Monthly Archives: March 2011

Being Awarded Social Security Disability is based on functional capacity, but what is functional capacity?

If your Social Security Disability application is reviewed by a Social Security disability examiner or an Administrative Law Judge they will use three basic criteria to determine if you are disabled. First, do you have a mental or physical condition that is substantiated through medical documentation? Second, is your condition so severe that it prevents you from performing substantial gainful activity? Third, is your mental or physical health condition expected to last for at least 12 months or result in your death?

The disability examiner will specifically use what the Social Security Administration calls the Sequential Evaluation Process to determine if you are disabled.

STEP 1: Are you working?

If a claimant is working and the Social Security Administration determines it is “substantial work” the Social Security Disability claim is automatically denied without a review of the claimant’s mental or physical health condition.

STEP 2: Do you have a severe impairment?

If a claimant’s condition is not severe and does not affect their functional ability to work the claimant is denied Social Security Disability benefits.

STEP 3: Does the impairment equal or exceed an impairment listed in the guidelines?

The Social Security Administration has a list of impairments which they consider severe and if a claimant’s condition equals or exceeds the listing the claimant is automatically awarded Social Security Disability benefits.

Now you may be curious about the question of functional capacity to perform work and how it is factored into the Social Security Disability decision. Until Step 4 of the sequential analysis, functional work capacity is not considered, but at Step 4 it is the most important consideration that the disability examiner will consider when awarding disability benefits.

STEP 4: Are you able to do your past employment?

The disability examiner will review all of the relevant jobs a claimant has performed over the past 15 years and determine if the claimant has enough “residual work capacity” to perform their past job or a similar job. If the disability examiner determines you are not substantially limited by your mental or physical health condition and you can perform past work, you will be denied Social Security Disability benefits.

STEP 5: Is there any other lighter work you can do?

The disability examiner will assess a claimant’s physical abilities which include the nature and extent of the claimant’s limitations and their ability to work a job on a continuing and regular basis. Physical limitations can include the inability to: sit, stand, walk, lift, carry, push, pull, stoop, reach, crouch or manipulate objects. The mental abilities of the claimant are also evaluated including their inability to: understand, remember, carry out instructions, respond to supervisors or adapt to a work setting.

The Social Security Administration does not decide disability based on functional capacity alone in fact, there are a variety of vocational factors which are also considered such as a claimant’s age, educational level and work history. The most important consideration for claimants, however, is not what type of disability they have been diagnosed with but whether or not their condition(s) are severe and leave them with so little residual functional capacity to work that the claimant is unable to perform substantial gainful activity.

Eligibility for disability benefits from the Social Security Administration

The Social Security Administration (SSA) estimates 3 out of 10 Americans may become disabled prior to retirement age. Not everyone who is unable to work is considered “disabled” by the Social Security Administration. If the Social Security Administration determines you are disabled you may be able to qualify for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Each of these disability benefit programs is administered the United States federal government and require claimants to meet very specific qualifications.

Social Security Disability Insurance

Social Security Disability Insurance or SSDI is offered to disabled workers who have contributed to the Social Security Trust Fund through their employment taxes and have earned enough work credits to qualify. The number of work credits needed to qualify for SSDI may vary, but most workers over the age of 30 will need 40 work credits. Most claimants working full-time can accrue up to four credits per year. In addition to accumulating work credits, SSDI claimants must be determined disabled by the Social Security Administration.

How do you know if you are disabled? Claimants must have a physical or mental impairment which is considered severe and which does not allow them to work for at least 12 months or is expected to result in their death. The Social Security Administration (SSA) will review a claimants medical records, and using their evaluation process, will determine if the claimant is able to perform their current job or any other job in the regional economy given their age, educational background and work experience.

Social Security Disability Insurance requirements:

  • Determined disabled by the Social Security Administration.
  • Disabled prior to your full retirement age
  • Disabled for at least 12 months or your disability is expected to result in death
  • Legally allowed to work in the United States
  • A United State’s citizen
  • If you are 31 or older you must have paid payroll taxes and worked for 5 of the last 10 years.  If you are younger than 31 there may other qualifications.

Supplemental Security Income

Supplemental Security Income, the second disability program administered by the federal government, is for the disabled, blind or aged who are disabled and have limited income and resources. Claimants who are attempting to qualify for SSI disability benefits must meet the same criteria as SSDI applicants. Claimants must be found medically disabled, either physically or mentally, with a disability which is so severe they will not be able to work for at least 12 months.

Supplemental Security Income, unlike Social Security Disability Insurance, is a “needs based” program, and claimants do not have to accumulate work credits to qualify. Claimants must, however, meet non-disability qualifications and have limited resources and income. Resource and income limits are established by the Social Security Administration and can include: stocks, bonds, cars, houses, bank accounts, trust funds and pensions. It is important to discuss your resources and income with a Social Security Disability lawyer to determine if you are eligible to file for Supplemental Security Income benefits. Claimants who do not meet the income and resource qualification will not be awarded Supplemental Security Income benefits regardless of their mental or physical disabilities.