Social Security and You by Tom Margenau

Q: I have an eye injury and can no longer do my job. I have been declared 20-percent disabled by the state. Can I get Social Security disability benefits? I have heard that the government automatically denies all disability claims the first time around and that you have to hire an expensive lawyer to get benefits. Is this true?

A: I'll take on your second question first. No, it's not true that the Social Security Administration automatically denies all first-time disability claims. In fact, studies show that about 40 percent of all initial claims for Social Security disability benefits are granted.

While even that number may still seem low to some people, it might make more sense when you learn that many people file Social Security disability claims more out of desperation than because they have a serious disability. I'm talking primarily about people who are unemployed rather than disabled. They file for Social Security disability benefits just because they figure it's worth a shot. And I guess you can't blame them for trying.

Put yourself in their shoes: You've been out of work for a long time. You've got a bad back and maybe a little high blood pressure. (Many of us, especially the older we get, have some aches and pains or other relatively minor and treatable medical conditions.) So, they fill out some disability forms at the Social Security office and wait for a decision. And more often that not, that decision puts them in that 60-percent bracket of people whose first claim for disability benefits gets denied. They rarely appeal the denied claim because they never really expected to get approval in the first place.

Having made my point about unemployed people versus disabled people, I don't want to mislead my readers into thinking that the majority of Social Security disability claimants are out-of-work gold diggers. In fact, just the opposite is true. Most people who file for Social Security disability benefits have some mental or physical impairment and truly believe they are disabled. But what they think of as a disability versus what the law defines as a disability may be two entirely different things.

For example, take someone with an eye injury who has been declared 20- percent disabled by the state. (Can you guess that I'm now getting around to answering your first question?) Social Security law doesn't recognize any degrees of disability.

You're either 100-percent disabled, or you're not eligible for Social Security disability benefits.

When it comes to Social Security benefits, Congress wrote a fairly strict and restrictive definition of disability. Although the actual law and its corresponding regulations are more complex than this, in their simplest terms the rules state that to qualify for Social Security disability benefits, you must have a condition that is so severe that it is expected to keep you from doing ANY kind of work for at least 12 months, or one that is expected to result in your death.

Here's an example I've always used to explain how the Social Security disability law works. Years ago when I was an interviewer for SSA, I took a disability claim from a 35-year-old truck driver. He had been in an accident. He was confined to a wheelchair, hurting himself to the point where doctors said he would never drive a truck again. But his Social Security claim was denied. He appealed several times, and his claim was denied over and over again. Although there was no question that he had a disability, he simply was not disabled enough for Social Security purposes. He couldn't drive a truck, but there were many other jobs he could do, even while in a wheelchair.

So, my educated guess is an eye injury, which has been classified as 20- percent disabling by your state, isn't going to meet the legal definition of a disability for Social Security purposes. And you could hire the best lawyer in your state, but I don't think you're going to change the outcome.

As I said, that's my "educated guess." I never discourage anyone from applying for Social Security benefits of any kind. You certainly have every right to do so. It's just that I don't think you should be lying awake at night waiting for that claim to be approved.

Finally, a quick word about lawyers and Social Security claims. Although you do not need a lawyer at any time during the Social Security disability process, studies show that a higher percentage of claims are approved if you do hire one. But, that is generally only true once you get to the appeal level. A lawyer really doesn't do you any good during your initial claim for benefits. If that claim is denied, lawyers come in handy in an appeal primarily because they know the law and know how to present your case to SSA's appeals judges. That's the good news. The bad news is they are generally going to take about 25 percent of any back-pay benefits you receive.

To find out more about Tom Margenau and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

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