Social Security Disability Insurance and Supplemental Security Income
The United States government provides certain benefits for those suffering from disabilities who are unable to work or unable to perform substantial gainful activity or SGA. The benefits are provided under the Social Security Disability Insurance, or SSDI, program and Supplemental Security Income, or SSI, program. To qualify for these programs, a person needs to be deemed “disabled” under the Social Security Act, or SSA, guidelines. This article provides a basic outline of who is considered disabled under the rules. If you are considering an application for these programs, speak with a disability attorney who is experienced and knowledgeable in the field.
Differences between Social Security Disability Insurance and Supplemental Security Income Plans
SSDI and SSI are programs with different purposes, though there is some overlap. SSDI is a taxpayer-funded program for those who cannot work anymore or have limited capacity to work due to a disability. The disability can be either physical or psychological in nature. To be eligible, you must have not worked for the past 12 months but you are “insured,” which is having a history of working five out of the past 10 years, so that you contributed enough to social security (those 31 and younger who do not have a significant work history can qualify under other rules). Under the current circumstances, you must not be able to perform substantial gainful activity, or SGA.
SSI, in contrast, is a program that is supplemental for those with low incomes who have a disability, either physical or psychological. The program is not tax funded so there is no requirement to be insured. However, similar to SSDI, there is an SGA threshold.
Substantial Gainful Activity
A person cannot be earning or have the capacity to earn above the SGA level. To be considered disabled with respect to the SSDI and SSI, which is administered by the Social Security Administration, or SSA, a person must be capable of performing only insignificant, or unsubstantial work. The current threshold is $1,180 per month and $1,950 per month for a blind person. If a person can earn those amounts, then he or she is not considered disabled according to the SSA guidelines.
At its basic level, the term gainful means: “Work performed for pay or profit; or [w]ork of nature generally performed for pay or profit; or [w]ork intended for profit, whether or not a profit is realized.”
For SSI, SGA is not used initially if the applicant is blind. To be considered blind under SSA guidelines, you would need to have no better than 20/200 with correction in the strongest eye “or a limitation in the field of vision in the better eye so that the widest diameter of the visual field subtends an angle of 20 degrees or less.” Once you satisfied the requirements for SSI, there is no SGA determination, and you can continue to receive benefits until your condition changes.
Nexus Between Disability and Inability to Work
To qualify, you must demonstrate that your disability harms your ability to work. The examiner assigned to your case will request that you undergo a residual functional capacity, or RFC, assessment. The examiner will work with a member of the Disability Determination Services, or DDS, in giving you the RFC assessment. There are various forms of assessment.
- Sedentary work: You lack the ability to lift more than 10 pounds at a time. A sedentary job is one that is something that can generally only require sitting.
- Light work: You can occasionally lift 20 pounds at a time and can regularly lift 10 pounds at a time. It requires that you can work by walking and standing and that you can frequently push and pull items.
- Medium work: You can occasionally lift 50 pounds and can regularly lift 25 pounds.
- Heavy work: You can occasionally lift 100 pounds and can regularly lift 50 pounds.
- Very heavy work: You can occasionally lift more than 100 pounds and can regularly lift 50 pounds.
In addition, the examiner will consider your capacity based on your ability to do non-exertional work, e.g. the ability to stoop, use your hands, and your ability to remember and follow instructions.
Attending Work Regularly
Even if you are deemed to be able to work beyond the disabled SSA definition, you must still be able to work full-time and are able to attend regularly. You must not need frequent breaks to rest. If you are unable to work full-time, then it is not considered “regular and sustained” work under the SSA and you would be considered disabled, even though your skill set and abilities make you otherwise not considered disabled.
Regular and sustained means that you are able to work 40 hours and five days per week or some similar schedule. Note however that if your past work was part-time then the SSA will evaluate your abilities based on what you can now do part-time. The time frame, i.e., how many hours part-time, either 20, 25, etc. is based on your past history and SSA evaluation.
In sum, there are various factors to determine whether you are disabled with regard to SSDI and SSI benefits. Factors include SGA, what type of work you can do, your past history, and whether your ability to work is regular and sustained.
Contact an Experienced Philadelphia Disability Attorney Today
The SSA had strict guidelines for qualifying for SSDI and SSI benefits. If you suffer from a disability, you may be eligible. However, obtaining those benefits is not easy. You need an experienced and knowledgeable attorney who understands the qualifications process. Contact the Philadelphia law firm of Krasno, Krasno & Onwudinjo at 800-952-9640 to learn more.