What if My Disability Gets Worse After I’m Approved for Benefits?

You worked hard to prepare your disability claim, and the Social Security Administration approved your for monthly benefits.  You’ve been receiving disability benefits for weeks, months, or years – but now your condition has gotten worse.  Do you need to file for benefits again?  Could reapplying increase your monthly payments?  Our disability lawyers explain how SSI and SSDI are affected.

How is Disability Calculated?

Congratulations on being approved for disability benefits.  You’ve already beaten the statistical odds, since the rejection rate during the initial application stage is well over 50% in most states, including Pennsylvania and New Jersey.

While getting approved is a triumph in its own right, many beneficiaries are confronted with a new problem later down the road: their original benefits are unable to keep up as the underlying medical condition worsens.  While effective management can help to stabilize or even reverse many conditions, such as Type 2 diabetes, there are also many conditions which tend to become more severe as time passes.  Some common examples of conditions that are prone to gradually worsening over time include HIV/AIDS, various forms of cancer, Parkinson’s Disease, and fibromyalgia (in about 25% of cases).

As you probably remember from filing your initial claim, being approved for disability is contingent upon demonstrating that your disability is severe.  At the same time, the amount of your disability payments depend not on the severity of your condition, but upon your earnings and work history.  The SSA uses complex calculation methods to determine how payments should be set.

Put simply, a worsening condition typically will not lead to additional benefits.  However, there are a few ways your monthly award could increase.

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Decreased Earnings Can Mean Increased SSI Payments

You might remember that, in addition to meeting certain medical standards, you also had to meet certain income thresholds.  The SSA refers to these thresholds as SGA, which stands for Substantial Gainful Activity.

When it comes to evaluating claimants who are children, SGA measures ability to perform basic social, mental, and physical activities.  However, for claimants who are adults, SGA refers primarily to how much money you earn every month.  In other words, your SGA is expressed in terms of how much work you can perform.

The SSA will not grant benefits to someone with an SGA which is too high, because the implication is that the claimant can perform steady work, and is therefore not disabled.  You would not have been approved for benefits on the first occasion if your SGA had surpassed the SSA’s SGA limits for the appropriate year.

So how does this affect you today?  If you receive SSI (Supplemental Security Income) and your earnings drop lower because your condition gets worse – for example, perhaps you used to perform several hours of work per week, but now cannot perform any work because your pain has increased or your mobility has decreased – you could potentially receive a larger monthly payment.  Your SSI payment is reduced by how much “countable income” you earn, so if your income goes down, your monthly SSI can potentially go up.

In the context of SSI, the income limit is called the Federal Benefit Rate (FBR) instead of being called SGA.  The FBR reflects both the monthly income limit and the maximum amount SSI beneficiaries can receive from the SSA.  Like SGA, the FBR changes each year to accommodate inflation.

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Blind SGA Amounts Set Higher Monthly Income Limits

As we mentioned a little earlier, SSDI (Social Security Disability Insurance) is determined by your past earnings and employment record.  Therefore, your monthly SSDI payments will not increase because your condition gets worse.  However, if your vision begins to deteriorate, you could potentially increase your monthly income.

The SSA does not award larger payments to disability recipients because they are legally blind.  However, vision loss can indirectly raise your monthly earnings because it has a significant impact on SGA.  The SSA uses dramatically increased income limits for blind individuals, which means you could continue to receive your normal monthly payments even if you start earning more money each month.

While SGA changes annually, the blind SGA amount consistently remains hundreds of dollars higher than the non-blind SGA amount.  Consider the following blind versus non-blind SGA amounts from recent years:

  • 2012
    • Blind – $1,690
    • Non-Blind – $1,010
  • 2013
    • Blind – $1,740
    • Non-Blind – $1,040
  • 2014
    • Blind – $1,800
    • Non-Blind – $1,070
  • 2015
    • Blind – $1,820
    • Non-Blind – $1,090

If you need help applying for benefits, or if your claim was denied, the social security lawyers of Young, Marr & Associates can help.  We have more than 20 years of experience and offer free initial consultations.  To talk more about how we can help you in a free, confidential case evaluation, call our law offices right away at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania.

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