How to Qualify Disability Insurance Benefits

Disability insurance benefits (DIB) or Title II benefits are given to disabled individuals who have worked and paid into the insurance system under the Social Security Disability Insurance program. Unlike Supplemental Security Income (SSI), DIB benefits are not needs based and have no income or asset requirements.

Under the rules of the Social Security Administration (SSA), a person may qualify to receive these benefits if:

• He/she has a physical or mental condition that prevents him from engaging in any “substantial gainful activity”
• The condition is expected to last for at least 12 months or result in death
• He/she has worked five of the last ten years as of the determined date of the onset of disability
• He/she is under the age of 65

The amount a disabled worker may receive as disability insurance benefits may depend on how long a person has worked and how much money he has made in “covered work”.

To be eligible for this benefit, an individual must meet the following requirements:

• He must qualify as a disabled based on SSA definition of disability
• He must have earned the required number of quarters of coverage

Generally, however, most workers who have worked at least five of the last ten years are insured for the disability insurance benefits. The longer one has worked and the higher the earnings, the higher the payment if he/she is found disabled.

In addition to this, individuals who were found disabled and entitled to these benefits may also be given retroactive benefits, which can go back one year from the date of the initial application. There is a five-month waiting period from the date the claimant is determined to be disabled until entitlement to these benefits begins.

A different rule however exists for younger claimants or applicants. For those who become disabled at or before the age of 22, the work requirement is waived since they may be allowed to collect on their parent’s work credits.

When applying for DIB, medical evidence must be submitted to demonstrate the applicant’s inability to work. In addition, the applicant must also meet the SSA medical listing for his/her condition. If the applicant’s condition does not qualify in the listing, his/her residual functional capacity is determined in relation to age, past relevant work, and education.

An applicant’s residual functional capacity is classified into so-called “five exertional levels of work”:

• Sedentary
• Light
• Medium
• Heavy
• Very heavy

An applicant’s residual functional capacity is often evaluated by a disability determination service (DDS) or on appeal, by an administrative law judge (ALJ) according to Title 20 of the Code of Federal Regulations. The evaluation is based on the medical opinion of a doctor.

To assist you in this matter, the skills and experience of a knowledgeable social security disability lawyer is truly necessary.