How Does the Social Security Administration Determine Disability?

Social Security Disability (SSD) is available through the Social Security Administration (SSA).  Similar to the benefits you can receive at retirement, SSD is available to help people with serious injuries continue to receive monthly payments to help support themselves and their families.  The SSA looks at a series of factors when deciding how you receive benefits, how much you receive, and whether you qualify as disabled.  The Philadelphia disability benefits lawyers at Young, Marr, and Associates explain these factors and how Social Security uses them to determine your disability benefits.

Important Factors for Social Security Disability Programs

The Social Security Administration has two different programs that fit under the umbrella of “disability.”  The first program is Social Security Disability Insurance (SSDI).  This is the primary program that people use when receiving disability and is usually the program people are referring to when they say “disability.”  Alternatively, Supplemental Security Income (SSI) is also available as a need-based program.

SSDI is based on your prior work history.  If you have enough years of “work credits” from paying FICA taxes, you should be able to qualify for SSDI benefits.  Stay-at-home spouses who may not have a history of working can qualify through their spouse’s work record, and many disabled children can also qualify using their parents’ record.  Even if the working spouse or parent is deceased or you were recently divorced, Social Security may still give you benefits based on their work history.

Talk to an attorney about whether you have sufficient work credits to qualify for disability.  If you don’t, you may still be able to get benefits through the other disability program or through private disability insurance.

Calculating Disability Benefit Amounts

When receiving SSDI, your disability benefits are calculated based on your previous income.  There is a complicated calculation involving multiple percentages, but it is important to get a glimpse of how the SSA calculates your benefits.

First, they will calculate an “indexed” wage called the “average indexed monthly earnings” (AIME).  This means they will compare your wages from various years to the national wage index to account for the differences across various years to find your average monthly income.  Next, they will take a certain percentage of your wage and set that as your base benefit amount, called the “primary insurance amounts” (PIA).  Lastly, they will adjust this depending on the age at which you claim disability.  They may also cap you at the highest maximum benefit, which is $2,788 per month in 2018.

Lastly, your benefits may be reduced if you receive other benefits for your disability.  One common “offset” that reduces your disability benefits comes from receiving state workers’ comp. benefits alongside disability.  Talk to an attorney about receiving other benefits that might lower your disability payments.

How to Qualify for Disability in Pennsylvania

The last set of factors that are vital in your disability claim are factors for qualifying as “disabled.”  The Social Security Administration considers you disabled if you suffer from a condition that prevents you from working.  The condition must also be long-term and significantly “severe.”

To determine whether or not you are able to work, the SSA looks at whether you can earn enough money to support yourself by whether you can perform “substantial gainful activity” (SGA).  “[S]ignificant physical or mental activities” make the activity “substantial,” while “gainful” refers to your ability to make money with those activities.  In 2018, non-blind individuals are considered “gainfully” employed if they can make more than $1,180 per month, and blind individuals have a higher threshold of $1,970.  If your disability prevents you from making this much money, you might qualify as disabled.

Your disability must also be a long-term issue to receive disability payments.  The SSA includes the length of the disability as part of its definition and requires that the disability you face is either expected to last for a year or more or end in your death.  Shorter disabilities may not qualify, but you should still talk to a disability attorney about your options.

The severity of your disorder is also a vital factor.  The SSA has a list of conditions that they typically consider to be severe enough to qualify for disability.  However, this list is not the deciding factor.  Instead, your condition must be a severe instance of one of these conditions.  The factors that make a condition “severe” are usually included in the SSA’s definition of the disorder to help clarify what Social Security looks for in a disability.  If your condition is not on the list, you may still be able to get disability if your condition is as severe as another condition on the list.

Pennsylvania Social Security Lawyers Offering Free Consultations

If you or a loved one is unable to work because of a severe disability, consider discussing filing for disability with the help of one of our experienced disability attorneys.  The PA and NJ Social Security Disability lawyers at Young, Marr, and Associates represent disabled individuals and their families and work to get their disability applications approved, their denials reversed, and their benefits maximized.  For a free consultation, call our law offices today at (215) 515-2954 if you’re in PA or (609) 557-3081 if you’re in NJ.