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Disability Benefits: How Social Security Decides If You Deserve Them


Source: Social Security Administration.

Most people think of Social Security as being a retirement program, but millions of people get disability benefits from Social Security. Many people aren't clear, though, on what's needed to qualify for disability benefits.

In the following video, Dan Caplinger, The Motley Fool's director of investment planning, runs through the tests that the Social Security Administration uses to determine eligibility for disability benefits. Dan points out the the rules boil down to three things: You can't do the work you did before, you can't adjust to other kinds of work, and your disability will last longer than a year. But Dan further goes into some of the details, with a specific five-step process that includes assessing other earnings, the severity of the disability, certain medical conditions that automatically qualify, and how the Social Security Administration looks at former work and the potential to adapt to new work. In particular, Dan notes that not being able to find a job isn't the same as not being able to work in that job, and so being unemployed won't automatically get you disability benefits.

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Read/Post Comments (20) | Recommend This Article (33)

Comments from our Foolish Readers

Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.

  • Report this Comment On July 13, 2014, at 9:40 PM, cobranut wrote:

    So basically, the only people who will ever benefit from what is stolen from us in FICA taxes are those who never bothered to get an education or job experience, to allow them to do more than simple manual labor.

    Anyone with such education is automatically DISQUALIFIED, due solely to the fact that they are qualified for ANY desk job at all, no matter whether it has anything to do with your chosen career path or not.

    Just one more example of our socialist government taking from the producers and giving to the LEACHES.

  • Report this Comment On July 13, 2014, at 10:28 PM, Rod57401 wrote:

    I don't agree with your comment about people that didn't get a higher education or job experience being leaches.

    I worked full time for 37 years without a higher education and made a pretty good living.

    I was able to buy a house and one new pickup

    before I was unable to work due to a couple of health issues and I never smoked or drank and spent my money wisely.

  • Report this Comment On July 14, 2014, at 8:56 AM, ugo wrote:

    cobranut, my wife paid for a long term disability policy through work for years. She was diagnoesd with lung cancer and ended up in the hospital after every round of treatments with serious complications and ended up with the LTD policy kicking in. With the first check was a notice saying the next checks would be reduced by the amount of social security disability they estimated she was eligible for. I went to the policy, and sure enough it was there in fine print. Another example of socialized risk and loss and privatized profit. I researched and discovered most ltd policies have this clause. She is on o2 24 hours a day and has many problems related to the disease and treatment. Her benefits are figured exactly the same way regular SS is...by the amount she put into it. By your logic, anyone collecting SS or medicare is a leach. You are another hypocritical "I am entitled to my my government benefits, you are a leach",

  • Report this Comment On July 14, 2014, at 9:17 AM, deckdawg wrote:

    There are 2 kinds of SS disability: The kind you "earn" which is SSDI, and the kind that is paid to people who have paid little or nothing into the system, which is SSI. I believe SSI is fine, but should not be funded from SS funds. If the program needed separate funding, it would likely get better oversight. Like any disability program, it is subject to significant abuse. There are folks that are experts in how to game the system. The same goes for SSDI. Over the years, the definition of "disability" has been expanded to include backpain. A fertile field for malingerers. The definition has also been expanded to include alcoholics and drug addicts. And there are a lot of folks getting a monthly check because they "can't" work due to their alcoholism. That just seems wrong, somehow.

    One of the big problems with SSDI, is that the system is so clogged up with folks in line for an undeserved handout, that it can take years for someone with a legitimate claim to actually start collecting.

  • Report this Comment On July 14, 2014, at 9:41 AM, angie45 wrote:

    @deckdawg-

    To qualify for disability benefits for substance abuse disorder, you would have to fulfill the SSA’s requirements for one of the underlying illnesses. For instance, if you suffer from cirrhosis of the liver caused by alcoholism, you would have to show you that suffer from specific severe symptoms listed by the SSA under chronic liver disease, such as hydrothorax (fluid accumulation in the lung cavity), peritonitis (abdominal infection), or hepatic encephalopathy (brain dysfunction caused by liver failure). However, if you are still drinking, the SSA would also have to make a DAA determination to determine if your liver problems would go away if you stopped drinking. If your liver problems would remain – that is, the damage is irreversible – you would qualify for disability benefits.

  • Report this Comment On July 14, 2014, at 9:47 AM, angie45 wrote:

    @deckdawg:

    While back pain can be agonizing and frustrating, and sometimes incapacitating, Social Security does not hand out SSDI or SSI disability benefits readily for back pain.

    To qualify disability benefits, Social Security requires you to have a “medically determinable” impairment that lasts for at least one year. This means that x-rays, MRIs, or at least your doctor's notes after a physical examination must show that your back pain is caused by some physical abnormality of the spine or spinal canal. If you have back pain without a physical impairment that normally produces pain symptoms like yours, you're unlikely to win disability benefits.

    (But note that back pain caused by obvious injuries like muscle strains and fractures usually heal within a few weeks or months, so won't qualify for Social Security disability or SSI.)

  • Report this Comment On July 14, 2014, at 11:38 AM, JohnG1964 wrote:

    When applying for disability benefits it is important that you always check mental disability as well as physical disability. I call this the one-two punch that almost always guarantees benefits.

  • Report this Comment On July 14, 2014, at 1:25 PM, Teako3 wrote:

    @cobranut

    First, I know you want to believe FICA is stolen, but it is not.

    Second, what does education mean to you. A high school diploma is all the higher over 50% of our population gets. Are you suggesting they need more to qualify? They don't need any education to qualify to vote. Do mean they don't pay FICA until they are "educated"?

    Third, what is experience? common labor jobs uis where you start in some industries. do mean their years at that level should not count? Do mean they don't pay FICA until they are promoted from that level?

    You seem to be no more than your typical anti-anything whiner.

  • Report this Comment On July 14, 2014, at 1:30 PM, Teako3 wrote:

    @deckdawg

    First, when you keep cutting the budget to run the program, you have fewer people to service the program.

    Second, have you ever reported a person you believe to be "playing the system". I have and they have now had to pay it back. It makes up for the budget cutting done by we both know who.

    Third, have you suffered from alcoholism? If not, you really have little to nothing to say about it that would be enlightening. I hope you are including all "Drug-type" addictions in this category.

  • Report this Comment On July 14, 2014, at 1:33 PM, Teako3 wrote:

    @JohnG1964

    Is this what you did?

    Do have any specific evidence we can look at?

    I'm pretty sure it would take more than checking a box for anything you claim to get anything.

  • Report this Comment On July 14, 2014, at 1:45 PM, watson14 wrote:

    I have heard that the first application is usually denied but the second (often with an attorney) is usually accepted and benefits are retroactive to the initial filing date. I could be wrong, just what I heard.

  • Report this Comment On July 14, 2014, at 5:00 PM, deckdawg wrote:

    Teak, fortunately you don't have to be an alcoholic to know something about it. Otherwise, I suppose the SS Admin would have to hire a board of alcoholics to determine whether an applicant's alcoholism was relevant to his SSDI claim. Unfortunately, dealing with a close (now dead) relative who was an alcoholic has taught me more than I wanted to know. ( and yes, all drug addictions.)

    Obtaining SSDI has much to do with following the right procedures and checking the right boxes. Have you noticed the lawyers advertising on TV that they will get you the SSDI "you are entitled to" without you having to pay unless you win? (They are paid from the retroactive check). These guys know how to work the system (of course they are not going to pursue your claim unless they believe they can get it).

    Angie, I stand corrected on drug abuse and alcoholism qualifying someone for disability on their own. I looked it up. That used to be the policy, but it has been changed.

  • Report this Comment On July 14, 2014, at 5:43 PM, SunnyLyren wrote:

    I am a highly educated, high school & 4 year college graduate {nurse} from the Midwest.

    I joined the Army after college to help pay for school, many years later while serving my COUNTRY I was injured in Iraq {IED explosion}

    I get SSDI & veterans benefits because I've had several major back & neck surgeries & permanent left leg & spinal damages.

    It took me longer to get my full 100% VA benefit then SSDI!

    {7 years fighting with the VA & 2 years with SSDI}

    As soon as my SSDI went through {of-course} after the appeal hearing was granted in my favor,

    I got a one year retroactive payment

    {BENDER & BENDER, hired lawyer firm & proof used from my own VA MEDICAL RECORDS}

    My VA benefits were granted almost ASAP, but only after showing PROOF to the St. Louis VA Regional Office, my SSDI award letter!

    .

  • Report this Comment On July 15, 2014, at 8:21 AM, ohiodale wrote:

    I believe there are a lot of people who need SS disability due to servere illnesses or injuries. I also know for a fact there are many people who are frauding SS disability. We all know some of these people. I would rather SS clean up their act and do a better job of screening people. The ones who really deserve the benefits could get more if SS got the scammers off the benefit.

  • Report this Comment On July 15, 2014, at 9:46 AM, semost66 wrote:

    Interesting comment above about lawyers and approvals for social security disability. About 2-3 weeks ago there was a congressional hearing which involved four administrative law judges being questioned because they were approving 98%+ of the disability cases coming before them. Sounds to me like the scam is that you are denied benefits by SSA employees and then you are almost assured of disability approval once you get a lawyer involved. Incidentally, an acquaintance said their lawyer was paid $5,000+ for handling their disability case.

  • Report this Comment On July 15, 2014, at 12:32 PM, DavidDavis wrote:

    How?

  • Report this Comment On July 16, 2014, at 7:00 PM, gskinner75006 wrote:

    The fraud in the disability system is so high, it over shadows anything good the program has done or could do. What a mess.

  • Report this Comment On July 18, 2014, at 1:01 PM, Michlock wrote:

    To those who are calling me a leach (sp), let me tell you my story. I'm an M.D., and developed a neurologic disorder and had no choice but to stop working. At the time it happened, it was like an axe fell on me out of nowhere. Strange coincidence, I had a disability plan with my job. I say strange coincidence, because I never bought a disability plan for myself for all the years a worked as a solo practitioner. I had only recently taken a position with a company because I moved from one state to another in order to help my father take care of my mother who had Alzheimer's disease.

    The policy required that I apply for social security disability. Despite the fact that I could hardly function at the time, literally, I was denied social security because they decided I could still perform tasks like sweeping a floor (which actually I couldn't do at that time). I didn't contest it because I was both too depressed and stretched thin and was also receiving income from my disability plan through work. After several years, the disability plan paid 20% less than it originally did (by virtue of its terms), I had been through bankruptcy and I was still not able to work. I reapplied for social security, was awarded it and that entitled me to Medicare.

    My dear Foolish friends who think all these low lifes are sucking away your tax dollars on Social Security Disabilty and Medicare. You'll think twice should the situation ever come up where you turn around and your life has completely changed everything for you.

    You're paying into Social Security and Medicare for good reason. Whether you believe it or not.

    P.S.

    In the course of my career, I treated many (too numerous to count) people who were or became disabled. I now recognize their plight in a way I never had.

  • Report this Comment On July 18, 2014, at 1:20 PM, Michlock wrote:

    P.P.S.

    fyi, I asked Social Security why they gave it to me the second time I applied, and not the first time. This was five years later by the way. They told me that my age had a lot to do with it, because statistically, I would be less likely to find a job.

    There are criteriae that SS uses and if you don't

    'fit' all the criteriae, it doesn't matter what is wrong with you, you simply will not get it unless you fit the criteria. I suspect this is a major reason, if not THE reason that law firms can make so much money dealing with this issue. By the way, they are not ripping off SS because what they are doing is getting people what was rightfully due them and take a percentage of the retroactive SS.

    For the record here, I did not use an attorney since I did not have to appeal the decision, but even if I had to appeal, I still would not have necessarily needed an attorney.

    Of note also, when people are sick, they are sick. When you're sick, filling out zillions of forms, calling all your doctors, going through even just the application is entirely draining. Imagine if you have to appeal!

    Furthermore, of the hundreds and hundreds of disable people I've cared for in the course of my career as a physician, I have NEVER had a patient who was on disability and didn't deserve it. That doesn't mean I didn't have patients who WANTED to be on disability and didn't 'deserve' it, but I never had someone on disability that I recognized as not being disabled.

    In retrospect, if I could, I'd go back in time and re-evaluate everyone that I DIDN'T think 'deserved' disability, because I may have been blinded by my own arrogance that everyone can work for godssake, after all, I used to practically crawl to work with sciatic nerve and back pain and work 16 hour days, why couldn't they (my arrogance blinding my ability to perhaps really evaluate some complaints that I regarded as unimportant)? (my disability by the way has nothing to do with back pain or sciatic nerve).

    We are all ignorant to some degree or another whether you want to believe that or not.

  • Report this Comment On July 24, 2014, at 6:40 PM, PaulBear wrote:

    I'm sure there are some people who qualify for social security who also refuse to accept it. There aren't many of them, though. I heard of some millionaire collecting social security. He must have had some good disability lawyers or something. There are also those who could use such representation who are in dire need of SS benefits.

    Paul | http://www.lostjobs.ca/en/disability_claims.html

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Dan Caplinger
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Dan Caplinger has been a contract writer for the Motley Fool since 2006. As the Fool's Director of Investment Planning, Dan oversees much of the personal-finance and investment-planning content published daily on Fool.com. With a background as an estate-planning attorney and independent financial consultant, Dan's articles are based on more than 20 years of experience from all angles of the financial world.

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