Social Security Disability Programs

The Social Security Administration (SSA) administers two types of disability programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). While the medical requirements for these programs are the same, there are important differences in the non-medical requirements. It is possible to be eligible for both programs.

SSDI, or Title II, Benefits

To receive SSDI benefits, the claimant must show that he or she became disabled prior to the "date last insured" (DLI). The DLI is determined by how much the claimant has paid in Social Security taxes. Generally speaking, if the claimant has worked five of the last 10 years, he or she will be fully insured; the DLI typically expires five years after the claimant stops working.

SSI, or Title XVI, Benefits

To receive SSI benefits, the claimant must meet certain income requirements. Generally speaking, SSI is like a welfare program for the disabled. Those who have a limited work history or become disabled after the expiration of their DLI may qualify for SSI.

Medical Requirements

The medical requirements for these programs are identical. The claimant must show that the impairment suffered is so severe as to prevent him or her from performing any work for a period of at least 12 consecutive months. Due to this durational requirement, it is advisable to wait until an individual has been out of work for at least six to eight months before applying.

Once an application is received, the SSA performs a five-step evaluation to determine the issue of disability:

The first step is an earnings test. If the claimant is engaging in "substantial gainful activity" ($940/month for 2008), he or she is found "not disabled." If the person is not performing substantial gainful activity, the process goes to the next step.
The second step is a medical severity test. The claimant must show that he or she has a "severe" impairment. If this is not the case, the claimant is found "not disabled." This is intended to weed out groundless claims. If the impairment is found to be severe, the claim proceeds to the third step.
The third step is a presumptive disability test. The SSA maintains a list of impairments that are judged to be automatically disabling. If a claimant can show that he or she has an impairment on this list, the individual is found to be "disabled." If no such impairment exists, the claim proceeds to the fourth step.
Before the fourth step, the claimant's "residual functional capacity" (RFC) must be assessed. This is an assessment of the claimant's ability to perform work-related functions, such as standing, walking, sitting, lifting and carrying. Following this assessment, the claim proceeds to the fourth step, which is a test to determine if the claimant can perform his or her past relevant work. The claimant's RFC is compared to the demands of his or her past work. If the individual is able to perform work as in the past, the claimant is found to be "not disabled." However, if the claimant is unable to perform his or her past work, the claim proceeds to the fifth and final step.
The fifth step is a test to determine if the claimant can perform any work. If the claimant is found to be capable of performing any work, he or she is found "not disabled." For example, showing that an individual is no longer able to perform construction work is insufficient — the claimant must show that he or she is unable to perform any work, even a desk job, before being found "disabled" by the SSA. When the claimant is over 50, his or her age, education and past work are considered at step five of the sequential evaluation.

For more information see our Diagram: Disability Decision and Sequential Evaluation Process.

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At Schwartzapfel Partners P.C., we have more than 150 years of combined legal experience representing clients just like you through the SSDI and SSI benefits claims processes. Throughout the years, our hard work and dedication to our clients earned us a 98 percent success rate on all the cases we have undertaken.*

Call us at 888-801-1914 or contact our New York law firm online to learn more during your free claim evaluation. You pay no attorneys fees unless and until we win money and benefits for you.

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