Mythbusters: What you think you know about Social Security disability is probably wrong.
Posted October 1, 2015 by Tom Nash
It’s a fact: Qualifying for the Social Security disability benefits you have rightfully earned can be difficult, time-consuming, and stressful. The process becomes even more difficult if you are misled by common myths and misconceptions about Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Here are five things most people get wrong:
People get SSDI/SSI benefits for drug and/or alcohol addiction. False. Disability benefits are not awarded to individuals based on alcoholism and/or drug addiction. The Social Security Administration (SSA) website clearly states, “In 1996, Congress passed the Contract with America Advancement Act…which terminated benefits for Supplemental Security Income (SSI) and Disability Insurance (DI) beneficiaries whose primary impairment was drug addiction, alcoholism, or both.” SSA may also deny benefits if it determines that drug or alcohol addiction materially affects a person’s disability.
However, suffering from alcoholism and drug addiction does not automatically disqualify an individual from receiving disability benefits. For example, an individual who takes a painkiller after surgery and becomes addicted may not be disqualified because the abuse is not (in SSA’s terminology) “a contributing fact material to the determination of disability.” The issue of materiality, as you might expect, is complicated and can be quite subjective.
If my doctor tells me that I am disabled then I should have no trouble qualifying for benefits. Unfortunately this is not the case. The word “disabled” can mean different things to different people and even to different parts of the government. Webster’s dictionary defines “disabled” as “incapacitated by illness or injury; also: physically or mentally impaired in a way that substantially limits activity especially in relation to employment or education.” Your doctor may have a somewhat different definition.
To Social Security, “disabled” means that you cannot sustain any job in the national economy given your age, education, and work experience. For that reason, Social Security’s rules state that disability is a matter for the government to decide – not your doctor. Social Security has its own rules and its own procedures. Social Security even has its own doctors who will review your case and come to their own conclusions.
An important disability secret is that, in the end, labels such as “disabled” are not very important. Having a Social Security disability attorney can help get the right information from your doctor that will be useful in your particular case. We can ask your doctor the right questions so that, if professionally comfortable, he or she can explain your limitations to Social Security so that the government has the best understanding of your situation.
You must wait a year from the time you become disabled before you can apply for SSDI or SSI benefits. Not true and not advisable. Although the SSA’s definition of “disability” stipulates, in part, that to qualify for disability benefits you must be disabled or expect to be disabled for at least “12 consecutive months,” you are not required to wait that long before applying. We encourage our clients to file their disability claims early if they honestly believe (and have medical evidence to show) that they will be unable to work for at least one year. The disability process is frustratingly slow, so it is to your advantage to apply early.
It’s harder to get disability benefits if you are disabled due to a mental health disorder. This is false. The Social Security Administration makes decisions regarding disability cases based on an applicant’s ability to work. Under its framework, there are numerous mental disorders—such as depression, post-traumatic stress disorder (PTSD), bipolar disorder, schizophrenia, and others—that qualify for disability benefits, if they are severe enough to prevent an individual from working.
Statistics show that a person dealing with a mental issue is no less likely to be awarded benefits than a person with a physical disorder. That’s the good news. The not-so good news is that it is difficult for everyone to qualify for benefits. More than two out of three initial applications for Social Security disability benefits are denied, and fewer than four in ten are approved after all levels of appeal. This underscores the need for competent and vigorous representation.
There is an easy way for a layperson to understand SSDI work rules. Sadly, this is not true. As a general rule, to be eligible for benefits, SSA says you cannot be engaged in “substantial gainful activity” (SGA). How this plays out is absolutely different in each case. Issues such as the type of work involved, how long it lasts, earnings amount, and how the job ends, are only the beginning of what can be important. There are also different rules for individuals who are blind, or are self-employed, or are seeking SSI payments. The whole issue of working and collecting benefits at the same time is, in our experience, complex and confusing for most clients. Getting the advice of an experienced Chicago-area Social Security Disability attorney is strongly recommended.
Congratulations! Now you know more about Social Security disability than most Americans do. But even from this short article you can see that Social Security disability rules are complicated and not easily understood. To make matters worse, the rules are constantly changing. At Nash Disability Law, this is the world we live in every day. So, if you’re not sure if what you think you know about SSDI or SSI is fact or fiction, give us a call.