 by Alan Harder
There are many wonderful, insightful, helpful and well-written articles about Social Security disability benefits on both PHCentral and the PHA websites. I expect I'll inadvertently repeat material from some of those articles—it would be hard not to. But I do want to offer some thoughts on how to decide whether to file, how to file an effective claim and about what Social Security benefits really are.
One note, however: I did not work in a Disability Determination Service. And although we all get quite an education about PH when when this disease comes to visit our families, it won't take very long for me to run out of expertise on questions about Social Security's medical evaluations.
Should I file?
This first step can be daunting. In my wife's case, I think saying: "I am disabled" was harder and more traumatic than anything else that has followed. In spite of evidence to the contrary, we wanted to believe that things would get better. (Of course being a guy, I wanted to engineer a solution to limitations of endurance and mobility.) Accepting the limitations of PH as a new fact of life and moving on took some doing.
It was a help to collect facts. If you haven't made the decision to file yet, Social Security can help by providing some facts about your benefit rate and about the process of filing. They have a great web site ( www.SocialSecurity.gov ) that has lots of useful information about how they define disability. I'll say more about that below as well. SSA sends out yearly statements that show your earnings history and give an estimate of your benefit rate. Those estimates get you in the ballpark, and if you want a more specific estimate, you can visit an SSA office. A representative can give you a projection that is very accurate.
What is Social Security Disability, anyway?
Social Security is an insurance plan. This may be the single most misunderstood thing about Social Security. It's not just similar to an insurance plan, it IS an insurance plan. The "I" in SSDI stands for Insurance—Social Security Disability Insurance.
Social Security insures against loss of earned income from: retirement at "old age"; the death of a wage earner; or disability. You become covered by paying "premiums" (FICA or SECA tax.) You receive benefits in the form of a partial replacement of your earnings if you incur a covered loss. (On average, Social Security replaces 43% of lost wages.)
So that's the widest possible overview; Social Security Disability is one of the three insurance programs they administer that pays monthly benefits based on your prior earnings. The agency also administers the Supplemental Security Income (SSI) disability program which is based on financial need rather than prior earnings.
How disabled is "disabled" for SSA purposes?
Briefly, SSA considers you disabled if you aren't able to work at "substantial gainful activity" because of a medically determinable physical or mental impairment. If you have been working for wages, "Substantial Gainful Activity" isn't too hard to decipher. It means gross wages of $900 per month or more in 2007 increasing to $940 in 2008. (If you have been self-employed, defining "substantial" will involve looking at what you do and how long you can do it.)
The devil, as you might suspect, is in the detail of that phrase "medically determinable." Don't try to outguess that part. If you've had to stop work because of your condition, or to cut back to less than $900 per month, get started on an application. Let SSA do the work of making the decision.
How many work credits do I have to have? And what's a quarter of coverage?
"Works Credits" and "Quarters of Coverage" are one and the same. Before 1978, they were called "quarters of coverage " After that, the way they were counted changed, and they were called "work credits."
How many credits you need depends upon your age. The best resource is on the SSA website.
When I finally decide to file, what's the best way?
If you have high speed internet access and reasonable writing skills, then hands down, the best way is to file online. Here's why: If you complete your own application, you know what's in it. If you have difficulty navigating the website, or with writing things down, try to find someone with those skills to help. Head to http://www.ssa.gov/applyfordisability/ to get started.
If you'd rather not file online, then call the national toll-free number (800)772-1213, or your local Social Security office to schedule an appointment. PH patients should also probably take a look at the A.C.C.E.S.S. website.
Some advice, though: After anyone else has helped you fill out the forms, whether it's SSA or a representative like A.C.C.E.S.S., ask Social Security for printouts of everything that was submitted. Do it right away. Then proofread them carefully. Do the written reports match the truth of your case? Regardless of how astute and professional your representative is, there is still room for misinterpretation between what you say and what someone else hears. Remember the old telephone game where a message is whispered to one person and then relayed around a room? The message at the end was never anything like the original. Take the trouble to get it right BEFORE the evaluation begins. It will save far more time, effort and delay down the road.
Debunking a myth:
Myth: "Social Security always turns you down twice before they approve you."
Fact: Social Security approves about 30% of disability applicants on their initial filing. Be thorough and careful with your application from the start and you stand a much better chance of being in that 30%. If you do it haphazardly believing it will only be denied, you increase the chance that it will be.
Read Alan Harder's other articles:
Social Security Claims—What's in YOUR File?
Alphabet Soup Spelled Out—(Where Your Disability Claim Goes After it's Filed.)
Work and Social Security:
(Yes! You Can!)
Have a Question? Ask the PHC Action Desk
If you're looking for information about Social Security/Disability, we may be able to help. Alan Harder is here to answer your questions.
Submit a Social Security/Disability Question to Alan Harder
Ed. Note:
Alan Harder worked for Social Security for many years. To learn more about the author, visit his bio on the PHC Staff Page.
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