WHAT EXACTLY IS SSDI?

The word that makes SSDI so confusing to most people is "insurance." Social Security disability isn't often thought of as insurance, but it is. Some things to keep in mind as you begin to view SSDI as insurance:

• insurance has a starting and ending date. It expires.

• Insurance has to be paid for.

• Insurance only covers certain "insured" persons - not everyone.

• You may only file a claim if you suffered a loss while you were an insured person.

SSDI is a disability insurance plan that the federal government requires for most workers. It insures the worker against becoming unable to earn a wage due to a physical and/or mental impairment. This insurance is mandatory. It is paid for by having FICA deducted from each pay check (and the employer matches it dollar for dollar). These withholding taxes go into an account under the worker's name and Social Security number and can be used to pay a benefit when the insured worker meets the qualifications set out by the Social Security Act.

When the worker stops working (for any reason) FICA is no longer collected because there is no paycheck to deduct from. After about 5 years, the worker ceases to be an insured person under the Social Security Act and may not be able to file a new disability claim. Many individuals who have not worked in the last 5 years find themselves uninsured under the Social Security Act.

For workers who remain insured-- and become disabled--Social Security may pay a monthly cash benefit for the duration of their disability. Many beneficiaries continue to receive SSDI payments until they reach retirement age, at which time benefits automatically convert to retirement benefits (in the same amount).

SSDI is not based on how severe your disability is. You are either 100 percent disabled or not disabled at all. It is not based on how much income you have or your financial need. The average SSDI payment is 2020 was around $1,255 per month. If the disabled person has dependents under the age of 18 (or 19 if still in school), Social Security may pay them a monthly benefit, too. The average dependent's benefit in 2020 was $368 per month.

What's the Hardest Part of Getting Approved for SSDI?

The most difficult part is convincing Social Security that you meet their definition of "disabled," which is very strict and very narrow. For persons under age 50, they are only disabled if they cannot perform any type of full time work which exists in the national economy. This means that they are so severely disabled that they can't perform sedentary work such as a ticket taker or an envelope addresser. For older individuals, being disabled may mean that they cannot perform any of their "past relevant work," meaning any of the jobs they have performed during the most recent 15 year period.

Social Security will often send a denial letter stating that the claimant is "not disabled according to our rules." And they do have their own rules which may be different from the rules used by other government agencies or insurance companies.

The proper response to a denial is to appeal. You are only given 60 days to file a written appeal. After that, it's too late.

Our office exists to help individuals meet the government's requirements to get SSDI payments. It is complicated, tedious work that involves mapping out a legal strategy to prove that the claimant is disabled--and obtaining medical evidence that proves the case. Of all the persons who apply for SSDI, about 70 percent are initially denied. Of all that go through the appeal process, about 45 percent will eventually be approved.