Articles Posted in SSDI

An individual may qualify to receive benefits through the Social Security Disability Insurance (SSDI) program in several ways. One way is to demonstrate that they are suffering from one or more medical impairments identified by the Social Security Administration (SSA) in its official listing of impairments, commonly known as the Blue Book, and that their condition meets the criteria set forth in the particular listed impairment. Even if a claimant cannot point to any of the Blue Book impairments that they either “meet or equal in severity,” the Social Security Administration will undertake the next steps in their sequential evaluation process.  Step 4 of the 5 step evaluation process requires the Social Security Administration to determine whether one is capable of performing any of their “past relevant work,” which is defined as any of the past types of work they had performed in the 15 years prior to becoming disabled.  If one is determined to be capable of performing their past relevant work, they would be deemed to be not qualified for disability benefits (and would be denied benefits).  Assuming, however, the SSA determines one remains incapable of performing their past relevant work, they are required to turn to step 5 of the sequential evaluation process and determine whether the claimant is capable of performing any jobs that exist in the national economy that exist in significant numbers in either their region or other regions of the country.  As part of undertaking this analysis, the Social Security Administration will turn to a set of rules called the “SSDI grids” to help them determine in what way one’s age may play a role in making a transfer to other forms of gainful employment unlikely (thereby calling for a finding of disabled under Social Security’s rules).   The grids establish guidelines for determining whether a person is disabled based on five factors:  age, capacity to work, education, skill level, and transferability of skills.

The Blue Book and the SSDI grids are the two methods used by the SSA to determine whether a claimant meets the “disability” criteria for SSDI eligibility. The two systems are laid out in the SSA’s regulations in Title 20 of the Code of Federal Regulations, in Subpart P of Part 404. Appendix 1 to Subpart P contains the listing of impairments. Appendix 2 describes the grids, formally known as the “Medical-Vocational Guidelines.”

Age Groups

The SSA divides claimants into four age groups for purposes of the SSDI grids:

– Younger individuals:  ages 18 to 49;
– Closely approaching advanced age:  ages 50 to 54;
– Advanced age:  ages 55 to 59; and
– Closely approaching retirement age: ages 60 and up.
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In order to receive benefits through the Social Security Disability Insurance (SSDI) program, a person must establish both (1) that they are eligible for benefits, and (2) that they have a disability that precludes gainful employment for at least a year. Eligibility is based on the amount of time a person has been employed and has paid into the Social Security system, usually through payroll taxes. People who are employed by a business, organization, or individual can often establish the amount of time they have worked with documents such as W-2 forms, pay stubs, and tax returns. Self-employed individuals do not always have the same documents to establish their employment history, but they can still demonstrate eligibility for SSDI benefits. Likewise, they can meet the second main requirement for SSDI by showing that their disability precludes them from either their normal gainful self-employment or other forms of gainful employment.

How Payroll Taxes Fund Social Security Benefits

When a person has an employer, they typically only pay one-half of their payroll tax liability. The employer withholds payroll taxes from their paychecks and matches that amount. It then pays the taxes directly to the Internal Revenue Service (IRS). At the end of each tax year, the employer reports the person’s wages and taxes to the Social Security Administration (SSA). A self-employed person is responsible for paying their entire payroll tax liability.

The term “Social Security” can refer to several different types of benefits paid by the Social Security Administration (SSA). The agency is perhaps best known for its retirement and disability benefits programs. The Old Age, Survivors and Disability Insurance (OASDI) program includes the SSA’s retirement program and the Social Security Disability Insurance (SSDI) program. The SSA maintains another benefits program that may be available to disabled individuals, known as Supplemental Security Income (SSI). Since the abbreviations “SSDI” and “SSI” are nearly identical, some confusion quite understandably exists about the two programs and how they are different from each other. Disabled individuals in Massachusetts and elsewhere around the country should be familiar with how each program might benefit them.

Work History

Eligibility for SSDI benefits depends on a claimant’s work history. Claimants must show that they are “insured” by the program through their payroll tax contributions. The SSA typically measures work history in yearly quarters. A claimant must have worked a certain minimum number of quarters in their lifetime—at least six (and this is the bare minimum, with the minimum number depending on a variety of factors for each individual, including but not limited to one’s age) —to be “fully insured.” They must also be “currently insured,” meaning that they worked a certain number of quarters immediately prior to the month they became disabled. The number of quarters largely depends on the claimant’s age at the time of his or her disability.

The SSI program, meanwhile, has no work (and earned quarters of coverage) requirements. SSI benefits therefore might be available to people who do not have enough work history to qualify for SSDI or who may never have worked previously.

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