Social Security Disability Law in a Nutshell

The Social Security Administration (SSA) administers two disability compensation programs mandated by the Code of Federal Regulations:

Title II or SSDI (Social Security Disability Insurance) cases based on credits earned during work.
Title XVI or SSI (Supplemental Security Income) cases provides income based on assets.

The definition of disability is the same for both, an inability to engage in any substantial gainful activity by reason of a determinable physical or mental impairment which can result in death or lasts for a continuous period of no less than 12 months. An individual is not found disabled if drug addiction or alcoholism would be a material factor but entitled to compensation if the disability would be the same without these addiction diseases.
Children are eligible for SSI. The definition of disability is described differently, a child is eligible if he or she has severe functional limitation.

Substantial Gainful Activity (SGA) is a set amount of earning that disqualify an applicant from disability insurance compensation. Earnings under this established SGA amount (currently a little over $1000/month) does not disqualify.

SSA accepts applications on line, over the telephone or in person in the local SS office. SSA evaluation can take several months to years (average 2 years with appeals) and it is a 5-step process:

1. The first step is the assessment of claimant’s SGA.

2. The second step is to establish that the claimant has a “severe” impairment that limits his physical or mental activity. More than a “de minimus”, like a medical diagnosis suffice. These steps are usually easily satisfied.

3. In the third step the SSA looks at the “listing” of severe impairments. If the applicants condition meets or equals the listing, he is deemed disabled. Very few compensation awards made at this step. You can see the listings yourself on line.

4. The fourth step is asking whether the severity of claimant’s impairment prevents him to perform his past relevant work.

5. The fifth step is looking for a possibility of transferring his skills to other work in the national economy. SSA will look at the work history, medical records and all the allegations in order to establish a residual functional capacity (RFC), what the applicant can do inspire of his disabilities.

Medical records and treating physician’s opinions are evaluated. SSA will collect records listed on the application. Records from the year prior to application are the most important but earlier records can also be useful to establish the onset of disability.

If denied, applicant can ask for reconsideration and has a right to appeal the decision to SSA and possibly to the Federal Courts.

Recognizing the difficulties of older disabled workers in the job market, SSA treats applicant differently over age 50, thus it is somewhat easier to get compensation for older individuals.

Should you consult with an attorney? If you have a severe impairment and feel that you can handle all the required paperwork, you can probably handle your own applications. You can call an attorney at any point if you feel you need help in your applications.

Many attorneys get involved at the appeal level, after your application is rejected. This author feels the sooner the better to get advice.

Most attorneys get paid on a contingency basis after a successful resolution and approval by an Administrative Judge.

Disclaimer: All information on this web site is for the purposes of informing the public and legal professionals about Dr. Melez's legal practice. No information should be read as personal medical or legal advice and no communication through this web site creates an attorney/client or doctor/patient relationship without personal consultation and agreement.