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What Makes Someone Eligible for Social Security Disability?

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The Social Security Act enables disabled Americans to file claims for Social Security Disability benefits. There are two main forms of Social Security Disability benefits, and both have unique qualification criteria. Therefore, if you believe you have a qualifying medical condition, it’s important to understand the official eligibility criteria and the claim filing process.

Navigating the Social Security Disability claims process is very challenging, even if you think you have compelling evidence that proves the scope and severity of your condition. The claim process is very complex, and the Social Security Administration (SSA) denies most of the claims received yearly for disability benefits. Working with an experienced Social Security Disability attorney is the best way to maximize your chances of success with a  claim for any form of Social Security Disability benefits.

Eligibility for Social Security Disability Insurance (SSDI)

SSDI most often applies to individuals who sustain injuries that prevent them from working. The baseline eligibility criteria for SSDI benefits in the United States is that the injury must cause a disability lasting one year or longer that prevents the claimant from working. Additionally, the claimant must have a record of paying into the Social Security system via payroll taxes. Everyone who works in jobs covered by Social Security accumulates work credits as they continue working. These credits can translate to SSDI benefits if they are injured and unable to work.

SSDI benefits fluctuate based on several factors. For example, if an individual has sustained a work-related injury resulting in a permanent disability, they may have already filed a state-level claim for workers’ compensation benefits. As a result, the SSA adjusts SSDI benefits determinations based on other forms of benefits a claimant already receives. Additionally, if an individual is receiving SSDI benefits when they reach retirement age, their SSDI benefits will automatically convert to retirement benefits.

Some of the most commonly reported disabilities that qualify for SSDI include:

  • Traumatic brain injuries from work-related accidents.
  • Amputation injuries resulting in the loss of a limb.
  • Serious medical conditions acquired from hazardous work environments, such as cancer or chronic respiratory illness.
  • Nerve damage from traumatic injury that interferes with fine motor skills, coordination, and the ability to perform previous work duties.

If you are unsure whether your recent work-related injury qualifies for SSDI, or if you are already receiving workers’ compensation benefits and wonder how those benefits will interact with SSDI, it’s best to consult an attorney as to what you can expect from your claim.

Eligibility for Supplemental Security Income (SSI)

The second form of Social Security Disability benefits from the SSA is SSI, which applies to individuals with limited financial resources and disabilities that have prevented them from working in jobs covered by Social Security. Unlike SSDI, which requires a claimant to prove a record of covered employment, SSI requires the claimant to prove financial need. This form of Social Security Disability benefits is most often granted to adults with mental disabilities and children who will be unable to work in the future due to their medical conditions.

Many people who qualify to receive SSI will also qualify for Medicaid and other programs that can alleviate the financial burdens caused by their medical conditions and disabilities. While very different from SSDI, applying for SSI is just as complex, and you are most likely to have a positive experience with your claim if you work with an experienced attorney who can help you file it.

SSI is most commonly awarded to individuals born with disabilities that severely limit their ability to earn income and handle everyday household tasks. Blindness, deafness, mental impairment, developmental disabilities, and brain injuries sustained during childbirth are some of the most commonly cited disabilities that qualify for SSI benefits.

Filing Your Claim for Social Security Disability Benefits

The SSA denies most of the claims the agency receives each year for both SSDI and SSI. The SSA is very strict regarding what conditions the Social Security Act covers and how one qualifies for either form of benefits. As a result, many claims are rejected for clerical and administrative errors. Others are denied or delayed because the SSA requires more supporting evidence than the claimant has provided. The best option when your claim for benefits is denied is to file an appeal. If a clerical error or paperwork mistake of any kind caused your denial, a swift appeal might be all that is required to clarify the situation and secure benefits.

Some appeals are more complex, and claimants must prepare for courtroom proceedings before administrative law judges. Therefore, if you must attend a Social Security Disability benefits appeal, it’s best to have reliable legal counsel on your side so you can accurately address the unique details of your case. In addition, an experienced lawyer can help you gather any supporting evidence you may require to support your claim, such as reports from your medical treatment team and other caregivers who have helped you in the past.

What to Expect From a Social Security Disability Attorney

Navigating the claims process with the SSA is very complex, and the average person is likely to make mistakes in their claim and face an initial denial if they attempt to complete this process alone. Working with an experienced Social Security Disability attorney significantly increases your chances of success with your claim for benefits. In addition, if it is still denied for any reason, you will be prepared to address the situation and approach the appeal process with confidence with the help of your attorney.

Gade & Parekh, LLP, has years of professional experience representing clients in a wide range of Social Security Disability disputes. We understand how challenging it can be for anyone to face a difficult claim process when they are already struggling with their medical needs and the inability to earn income. Our firm provides compassionate and client-focused legal counsel to every client we represent. To file your claim for SSDI or SSI, contact us today and schedule a consultation with our team and find out how we can assist you.

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