Social Security Disability Programs
Social Security Disability Programs
The Social Security Administration administers two types of disability programs, Disability Insurance Benefits (DIB) and Supplemental Security Income (SSI). While the medical requirements for these programs are the same, there are important differences in the non-medical requirements. It is possible to be eligible for both programs.
DIB, or Title II Benefits
In order to receive these benefits, the claimant must show that he became disabled prior to his “date last insured” (DLI). The DLI is determined by how much the claimant has paid in Social Security taxes. Generally speaking, if the claimant has worked five (5) of the last ten (10) years, he will be fully insured; the DLI typically expires five years after the claimant stops working.
SSI, or Title XVI Benefits
In order to receive these benefits, the claimant must meet certain income requirements. Generally speaking, SSI is like a welfare program for the disabled. Those who have a limited work history or become disabled after the expiration of their DLI may qualify for SSI.
Medical Requirements
The medical requirements for these programs are identical. The claimant must show that he has an impairment so severe as to prevent him from performing any work for a period of at least twelve (12) consecutive months. Due to this durational requirement, it is advisable to wait until an individual has been out of work for at least six to eight months before applying.
Once an application is received, the Social Security Administration performs a five-step evaluation to determine the issue of disability. The first step is an earnings test. If the claimant is engaging in “substantial gainful activity” ($940/month for 2008), he is found “not disabled.” If they are not performing substantial gainful activity, the process goes to the next step. The second step is a medical severity test. The claimant must show that he has a “severe” impairment. If he does not, he is found “not disabled.” This is intended to weed out groundless claims. If he does have a severe impairment, the claim proceeds to the third step. The third step is a presumptive disability test. The Social Security Administration maintains a list of impairments that are judged to be automatically disabling. If a claimant can show that he has an impairment on this list, he is found to be “disabled.” If he does not have such an impairment, the claim proceeds to the fourth step.
Before the fourth step, the claimant’s “residual functional capacity” (RFC) must be assessed. This is an assessment of the claimant’s ability to perform work-related functions, such as standing, walking, sitting, lifting and carrying. Following this assessment, the claim proceeds to the fourth step, which is a test to determine if the claimant can perform his past relevant work. The claimant’s RFC is compared to the demands of his past work. If he is able to perform his past work, he is found to be “not disabled.” However, if he is unable to perform his past work, the claim proceeds to the fifth and final step.
The fifth step is a test to determine if the claimant can perform any work. If the claimant is found to be capable of performing any work, he is found “not disabled.” Showing that, for example, an individual is no longer able to perform construction work is insufficient — he must show that he is unable to perform any work, even a desk job, before being found “disabled” by the Social Security Administration. When the claimant is over 50, his age, education and past work are considered at step five of the sequential evaluation.
For more information see [Diagram: Disability Decision and Sequential Evaluation Process].
