job in some way or another. For example, severe arthritis in your right shoulder may make it painful for you to reach overhead with your right arm. Lower back pain due to degenerative disc disease might make it hard for you to lift heavy objects or sit or stand in place for long periods of time. Severe anxiety may make it hard for you to interact with people in public.
In order to establish severe impairments, having a record of medical treatment to back it up is key. X-rays, MRI’s, and other medical test results will help you show that what you are saying is true. Having treatment notes showing where you went to the doctor and complained about pain or other symptoms also helps. That is why the best disability claims are ones that are backed up by multiple medical records, ideally with treatment notes where a doctor has given you restrictions to avoid certain activities, such as lifting.
As a caveat, Social Security will only consider severe impairments that have lasted for at least a year, or that are expected to last at least a year. So, that broken leg is not going to impress them much because they make the assumption that the leg will heal in less than a year. If you are uncertain about how long it might take you to get better, it’s a good idea to go ahead and apply for benefits anyway. Social Security will probably deny your application pretty quickly based on “the durational requirement”—meaning they think you will be better in less than a year. But you can appeal that ruling. If you end up getting better during this process, that’s awesome! And if you don’t, you already have a case going and are ahead of the curve.
Often, a person who is pursuing disability benefits doesn’t have health insurance and cannot afford to see a doctor very much. In those situations, Social Security might send you out to see one of their doctors for an evaluation and pick up the tab for it. So while it’s beneficial to have strong medical records going into the application process, it isn’t necessarily a deal breaker for your case if you don’t.
#4-AGE IS A KEY FACTOR, BUT NOT THE ONLY FACTOR.
If you are here researching about disability benefits, you’ve probably read some other stuff online and/or talked to people you know about the system already. It’s common knowledge that Social Security’s rules make it easier to get approved for benefits as you get older and closer to retirement age. If you are less than 50 years old, Social Security labels you as a “younger individual.” Younger individuals have to establish that not only are they unable to work in the kinds of jobs they have done in the past, but they also could not do any job that exists in America. This includes jobs where you sit at a desk all day. Social Security does not care whether or not you’ve ever actually had a job working at desk before—they assume that since you are a younger individual, you can figure it out. Therefore, people that are younger than 50 have the highest burden to overcome in order to get benefits. That isn’t to say that you won’t be able to get benefits at all if you are younger than 50; our office has won many cases for people as young as 19 or 20 years old. But know that if you are younger than 50, you must have a rock-solid case, be seeing doctors regularly, and be significantly impaired such that you can’t even work at a desk.
When you turn 50, the rules for eligibility relax somewhat. They relax even more at ages 55 (Social Security considers you to be “advanced age” at age 55), and they relax again at age 60. The rules that apply to people ages 50 and up are commonly referred to as “the Grid rules” and they are very complicated, which is why they will be the subject of a later blog post. But for now the main thing you need to know is that generally speaking, your odds of getting approved start getting better at age 50 and continue to get better at 55 and 60.
This is merely the tip of the iceberg, but the takeaway here is that you should apply for disability benefits if you are:
- unable to work or working part-time and making less than SGA;
- have at least one severe impairment that limits your ability to function at work for at least a year;
- have worked enough to qualify for SSD benefits or meet the income requirements for SSI; AND
- your odds are better if you are at least 50 years old.
So now you have either stopped working outright or cut down your hours/income due to your medical problems. You’ve thought about your finances and made plans for how to survive during the disability waiting game. You’ve determined your non-medical eligibility for SSDI or SSI. You have seen at least one doctor who has diagnosed you with a severe medical impairment. You now have a solid foundation to move forward and file for disability. The next step in the SSDI process is all about gearing up to actually file your disability application.