Joint Replacements, a Baby Boomer’s Story
We turned to one of our member company experts – Ted Norwood of Integrated Benefits, Inc. – to answer your questions. Norwood, an attorney, represents SSDI claimants nationally.
What is the meaning of “acquired disability”?
Some people are born with disabilities, and some people become disabled later due to disease, accident, degenerative conditions or something else. Someone with an acquired disability was not born with their disability. This term covers a veritable plethora of conditions.
I had the pleasure of speaking with Gaby Dunn, host of the popular Bad with Money podcast. Gaby noted that developing an acquired disability was one of the few ways you can become part of a minority and see a truly different side of life in America. It is a meaningful observation that addresses the impact of acquired disabilities.
Defining the word “disability” is more difficult. The Social Security Administration (SSA), the Americans with Disabilities Act, workers’ compensation rules, the Railroad Retirement Board, the Federal Employee Retirement System, and private insurance companies all use different definitions. It is a good idea to make sure you understand the definition of disability you are referencing. It is also important to respect how people with disabilities approach their condition and how it fits their identities.
Questions about how to appeal an SSA decision
I just got a cessation of benefits letter from Social Security Disability Insurance. What should I do to challenge this?
How do I get SSDI after being denied?
One thing the Social Security Administration does very well is explain your options in their letters. The letter should tell you how to appeal the decision and what your time limitations are. Many claimants still struggle with these issues for any number of reasons.
It is always a good idea to ask a Social Security representative. Many are lawyers, but there are non-lawyer representatives, too. The National Organization of Social Security Representatives (NOSSCR) can refer you to someone. So can the National Association of Disability Representatives (NADR). Your Social Security district office will usually be willing to help you submit an appeal or they can refer you to a non-profit representative.
If you had a representative when you first qualified for benefits, then they are a good place to start. They likely still have your file and that will be useful.
Appealing SSA’s determinations is sometimes easy and other times incredibly challenging. I strongly recommend working with a representative. Importantly, I have never heard of a Social Security attorney or representative who does not offer a free consultation. Social Security has very strict rules about fees and SSA must approve any fee you pay a representative. There is rarely a fee unless you win.
Questions about the longevity of a disabling condition
Does my disability have to be permanent to receive SSDI benefits?
Once someone applies for SSDI, doesn’t this mean they have to quit working for good?
Social Security calls medical conditions that contribute to disability “severe impairments.” If someone has severe impairments that SSA determines keep that person from being able to sustain work activity in a significant number of jobs, then that person is “disabled” under Social Security’s definition. Generally, the term “disability” refers to the program or a person’s payments.
SSA does not require permanent exit from the labor force to qualify for benefits. And Social Security not only allows you to return to work, they encourage it.
Social Security does require your medical condition to last and to keep you from working for at least 12 months. Some claimants are back to work before they win their case and then they receive a lump sum for the time when they were out of work.
Does SSDI replace my work income in full?
Almost certainly not! Your SSDI is based on what you paid into the system, just like your retirement benefits with Social Security. The average SSDI payment is about $1300/month. Most monthly benefits range from about $800 to $2800. If you live on SSDI alone, you are unlikely to be too far above the poverty line and are unlikely to maintain a life of luxury.
There are a lot of rules and formulas for determining payments. I won’t go into them here because they are just as boring to write about as to read about.
Does my income affect my eligibility for SSDI?
There are a couple ways to look at this question. I will address both, and the short answer to each is yes.
First, your income determines if you have enough quarters or credits to have SSDI coverage. You must work five of the ten years before your disability begins. You also have to make enough money during that time to qualify, but the amount is low: $1410/quarter in 2020.
There are more detailed rules, but they are far from interesting reading. If you want to know about your work history and coverage with SSA, you should check out your SSA account online. “My SSA” is a good resource. The Social Security Administration is trying to encourage as many people as possible to activate their accounts.
Second, you may earn income after you applied for SSDI. That income may be from work activity, insurance, investments, severance, workers’ compensation, litigation, inheritance, or many other things. Technically, as long as you are working and not earning over the substantial gainful employment (SGA) amount, your income should not matter to your case.
However, we live in the real world, so sometimes it does. If an adjudicator thinks you have too much money and do not really need the SSDI benefits, they may find a way to deny your case. When this happens, the appeals are usually strong. Also, if you are working part time under the SGA level, many (though certainly not all and maybe not even most) SSA adjudicators presume you could work more hours – even if your doctors support you.
Questions about working while on SSDI
How much are people allowed to try and work and earn while on SSDI?
Can I protect my SSDI benefits if I try to work again?
SSA has several options that allow you to work. People returning to work is good for Social Security and for you. However, I recommend diligence when you work while receiving benefits because many individual adjudicators at Social Security interpret policies in different ways, often opposing claimants and beneficiaries.
If you are on benefits but you want to try to earn some extra money, you can. You may perform work and earn up to the SGA level each month, as long as you never cross it. Currently, that amount is $1260/month for non-blind individuals. I recommend that you notify SSA before you start working and keep detailed records of your job duties and any accommodations you receive.
If you are interested in attempting to return to full-time work above the SGA level, then Social Security has good options for you as well. For up to nine months in a rolling three-year period, Social Security will continue to pay your disability benefits while you attempt to work. The nine months of work is called a trial work period. If your trial work period fails, then you can stay on benefits. Again, I recommend keeping detailed records of your duties and any accommodations, just in case. Also, you should notify SSA before beginning any work attempt.
Social Security also has a national network of entities that can help disabled individuals return to work. It is called Ticket to Work. It is only available to individuals who have been found disabled, so you cannot access this program until Social Security approves your application. Generally, people consider Ticket to Work underfunded and less than optimal. It can help though, and has helped many people since its development.
In Closing
I hope I’ve clearly answered your questions. SSDI is a great program. It has flaws and plenty of room for improvement, but like Social Security retirement, it is best utilized as only a part of an individual’s income-protection plan.
If you rely entirely on SSDI, you may have a tough time. If you utilize it with private insurance policies (usually through your employer) for short-term and long-term disability, the program is much more useful. Group disability insurance policies usually require claimants to pursue SSDI benefits. The insurers offset the benefits Social Security pays you. However, this allows insurers to price policies at an amount that is affordable for employers and workers.
Talk to your employer to find out what benefits they offer and make sure you protect yourself and your income. If you are already looking at applying for Social Security benefits, reach out to a professional representative. They are always happy to help.
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