Social Security Disability Insurance (SSDI) can be an enormous help for those who become unable to work due to a physical or psychological impairment. However, many disability claimants in Clearwater feel overwhelmed by the complex forms, legal terminology, and procedures involved with their SSDI applications. An experienced attorney could clarify some key disability concepts and help you seek the benefits you need.
To qualify for SSDI benefits, an individual must be impaired to the extent that they cannot engage in substantial gainful activity (SGA). This term sounds complex, but it is actually a simple earnings threshold. If an individual earns more income than the number given by the Administration, they are considered to be engaging in substantial gainful activity.
For 2018, the SGA limit is $1,180 per month. If someone earns more than this amount, that is considered gainful activity and is inconsistent with disability. In addition to the financial ceiling, SSA considers several other questions about the claimant’s situation. Is the work substantial? What are the circumstances of the work? How much mental activity is involved? How much physical activity is involved?
SSA defines disability as the inability to engage in substantial gainful activity due to severe mental or physical impairment likely to last at least 12 months or result in death. The condition resulting in disability has to be medically-determinable, meaning it is established by medical evidence. A claimant may think that they are disabled and may know that they cannot work, but in order to meet the guidelines for disability, SSA requires evidence from medically-acceptable clinical and laboratory diagnostic techniques.
The term ‘severe’ basically means that the condition significantly limits one’s physical or mental abilities to perform basic work activities. For example, valid disability under SSA standards is chronic or long-lasting in nature. General aches, pains, sprains, or strains do not count. Disabilities may include chronic pain conditions, chronic mental conditions, or chronic cardiac conditions that limit the person’s ability to perform work activities.
Because SSDI is an insurance program, an individual must have paid into the program via taxes to qualify for benefits. Credits are generally based on how much money a person earns over the course over a year. For each $1,300 an individual earns, they receive one work credit. A maximum of four work credits can be earned each year. To qualify for SSDI benefits, individuals must have earned 20 work credits within the last 10 years, meaning they worked for five of the 10. For younger applicants, the work credit requirement may be lower.
Residual functional capacity is a determination SSA uses to describe what an individual’s maximum capabilities are from a mental and physical standpoint. The Administration evaluates the severity of an individual’s physical and mental conditions and makes a conclusion about the person’s ability to perform heavy jobs, medium jobs, light jobs, or sedentary jobs. In some cases, the person may not even be able to do a sedentary job because of the nature of their condition, and that would be considered a less-than-sedentary RFC.
When evaluating a physical residual functional capacity, SSA considers information like the individual’s ability to stand, walk, sit, or lift. They also consider the person’s ability to bend, grasp, and use their hands for work activities. If an individual is alleging a mental impairment, the administration will evaluate the person’s mental health symptoms. SSA evaluates whether the person can perform a skilled job, a semi-skilled job, or an unskilled job.
The RFC also considers how frequently someone can perform these activities. For example, can they occasionally lift of 20 pounds or can they frequently lift of 50 pounds? For a mental RFC, how frequently can a person interact with others in a work environment, handle stress, and maintain attention? All of those things are evaluated when it comes to the RFC.
Without representation, many claimants in Clearwater get lost somewhere in the SSDI application process or confused by the complex terminology. An experienced attorney could help applicants gather their medical records, assemble a compelling application, and even pursue an appeal if SSA denies a claim. Call today to learn how an attorney can help in your case.