An introduction to Social Security Disability Insurance

SSDI has its own definition of disability.

If you have applied for Social Security Disability Insurance or SSDI and been denied, do not give up. In fact, most applications are initially denied, but often are approved at a later stage. Understanding some basics about SSDI claims may put your mind at ease.

It is important that anyone facing a disabling condition preventing him or her from working contact an experienced SSDI attorney. Having a knowledgeable lawyer on your side can make all the difference. For example, legal counsel can assist in gathering crucial medical evidence and communicate with the Social Security Administration or SSA on your behalf.

Your attorney will walk you through the steps to take in filing or appealing your application, including advice about potentially important deadlines. A lawyer can step in and help at any stage: initial application, reconsideration, hearing before an administrative law judge or ALJ, review by the Appeals Council or appeal to the federal courts.

What is SSDI?

Some people are not aware that throughout their working lives, when they have federal deductions taken out of their paychecks, the portion that goes to Social Security also establishes their potential eligibility for SSDI. SSDI is a type of public long-term disability insurance that the federal government administers for eligible people through the SSA.

In addition to meeting the definition of disability, to be insured and eligible, a person must have enough quarters of coverage. Basically, this means he or she must have worked enough over the years and recently enough to have earned insured status.

What is Social Security's definition of disability?

However, the definition of disability is distinct from the kinds of definitions used by private disability insurers or that used in workers' compensation. Specifically, to qualify for SSDI, a worker must have:

  • A severe, medically-determinable physical or mental impairment, or combination of impairments
  • Expected to last continuously at least one year or result in death
  • That prevents him or her from regular work, or to use the terms of the law, engaging in substantial gainful activity or SGA

What is the evaluation process of a claim?

SSA uses a five-step "sequential evaluation process" to determine whether a claimant is disabled for SSDI purposes:

  • Is the person working or engaging in SGA? If yes, not disabled. If no, continue.
  • Is the impairment or combination of impairments severe? If no, not disabled. If yes, continue.
  • Does the claimant's impairment or combination of impairments meet or equal a listing? This refers to a list of medical conditions that the SSA has determined are so severe that the impact of having one means the person automatically qualifies for SSDI. If yes, disabled. If no, continue.
  • Can the claimant return to his or her past relevant work? If yes, not disabled. If no, continue.
  • Can the person perform different work after considering vocational factors like education, age and past experience? If yes, not disabled. If no, disabled.

This is only a very basic introduction to the SSDI program and processes, which are extremely complex and nuanced. It cannot be overemphasized how crucial the involvement of a lawyer can be. Anyone facing disability preventing meaningful work or who already has filed a claim should speak as soon as possible with legal counsel for information and assistance.

With offices in Toms River, Forded River and Brick, New Jersey, the lawyers at Silvi, Fedele & Honschke Attorneys at Law, L.L.C., represent Social Security Disability Insurance claimants at all stages of the application and appeals processes in Ocean and Monmouth Counties and across the state.