Social Security Disability (SSD) and Supplemental Security Income (SSI): Safety Nets for Disabled Workers

Most of us go to work each day thinking about the tasks that lie ahead, an important meeting, or maybe our evening plans. We don’t want to think about what might happen if we become disabled and are unable to work for an extended period of time. But according to the Social Security Administration (SSA), we should be prepared for just such an event. Fortunately, Social Security Disability Insurance (SSD) and its cousin, Supplemental Security Income (SSI), can act as safety nets for sick or injured workers and their families.

In 2004 – the most recent year for which figures are available – SSD payments totaled approximately $70 billion. Nearly 7 million disabled workers collected $6.2 billion in disability benefits during May alone. The average monthly benefit paid to injured or sick workers that month was $943.

SSD is available to a disabled worker and his or her family members provided that the worker meets certain criteria. SSD is a federally administered program financed through Social Security taxes. Disability benefits are calculated based on prior earnings; financial need is not a consideration. Once SSD beneficiaries have received payments for 24 months, they also become entitled to Medicare coverage.

Unlike SSD, Supplemental Security Income, or SSI, is based solely on financial need. An SSI recipient need not have paid into the Social Security system through prior jobs in order to receive benefits. Disabled individuals who have less than $2,000 in assets may be eligible for SSI benefits. The maximum dollar figure jumps to $3,000 in assets for couples. SSI recipients are also entitled to Medicaid free of charge. In some cases, a worker may receive SSD and SSI payments.

While the thought of a financial safety net might help us sleep better, the administration denies a surprising 60 percent of all initial SSD claims. This is partly because the SSA uses a complex set of regulations. Under the Social Security Act, a “disability” is defined as the inability to work due to severe physical or mental impairment that has lasted, or is expected to last, for at least a year, or that is expected to result in death. Whether you can work is determined not by your ability to go back to your previous job, or by whether you have been able to find a new job, but rather by your physical and mental ability to do a job that is available in the everyday work place.

The five-step process that is used to determine eligibility for benefits looks like this:

1. Current Employment Situation: If you are working and earning more than $860 per month, you generally will not be considered disabled. If you are not working or are earning less than $860 per month, the administration moves on to step 2.
2. Severity of Condition: This is where the technical definition of “disability” comes into play. Your condition (or combination of conditions) must be severe enough to interfere with basic work-related activities, and must have lasted, or be expected to last, for at least one year, or be expected to result in death.
3. List of Disabling Impairments: At this stage, the administration checks to see whether your condition is found on its list of impairments that are so severe that they are automatically considered disabling. If your condition does not appear on the list, the administration will determine whether your condition or combination of conditions is of equal severity to an impairment on the list. If so, your claim for benefits will be approved. If not, the administration moves on to step 4.
4. Ability to Return to Work: Here, the administration examines whether your illness or injury makes it impossible for you to do any work that you have done during the last 15 years. If it does not, your claim will be denied. If it does, the administration moves to step 5.
5. Ability to Do Another Type of Work: The administration will examine your age, education, past work experience, medical condition and transferable skills to decide whether or not you are capable of adjusting to a new kind of work. If you are not, your claim will be approved. If new work is a possibility, your claim will be denied.

Many of the 60 percent of applicants whose initial claims are denied simply give up and assume they will not be able to obtain benefits. This is a mistake because it is possible to ask the administration to reconsider an application. Approximately 20 percent of reconsiderations results in an approval.  Applicants who are denied still should not give up. The second denial can be appealed, and statistically, more than 50 percent of all claimants who continue to pursue benefits ultimately receive them.

While you are entitled to seek benefits without the help of an attorney, statistics show that applicants represented by counsel have a greater chance of obtaining benefits. At the beginning of the process, an experienced lawyer can help you gather, prepare and submit the evidence necessary to show you are disabled. Your attorney can contact your physician to make sure that he or she submits a report consistent with Social Security regulation requirements. Your lawyer can also help you obtain documents from your SSD file. If you hire an attorney during the appeal process, he or she can help you prepare to testify at your hearing, present medical and other evidence to support your claim and make sure you receive a fair hearing by objecting to improper evidence and questioning adverse witnesses. If you secure benefits, your lawyer can make sure that the administration calculates them correctly. If benefits are denied, your attorney can help you appeal to a federal court.

We handle SSD cases on a contingency basis and will only be paid if you obtain benefits. By statute, your attorney can earn either 25 percent of the past-due benefits or $5,300, whichever is less. Applicants who do not obtain benefits will pay no fee. 

It is important to apply for benefits soon after you become disabled and unable to work. You do not need to wait 12 months to apply. If your initial application has been denied, you have a very limited amount of time to appeal, so it is important to take action quickly. Our lawyers are available to answer your questions and to guide you and your family through the process of obtaining the benefits you are owed. For more information, please contact us for assistance here or call our office at 215-663-0400.