6 REASONS GETTING A DISABILITY BENEFIT IS SO HARD

The US Government offers benefits to disabled workers through the US Social Security Administration. This is often called SSDI (Social Security Disability Insurance). But qualifying for the benefit isn't easy. In fact, it is often very difficult and extremely complicated. There are several reasons for the difficulty:

1. The program was designed to be long and difficult. The framers of SSDI didn't want "everyone" to be able to get benefits. So, they made it hard on purpose. They calculated that there should be at least 14 workers paying FICA (Social Security tax) for each beneficiary receiving benefits. So, 14 workers supported each beneficiary by paying FICA tax (payroll deductions) into the trust fund. This worked well for a long time. But over the decades fewer workers supported more and more beneficiaries. Today there are only 2.7 workers supporting each SSDI beneficiary. As the trust fund dwindles, Social Security finds new way to make new disability claims more difficult.

2. You must have sufficient "work credits" to be covered by the Social Security Act. Individuals over age 30 will need 20 work credits. (In 2022, you earn 1 work credit by earning at least $1,510 in wages during one calendar quarter). The basic rule: You should have worked at least 5 years out of the past 10 year period. Individuals who have never worked, or who haven't worked in many years, may not have enough work credits for a disability claim. Call your local Social Security office to be sure.

3. Social Security's definition of "disabled" is very strict and very limited. For most claimants, "disability" means that you are not able to perform any of your past relevant work AND you are not able to adapt to an easier job of any kind. This conjecture must be PROVEN with objective medical evidence. It is a very high burden of proof and difficult to meet.

4. You must have a medically proven physical or mental condition that prevents any full-time work for a period of at least 12 straight months OR the condition is expected to end in death. Thus, Social Security has no temporary or short term disability program. They only consider conditions lasting 12 straight months, or more, or which are expected to end in death.

5. Social Security is a US government program--wrapped up in complicated layers of government red tape and bureaucracy: Rules of evidence, medical proof, reviews, examinations, questionnaires and long delays make the process frustrating. Many claimants hire attorneys or advocates to help wade through the long, confusing process and meet all the rules and regulations.

6. The odds are against you. There may be up to 3 levels of SSDI. Here are the average odds of being approved at each level.

• INITIAL APPLICATION: About 30 percent are approved., 70 percent are denied.

• "RECONSIDERATION": Less than 10 percent are approved here.

• HEARING: Nationally, about 45 percent get approved at a hearing before an Administrative Law Judge (ALJ). It may take 12 to 24 months to get before an ALJ. But this is the best chance you will get in the system.

Those claimants who eventually get SSDI benefits are those who know the system and the process (or hire someone who does), and who stick with it for months or years, even through multiple denials or failures. You seldom win until you get through the appeals process. The hearing is critical and you will need some professional help with it.