By Betty Berry, Tuesday, Feb. 15, 2011 Q: My husband was considered disabled by his employer, yet when he applied for Social Security disability he was turned down. Can you provide an explanation?
A: It is not unusual for a person to be turned down when first applying for Social Security disability. Perhaps Social Security just needs some additional information. I always suggest appealing the decision. You have 60 days from the time you receive the letter.
Not all disability programs are alike and eligibility for various programs depends on that program’s definition of “disability.” Some programs will pay for partial disability or short-term disability. Social Security does not.
Social Security has a very strict definition for disability. Under Social Security, disability is based on the inability to work. An applicant will be considered disabled if he or she cannot perform the work they did before the illness or accident that caused the disability and if Social Security determines that they cannot adjust to other types of work because of their medical condition.
In addition the disability must be expected to last for at least a year or result in death.
A second part of eligibility for Social Security disability benefits depends on the applicant’s work record. To qualify for benefits the applicant must have worked long enough and recently enough under Social Security.
The number of work credits needed depends on the applicant’s age at the time the disability occurred. Generally, the applicant must have worked five years (20 credits) out of the past 10 years ending with the year in which the disability occurred. Younger workers may qualify with fewer credits.
Applicants should apply for disability benefits as soon as they become disabled to get the application process started as the process is complex and lengthy taking from three to five months to complete.
Benefit payments usually start in the sixth month of disability. Payment amount is based on the applicant’s average lifetime earnings under Social Security.
Other types of payments may affect these benefits. Workmen’s Compensation, other disability payments and other government benefits, as well as any earned income received, could reduce the amount of the disability benefit.
Always keep Social Security informed about changes that occur to avoid overpayments.
Generally disability benefits continue as long as the medical condition prevents the person from returning to work. If the medical condition improves and the beneficiary is no longer considered disabled, the benefits will stop.
Disability cases are reviewed at regular intervals to make sure beneficiaries are still disabled. While on disability you have the responsibility for reporting any changes in your medical condition.
After receiving disability for 24 months you are automatically enrolled in Medicare. Medicare has two parts — Medicare Part A hospital coverage, which comes with no cost to you, and Part B — medical coverage which has a monthly premium that will be deducted from your disability check.
Those whose disability is permanent kidney failure requiring dialysis or transplant or amyotrophic lateral sclerosis (known as Lou Gehrig’s disease) may qualify for Medicare almost immediately.
If you remain disabled until you reach your full retirement age, your disability benefits will automatically convert to retirement benefits. The payment amount will remain the same.
While you are on Social Security disability, certain family members may also qualify for benefits based on your work record.
Those family members include your spouse, if age 62 or older; your spouse, of any age, if caring for your child who is younger than 16 or disabled; your unmarried child if under 18 or under 19 and in elementary or secondary school full time; and your unmarried child, 18 or older, if he or she has a disability that started before age 22.
Social Security disability is a very complex program. I hope this bird’s-eye view helps a little. If you have questions you should contact the Social Security Administration.