If you are out of work due to a permanent disability and are unable to return, you may be entitled to collect Social Security disability benefits. Initial denial of benefits is common, even when a claimant may be eligible for benefits and is later approved to receive them.
If you have been denied benefits and cannot continue to work, you need a disability lawyer with a proven track record. The attorneys at Thompson & Pureza bring decades of legal experience and have represented clients throughout northeastern North Carolina and the Outer Banks. While we cannot guarantee the outcome, we will make every effort to maximize your chances of being approved for Social Security benefits by working with you, your medical providers and the Social Security Administration.
What is Social Security or Supplemental Security Income Disability?
The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.
- Social Security Disability Insurance pays benefits to you and certain members of your family if you are "insured," meaning that you worked long enough and paid Social Security taxes.
- Supplemental Security Income pays benefits to disabled adults or children based on financial need.
To qualify for Social Security disability benefits, you must first have worked in jobs covered by Social Security. Then you must have a medical condition that meets Social Security's definition of disability. In general, monthly cash benefits can be paid to people who are unable to work for a year or more because of a disability.
Benefits usually continue until you are able to work again on a regular basis. There are also a number of special rules, called "work incentives," that provide continued benefits and health care coverage to help you make the transition back to work.
If you are receiving Social Security disability benefits when you reach full retirement age, your disability benefits automatically convert to retirement benefits, but the amount remains the same.
What is Disability?
The definition of disability under Social Security is different than other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability.
“Disability” under Social Security is based on your inability to work. You are considered disabled under Social Security rules if:
- You cannot do work that you did before;
- The SSA decides that you cannot adjust to other work because of your medical condition(s); and
- Your disability has lasted or is expected to last for at least one year or to result in death.
This is a strict definition of disability. The Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities, including workers' compensation, insurance, savings and investments.
What Qualifies Someone as Disabled?
To determine whether an applicant is disabled, the Social Security Administration uses a five-step process. The questions asked are:
- Are you working?
If you are not working, you will proceed to Step 2.
- Is your condition "severe"?
Your condition must interfere with basic work-related activities for your claim to be considered. If it does not, the SSA will find that you are not disabled. If your condition does interfere with basic work-related activities, you will proceed to Step 3.
- Is your condition found in the list of disabling conditions?
The SSA has a list of medical conditions that are so severe they automatically mean that you are disabled. If your condition is not on the list, the SSA will have to decide if it is of equal severity to a medical condition that is on the list. If it is, the SSA will find that you are disabled. If it is not, you will proceed to Step 4.
- Can you do the work you did previously?
If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then the SSA must determine if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied. If it does, you will proceed to Step 5.
- Can you do any other type of work?
If you cannot do the work you did in the past, the SSA will see if you are able to adjust to other work. The SSA will consider your medical conditions, age, education, work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied.
The Social Security Administration has developed two initiatives designed to expedite processing of new disability claims:
- Compassionate Allowances - Certain cases that usually qualify for disability can be allowed as soon as the diagnosis is confirmed. Examples include acute leukemia, Lou Gehrig’s disease (ALS) and pancreatic cancer.
- Quick Disability Determinations - The use of sophisticated computer screening to identify cases with a high probability of allowance.
Contact Us for a Free Consultation
If you have been denied Social Security Disability or Supplemental Security Income benefits, please call our office. Thompson & Pureza represents Social Security claimants throughout northeastern North Carolina. Please call us at (252) 335-7200.