Dissecting Disability Procedures

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Saturday, October 23, 1999

Insurance & Legal Matters

Dissecting Disability Procedures

Randi Field, J.D.

Every year thousands of people find themselves unable to work due to illness

or serious injury. If you or someone you know is in this situation, knowing

how to apply for disability benefits could make a difficult time a little

bit easier.

Should You Apply?

You will be considered disabled if you can prove you are unable to work and

your disability is expected to last at least a year or result in death. The

Social Security Administration (SSA) has a detailed step-by-step process for

determining if an individual is disabled. If you have been disabled for six

months or more and will probably be disabled for more than a year, you

should apply for benefits. SSA generally will not accept your application

until you have been disabled for at least six months. Benefits are only paid

for one year prior to your application date, so don't delay in filing.

Where Do You Begin? What Do You Bring?

You can file a social security disability claim by going to your nearest

Social Security office and waiting (often for a few hours) to see someone.

You can also call 1-800-772-1213 and arrange for an interview.

When go for your interview with an SSA representative, you should bring

several items to help process your claim: your social security number; birth

certificate; military discharge papers; your spouse's birth certificate and

social security number if he or she is applying; your children's birth

certificates and social security numbers if they are applying; dates of

prior marriages if your spouse is applying; and your checking or savings

account information.

In Addition, You Will Need to Provide:

Names, addresses, and phone numbers of doctors, hospitals, clinics, and

institutions that treated you and dates of treatment

Names of all medications you are taking

Medical records from your doctors, therapists, hospitals, clinics, and

caseworkers

Laboratory and test results

Work history for the past 15 years and last year's W-2 Form (Wage and Tax

Statement).

Be honest and complete when giving information to SSA. Sometimes claimants

fail to mention embarrassing conditions, such as psychiatric problems or

learning disabilities. The agency is supposed to consider the combination of

impairments an individual suffers when determining disability. If you have

multiple health problems make sure you list them all so the combined effects

of your health problems can be considered.

How Is a Disability Determined?

After examining your medical history, SSA will determine if you are disabled

using a five-step process:

1. Are you working? If you are and your earnings average more than $500 a

month, generally you are not considered disabled.

2. Is your condition severe? Your impairments must interfere with basic

work-related activities for your claim to be considered.

3. Is your condition on the list of disabling impairments? SSA maintains a

list of impairments for each major body system that are so severe they

automatically qualify you for benefits. If your condition is not on the

list, SSA decides whether it is of equal severity to an impairment on the

list. If it is, your claim is approved. If it is not, SSA proceeds to next

step.

4. Can you do the work you previously did? Does your condition interfere

with your ability to do the work you did in the last 15 years? If not, your

claim will be denied. If it does, your claim will be considered further.

5. Can you do any other type of work? If you cannot do the work you did

during the last 15 years, the agency examines whether you can do any other

type of work. SSA considers your age, education, past work experience,

transferable skills, and the jobs' demands. If you cannot do any other kind

of work, your claim will be approved. Otherwise, your claim will be denied.

Once a decision is reached, SSA will send you written notice. If your claim

is approved, the notice shows the amount of your benefit and when payments

will start. If it is not approved, the notice explains why. In most cases

the agency makes a decision within three to five months. Processing times

for disability applications vary from state to state.

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