Monday, November 10, 2008



SSD Benefit Requirements and Work Credits

In order to qualify for Social Security Disability (SSD) benefits, an individual must have paid a certain amount into the social security fund through the FICA taxes deducted from his or her paycheck (or paid in to the system directly as a result of self-employment).

In other words, if you have not worked, or have not worked many hours, or have not worked in recent years, you may not qualify for SSD. In attempting to understand this, it helps to think of SSD by its other name, Social Security Disability Insurance (SSDI). Basically, everyone who works contributes to the national disability insurance fund, and like any other "insurance policy" (title II benefits are actually called SSDI, social security disability insurance), this resource can be drawn on if one becomes disabled, if you have paid enough into the system.

How much in FICA taxes do you have to have to have paid to be eligible? Well, this can get a bit complicated, because social security doesn’t measure your contribution in dollars or hours, but in work credits. This is necessary to compensate for inflation—the dollar amount associated with one work credit changes each year. In 2008 one work credit is equal to $1,050, and in 2009, one social security work credit will equal $1,090.

To make it even more complicated, you must have earned at least half of your work credits fairly recently, and even this requirement varies according to your age. Here is a very basic rundown of work credit requirements that must be met in order to qualify for SSDI: If you are younger than 24 years of age, you must have earned 6 credits in the past three years; if you are 24-31 years of age, you must have earned 12 credits in the past 6 years, and if you are over 31, you must have earned 20 work credits in the past 10 years.

Assuming you have worked enough to be eligible for social security disability insurance, or SSDI, you also have to meet the following SSD benefit requirements: 1) your medical records must indicate that you have a severe physical or mental impairment; 2) your condition must have existed or be expected to last for a period of at least one year regardless of medical treatment; and 3) your medical condition must be severe enough to prevent you from earning the current SGA, or substantial gainful activity amount.

Unlike Supplemental Security Income (SSI) disability benefits, which is awarded based on financial need, you do not have to demonstrate that you are impoverished to qualify for SSDI; only that you have worked enough to qualify and that you are now unable to earn the current SGA amount.

Whether you drive a Porsche or a Jetta, if you have contributed the required amount in FICA taxes in recent years, and your medical records show that your impairment is severe enough to prevent you from earning the amount for substantial gainful activity, you could collect SSD or SSI disability benefits.

However, it is important to note that, unless you have a fairly straightforward disability, such as blindness, paralysis, brain trauma, or any other medical condition listed in the social security disability list of impairments handbook (commonly referred to as a blue book, this is a listing of medical conditions that Social Security considers disabling), you will probably have a hard time proving disability regardless of your employment history or the information in your medical records. That's not to say, however, that it will be impossible to win disability benefits. In fact, the majority of claimants who appear at a disability hearing (the second appeal step) do get approved for benefits. They simply have to weather going through the appeal system.

The fact is, about 70 percent of all SSD applications are denied, and many of these denials occur because the disability examiner decides that, although the claimant is impaired, he or she is still able to perform past work or some other type of work. Past work may be any job the claimant has held in the past 15 years (social security calls this the “relevant period”); other work may include any job that the claimant may be qualified to perform given his or her age, education, job skills, and physical or mental limitations.

Claims are routinely denied at the lower levels based on the ability to perform past work or other work. However, refuting this can be a matter of presenting an RFC form from a physician, more accurately addressing a claimant's work history and job skills, providing additional medical record documentation, or arguing the merits for an approval...all of which are more likely to occur at the hearing level.



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