Flowers Disability Law Offices is a law firm that represents people who have Social Security claims. We are sometimes asked how potential Social Security claim can be recognized. Patients with chronic or acute illness, injury, or mental illnesses are appropriate to screen for possible Social Security eligibility. Most of these cases involve the issue of whether the person has a “disability” as defined in the Social Security Act and interpreted in the regulations and rulings. However, others involve issues such as whether work was “substantial gainful activity” or whether a child was “dependent” on a worker.

Social Security and Medicare play an important part in the lives of almost all Americans. In 1956, the U.S. Congress created the Social Security Disability Insurance Program. (SSDI) The Disability Insurance Program joined Worker’s Compensation programs in the states in offering the public protection against destitution because of disability. In 1972, Congress enacted the Supplemental Security Income program to provide disability benefits to the indigent who lack earned quarters of coverage to qualify for Disability Insurance. Unlike Workers Comp, which paid partial disability benefits for injuries occurring in the workplace based on a rating system, federal disability benefits took an all or nothing approach to disability, requiring the claimants be unable to engage in “any substantial gainful activity.” This is a very difficult standard and helps explain why the overwhelming majority of claims are initially rejected by the Social Security Administration. However, for the disabled, these benefits are often their only financial lifeline.

First in order to be qualified for disability benefits, the worker must be “fully insured” and “Currently insured.” Forty quarters of coverage with fully insure any worker for life, so that a worker with 10 years of work in jobs covered by Social Security can assume that they are fully insured. The worker is “currently insured” when thy have 20 quarters of coverage in the 40-quarter period ending with the quarter when disability began, with some exceptions for younger persons, the blind, and those who were disabled before age 31, recovered for a time and became disabled again after age 31.

The law also pays benefits to disabled adult children past the usual cutoff age, if they become disabled before age 22 and remain disabled, and are eligible to draw on a retired, deceased or disabled parents’ earnings record. Disabled widows, widowers, and surviving divorced spouses can also receive benefits at age 50 and later, but benefits are reduced because of the earlier entitlement. Also, disability must usually begin before, or within 7 years after, the worker’s death.

If the worker also gets workers compensation or other disability benefits under a federal, state or local government plan, there can be a reduction in the Social Security benefit if the total benefits payable to the worker and his family.

And of course, SSI benefits are payable to those disabled and elderly who are below the income and resource limits; generally, no income and the resource limitation is $2,000 for an individual and $3,000 for a couple.

A disabled person is entitled to Medicaid if they are on SSI, and Medicare eligibility begins 24 months after the disabled person is entitled to receive disability insurance benefits.

Please feel free to call us if you have any questions about the eligibility for a Social Security claim.