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Understanding Approval SSA Disability Programs

Understanding the Criteria for Approval for SSA Disability Programs

If you have a disability, you may be eligible for disability benefits under programs administered by the Social Security Administration (SSA). However, many people who apply have their claim denied. Having a general understanding of the programs offered, the differences between them, and how to determine eligibility requirements for your condition are vital before applying to ensure a timely resolution and to avoid costly pitfalls.

Types of Disability

It’s important to understand that Social Security manages multiple different disability programs. One such claim is for Supplemental Security Income benefits (SSI), which, for individuals under age 65, is based on disability and financial need.  Your income and resources must be below a certain level. To qualify for this benefit, you are not required to have paid into the Social Security system.  At a minimum, you must have less than $2000 (if single) or $3000 (if married) in countable resources.  Many resources, such as one car and home are not counted.  You must also have minimal monthly income.

Social Security Disability Insurance Benefits (SSDIB) is similar to Social Security retirement benefits in that the benefit amount takes into account the amount of time you have worked and the amount you have earned. With SSDIB, your benefit calculation only takes into account jobs for which you paid into Social Security.

If you have a work history, a disability and limited income, then it is possible to qualify for both programs. However, an offset applies.  If your Supplemental Security Income amount is greater, then you first receive your Social Security Disability Insurance Benefits and the Supplemental Security Income is only paid by the proper amount after offset for the SSDIB.  The first $20 of SSDIB is not considered in the offset.

Qualifying Impairments

For either program, you must have a disability as defined by the SSA that precludes you from working for at least a year, or that will result in death. The SSA provides an impairment listing manual, referred to as the Blue Book, which lists impairments that will qualify for either SSI or SSDIB. There are certain illnesses that, with a documented diagnosis, will automatically qualify you for benefits, such as Lou Gehrig’s disease, kidney failure, an organ transplant, or certain serious cancers. However, for most disability claims that don’t fall under one of these diagnoses, you will need to demonstrate that your condition meets specific criteria such as certain physical or cognitive limitations and specific symptoms. Depending on your illness or injury, the listing will also specify which medical tests you will need to have performed to be considered.

Impairments Not Listed

If you have a condition that is not listed in the Blue Book, this does not mean you won’t be approved. However, you will have to prove that the condition is serious enough to prevent full time work or otherwise qualify under the Social Security Administration’s Regulations.  To do this, you need to demonstrate that:

  • Your impairment is a “medically determinable impairment,” which means that your condition must be confirmed with clinical and/or laboratory findings and not based on your reported symptoms alone; and
  • Your impairment reduces your “residual functional capacity” (RFC) to a level that is disabling. In layman’s terms, RFC is a measurement of how much you can do and for how long in various work-related tasks/functions. It is a determination of your ability to work.

Legal representation can assist you with ensuring you are taking the right steps and providing the right information at the right time to give you the best possible outcome.

Contact Schiffman Law Office today at (602) 638-2864 to take advantage of more than 60 years of combined experience in helping people with disabilities get the benefits they deserve.

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