Are You Filing for Disability?

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 What is Disability?

Disability is a term in employment law that refers to situations in which an employee’s work is affected by a medical condition or an injury. Employment disability laws as well as individual disability contracts may allow a worker to claim certain benefits even though they are not working because of a disability.

For example, if a worker has filed for disability because of repetitive strain injuries, they may be able to collect paychecks or other work benefits during the time they are recovering. Federal laws and state laws provide guidelines for disability arrangements.

It is important to note, however, that employers are often able to negotiate individual contracts with workers, as long as those contracts comply with the applicable laws.

How Can a Person Receive Social Security Disability?

In order for an individual to receive Social Security Disability benefits (SSDI), they are required to meet the Social Security Administration’s (SSA) definition of disability. The SSA utilizes a 5 step disability analysis to determine which individuals qualify to receive SSDI.

It may be helpful to understand this analysis prior to filing for disability benefits. In order for an individual to qualify for SSDI, their disability must be serious enough to limit the individual’s ability to work for a living.

It may still be possible for an individual to work in a limited capacity and receive SSDI. However, there are limitations on the amount of income an individual is allowed to earn while receiving SSDI.

As a threshold for receiving SSDI, an individual must have accumulated sufficient work credits with the SSA through their employment to qualify for SSDI if they become disabled. The number of work credits an individual has is based on how much they earn in a year.

The SSA allows workers to earn no more than 4 credits each year. As of 2022, the SSA will provide an individual one credit for every $1,510 they earn.

In general, an individual needs a total of 40 credits to qualify for SSDI. 20 of the 40 credits must have been earned in the past 10 years.

If, however, an individual is under 50 years old and has a qualifying disability, the SSA may approve an SSDI application with fewer than 40 credits. The steps for analyzing an SSDI claim include:

  • Is the individual working?;
  • Do they have a severe impairment?;
  • Do they meet or equal a listing of impairment?;
  • Can they perform past relevant work?; and
  • Can they perform other work?.

SSDI Claim Analysis: Are You Working?

If an individual is performing substantial gainful activity (SGA), they cannot receive SSDI. The SSA provides that substantial gainful activity means significant and productive physical or mental work.

It may be difficult to determine exactly what qualifies as substantial gainful activity. The SSA provides that any individual whose income exceeds the annual thresholds will not qualify, even if they satisfy the medical criteria for disability.

SSDI Claim Analysis: Do You Have a Severe Impairment?

A claimant must show that they have a severe, medical impairment. Medical conditions may be severe if it can be determined that the medical impairment:

  • Significantly limits a worker’s physical or mental ability to do basic work activities, and
  • Is caused by a medical condition or conditions that have existed or will last for at least a year.

A combination of impairments may limit an individual’s physical or mental ability to do basic work, even if each impairment alone would not. If an individual’s medical condition causes functional limitations, for example, difficulty walking, standing, or lifting, it may be considered a severe impairment.

SSDI Claim Analysis: Do You Meet or Equal a Listing of Impairment?

If an individual has a severe impairment, the SSA will examine whether the individual’s impairment is on its Listings of Impairment. If an individual suffers from a qualifying impairment, their claim for SSDI should be approved.

The Listings of Impairment outlines the specific conditions and symptoms as well as outlines disability criteria. If an individual has severe symptoms related to a medical condition, they may meet a Listing criterion.

The conditions in the Listings are medical and technical. In order to determine whether an individual has one of the impairments on the list will require a thorough review of their medical records and possibly require interviews with doctors, family members, friends and others who have knowledge of the individual’s impairment and its effect on their activities.

If an individual has questions about the Listings of Impairment, they should consider discussing the criteria with their doctor and a Social Security lawyer.

SSDI Claim Analysis: Can You Perform Past Relevant Work?

When an individual applies for SSDI, they will provide the SSA with information about their work history. During this step, the individual’s ability to do their past work is evaluated.

Past relevant work (PRW) includes any SGA-level work the individual performed over the past 15 years. In addition, the job must have lasted long enough for the individual to learn to do it.

A very short work attempt may not be considered past relevant work. An individual’s past work will be categorized based on its physical and mental difficulty.

For example, the work of a computer programmer may be considered skilled and sedentary while the work of a commercial janitor is typically heavy and unskilled.

SSDI Claim Analysis: Can You Perform Other Work?

If an individual cannot perform their past relevant work, the SSA will determine if the individual is able to do other full-time work. If the individual is capable of doing other work within the national economy, their claim can be denied.

What Are Some Issues to Think About When Filing for Disability?

In some cases, disability requests are denied because of a number of facts or circumstances. One of the more common issues is when an injury or condition does not fall into one of the descriptions or categories of conditions that are covered by law.

Therefore, if an individual is filing for disability, it is important to first research whether or not the condition they have is covered by disability laws. Other issues to consider include:

  • Disability insurance: The outcome of a request may depend on whether or not the individual has some form of disability insurance;
  • Total vs. partial disability: In some cases, a disability request may result in only partial coverage; and
  • Nature and extent of the condition: Disability payouts may depend on what type of condition it is, how long the individual has had it, etc.

In many cases, the condition must substantially impair the individual’s major life activities in order to be classified under disability laws.

What if I Have a Dispute Regarding Disability Issues?

Disputes related to disabilities often require additional attention. Some cases may require the involvement of an investigatory government agency that will determine if there is a solution available for the dispute.

Other types of cases may require a lawsuit to resolve major issues, especially when an initial agency investigation fails to yield a proper resolution. All of these proceedings will require sufficient documentation and evidence for proving the individual’s claims.

Should I Hire a Lawyer?

Disability is a complex aspect of employment law. If you have any issues, questions, or concerns related to disability claims, it may be helpful to consult with an employment law attorney.

Your attorney can review your situation and provide you with an evaluation of whether you will likely qualify for disability. If you have to file a claim in court, your attorney will guide you through the process and represent you during appearances.

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