Some 8.2 million Americans receive disability benefits from the Social Security Administration (SSA) because they are unable to work. Payments also go to some family members, including 104,000 spouses and 1.4 million children.
The Social Security Disability Insurance (SSDI) program is governed by the Social Security Act and funded by payroll taxes of 0.9 percent on everyone’s income up to a cap of $142,800.
Qualifying for SSDI can often be tough, and it may require reconsiderations and appeals for your claim to go through. There is also a lot of confusion and misunderstanding about the program among the general population.
To help those in and around Raleigh, North Carolina, including nearby Roanoke Rapids, Fayetteville, and Greensboro, understand how the SSDI program works, I have prepared a list of common misconceptions with explanations and clarifications.
I formerly served as a Disability Judge for the Social Security Administration and since then have been helping North Carolina residents qualify for and receive the SSDI benefits they deserve. If you are applying for SSDI or have run into obstacles while doing so, contact me immediately at Lloyd King Law Firm PLLC.
SSDI benefits are only available for retired individuals: Not true, though SSDI benefits will turn into retirement benefits once you reach the age of retirement. SSDI is available for anyone who qualifies under the definition of a disability found in the Social Security Act, which is:
You have a medically determinable mental or physical impairment that will last at least 12 months or lead to death, and
You can show that your condition can prevent you from engaging in any “substantial gainful activity” (SGA), either what you previously did or any other type of work.
In addition, you must have earned enough work credits to qualify. Work credits accumulate from paying into the Social Security system through taxes at work. The number of credits needed hinges on your age, but generally, you must have earned 40 work credits, with 20 of them coming in the previous 10 years.
If my doctor says I’m disabled, SSDI should be a slam dunk: Getting your physician to submit documentation – even test results – to show you qualify for disability is certainly the first step, but it is not a guarantee of approval. In fact, about 60 percent of all claims are initially denied.
An often-cited reason for denials is a lack of sufficient medical evidence. In this case, the SSA may order you to undergo what’s called a consultative exam by a third-party medical expert. Approval will depend on what the third-party examiner finds. If you fail to comply, your claim will be denied.
The agency also maintains a list of what it considers to be disabling conditions, but the list is not comprehensive. If your condition does not appear on the list, you will have to go the extra mile to prove that your condition is disabling.
Does my savings account or other assets disqualify me for SSDI?: The answer is no. There is no resource limit for qualifying for SSDI. You must have a qualifying disability and enough work credits to receive SSDI. There is, however, an income limit, which currently stands at $1,310 a month, which is considered the SGA limit.
The benefits will stop if I return to work, even part-time: Actually, the SSA encourages SSDI beneficiaries to return to work. The SSA offers what is called a Trial Work Period (TWP). Under a TWP, you can work for nine months and still receive your SSDI benefits. The nine months are calculated based on your income before taxes. If you earn more than $940 gross wages in a month, it counts toward your TWP. Less than that, and it does not.
I can’t regain my benefits once I return to work: Once you’ve used up your nine months under TWP, a three-year window called Extended Period of Eligibility (EPE) opens. If your income doesn’t exceed the Substantial Gainful Activity (SGA) limit of $1,310 a month (2021 figure) or $2,190 if you’re blind, you will continue to receive your SSDI benefits. Once your income passes the limit, a three-month grace period kicks in, during which you will continue to receive benefits. After three months if the SGA is still exceeded, benefits will stop.
There is also a program called Expedited Reinstatement should your income fall below the SGA level, which will provide up to six months of temporary SSDI benefits. During those six months, the SSA will conduct a medical review to see if your benefits should be reinstated on a permanent basis. There is no need for you to reapply for the process to work.
I can’t receive workers’ compensation or other public benefits while on SSDI: Not exactly true. The SSA uses a formula to determine whether you can receive SSDI at the same time as other benefits, such as workers’ compensation or state or local government benefits. Basically, your total of all benefits cannot exceed 80 percent of your average earnings before you became disabled. Veterans Administration (VA) benefits are exempt, as is Supplemental Security Income (SSI).
With the denial rate so high, if you feel you qualify for SSDI, you should consider working with an experienced Social Security disability attorney. In my career, I have worked on both sides of SSDI claims, so I understand the process thoroughly and can help you obtain what you deserve.
If you’re in or around Raleigh, North Carolina, and you’re disabled and unable to work, contact me at Lloyd King Law Firm PLLC to discuss your options under SSDI.