Are you physically or mentally disabled due to an injury or illness?
Dealing with a disabling condition is tough enough without having to worry about your finances.
Depending on your specific condition, you may qualify for Social Security disability benefits.
So how does it all work and what conditions qualify for disability? We’ll take a look.
Social Security Disability Benefits
If you qualify for Social Security disability benefits, you will receive monthly payments to help support and sustain you should you be unable to work.
The Social Security Administration (SSA) pays disability benefits through two different programs.
1. Social Security Disability Insurance (SSDI)
Social Security Disability Insurance (SSDI) is a safety net program.
Like insurance, it covers workers in the event that they get sick or injured and are unable to work. Unlike insurance though, there are no premiums to pay to an insurance company.
Instead, Social Security taxes are taken out of paychecks to fund this program.
SSDI benefits can be paid to you the entire time you’re disabled until you reach retirement age. At that point, you would transition to retirement benefits.
2. Supplemental Security Income (SSI)
Supplemental Security Income (SSI) benefits, on the other hand, are awarded only to those with a disabling condition, low income, and limited resources. Although seniors over 65 also qualify for these benefits.
Rather than being funded through individual taxes, SSI benefits come from general tax revenue.
With SSI, you can qualify for benefits regardless of your work history. You must, however, have low income and few valuable assets.
What Conditions Qualify for Disability?
This is the big question. And the answer is not always clear cut.
The SSA has a list of conditions in what is called a Blue Book. For adults, medical conditions that qualify include:
- Musculoskeletal problems, such as back conditions and other dysfunctions of the joints and bones
- Cardiovascular conditions including chronic heart failure or coronary artery disease
- Digestive tract problems, such as liver disease and inflammatory bowel disease (IBD)
- Immune system disorders including HIV/AIDS, lupus, rheumatoid arthritis, and kidney disease
- Senses and speech issues, such as vision and hearing loss
- Mental disorders including depression, anxiety, autism, schizophrenia, and intellectual disability
- Respiratory illnesses such as asthma and cystic fibrosis
- Neurological disorders including Parkinson’s disease, epilepsy, multiple sclerosis, and cerebral palsy
- Blood disorders, such as sickle cell disease or hemophilia
Don’t see your exact diagnosis on the list? You may still qualify.
How the SSA Determines What Qualifies as a Disability
When determining whether you qualify, the underlying factor is always going to be whether you’re able to work.
Being “able to work” does not mean applying for a job and then doing it only as long as you’re able before your condition flares up and you’re unable to work again.
It means being able to sustain gainful employment for an extended period of time in a field for which you are reasonably qualified.
The SSA will work with a state agency known as the Disability Determination Services (DDS) to look at your medical records and employment history.
From there, they will determine your Residual Functional Capability (RFC).
Your Residual Functional Capacity (RFC)
Your RFC is your actual ability to work – regardless of whether your condition is in the Blue Book.
For example, paralysis is a disorder in the Blue Book. If you have only minimal use of your arms and legs, you would have difficulty finding gainful employment. Yet, having use of your arms would still allow you to have a sedentary job.
Then again, if your work history shows no evidence that you’re capable of sedentary work, then you may still qualify for disability.
Of course, your ability to perform physical tasks may not be a factor at all. Those struggling with severe mental illness may be physically able to deal with mental issues that don’t allow them to sustain a job.
Whatever the case, the most important part of applying for Social Security Disability is being able to provide proof of your disabling condition.
Providing Info about Your Condition
The SSA will require information about your condition from the doctors you see on a regular basis. This information can come only from licensed physicians and you must be willing to give the SSA authority to access these records.
They also prefer that it’s provided by experts in the field of medicine related to your disability. For instance, if you’re condition is cancer, then you’ll want to provide medical records from your oncologist.
Your best chance of getting benefits is by ensuring that your doctor fully documents your symptoms and any treatments you undergo.
In addition, the SSA may also require you to undergo an examination or evaluation with one of its doctors at some point during the application process.
Even having jumped through these various hoops, there’s still a chance your application will be denied.
What to Do If Your Application Is Denied
The denial rate for Social Security Disability benefits is high, so don’t be discouraged. There is recourse.
You’ll need to repeal.
This involves first putting in a request for consideration. A new disability claims examiner will review your claim and possibly approve it. If that’s the case, you won’t need to continue with the appeals process.
However, if he or she denies the claim again, then you will move onto a hearing before an administrative law judge (ALJ). If that’s unsuccessful, there will be a review by the Social Security Administration’s internal appeals board.
The final stage is an appeal to a federal court. Hopefully, it doesn’t have to go this far.
The decision not to award you benefits could be reversed at any stage of the appeals process. If your claim continues to get denied though, then you must go through each phase of the process.
At any stage of the appeals process, it’s advised you seek the services of a social security attorney to get you the best legal representation. It could make all the difference.
Do You Qualify for Disability?
Knowing what conditions qualify for disability can be tough.
And determining whether your medical condition qualifies can be even more challenging.
But finally getting these benefits can release you from a tremendous amount of stress. So it’s worth the effort.
For more tips on navigating your best life, keep checking back with us.
