A Fact Sheet About Disability Benefits

By Tom Margenau

May 21, 2014 7 min read

I must be a glutton for punishment. I have written yet another fact sheet on yet another controversial and misunderstood Social Security topic. This time it is the Social Security disability program. And my punishment is the fact that I will spend the next several weeks answering hundreds of emails from readers and sending them free electronic copies of the new fact sheet. (More about this later.)

But first, let me preview the fact sheet by giving a short summary of each of the major topics it covers.

First, there is an introduction that discusses the subjective nature of the disability program. Unlike Social Security retirement and survivor benefits, which have very cut and dried eligibility factors and evidentiary requirements, disability, by its very nature, can be a very wishy-washy subject. In other words, exactly how disabled is too disabled to qualify for benefits? And this lack of eligibility clarity is compounded by the fact that what one person considers a disabling condition is very different from what someone else may consider a disabling condition. The Social Security Administration tries to objectify the process by establishing disability criteria for each of the hundreds of different kinds of physical and mental impairments that may afflict a person. But despite their best efforts, the ultimate decision about whether a person is disabled or not is usually subjective.

The next section of my new fact sheet explains that SSA administers two entirely different disability programs that are often confused with one another. First, there is Social Security disability benefits. To qualify for these, you must be "insured," which means you must have worked and paid Social Security taxes for a prescribed period of time. Then there is the Supplemental Security Income, or SSI, disability program. SSI is a welfare program (funded out of general tax revenues, not Social Security taxes). So to qualify for SSI, your income and assets must be below certain levels.

The next section defines disability. It primarily explains that the inability to work, not just the disabling impairment itself, is the key to qualifying for benefits. For example, there are many people with disabilities (someone who is blind or someone confined to a wheelchair, for example) who have productive careers and are working full time. Even though such a person is "disabled," he or she would not qualify for Social Security or SSI disability benefits. But if you are unable to engage in what the law calls "substantial gainful activity" for at least a year or more, then you can usually be considered disabled.

The fact sheet then offers tips on filing for disability benefits. It goes on to point out that, despite conventional wisdom to the contrary, not all first-time claims are automatically denied. In fact, about 35 percent are approved the first time. There is also a discussion of the need for a lawyer. I point out that their services are usually not needed for the first claim or even for the first appeal, if necessary. But legal help does often prove helpful if your claim reaches the point where you are appearing before a Social Security judge.

The next section of the fact sheet discusses senior citizens and the Social Security disability program. It points out that if you become disabled after reaching age 66, there is no point filing for disability benefits. That's because once you reach that age, there is no difference between the retirement rate and the disability rate. However, if you are under age 66 and disabled, there may be some advantage to filing for disability benefits. Further, the fact sheet points out that if you are getting disability benefits and then turn age 66, you will be automatically switched from the disability to the retirement program — although the benefit amount remains the same.

Another part of the fact sheet takes on the topic of disabled children. In a nutshell, the rules say that the minor children of a retired, disabled or deceased worker will get monthly dependent's benefits until age 18. But benefits can continue beyond that age, and even into adulthood, if a child is disabled. And some disabled children from poor families may qualify for SSI disability benefits.

Yet another section discusses the effect that other public or private benefits have on the Social Security disability program. Most have no impact, with one notable exception. There is a law that says the combination of your Social Security disability benefit and any state worker's compensation you get cannot exceed 80 percent of your average salary before you became disabled. If they do, then one or the other will be reduced.

The next part of the fact sheet provides a very brief overview of the work incentive provisions of the Social Security disability program. In brief, the rules allow a person getting disability benefits to try working and earning some money (for a while) without impacting their eligibility for monthly payments.

Another section of the fact sheet explains that every disability beneficiary is subject to having his or her claim reviewed from time to time to ensure that he or she still meets the legal definition of disability for Social Security purposes.

And finally, there are tips on how to report alleged fraud. Even though Social Security disability eligibility criteria are generally considered very stringent and exclusionary (in other words, it is quite difficult to get benefits in the first place), sometimes it seems that everyone claims to know a neighbor or uncle or sister-in-law who is getting disability but doesn't deserve them. If you know such an alleged fraudster, this section tells you how to turn them in.

To get a free digital copy of this disability fact sheet, send an email to me at [email protected].

If you have a Social Security question, Tom Margenau has the answer. Contact him at [email protected]. To find out more about Tom Margenau and to read past columns and see features from other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

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