Social Security Disability

Disability Insurance Benefits

The purpose of Disability Insurance Benefits (DIB; Title II of the Act) "is to provide the measure of economic security for program beneficiaries." HALLEX I-1-2-57(A)(1)

To qualify for Social Security Disability (SSD) benefits, (1) you must have "insured status" under the Social Security Act (Act), and (2) you must be found "disabled" under the Act.

Medical Disability Standard

The medical disability standard for DIB and SSI is the same: "the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 20 C.F.R. § 404.1505(a); see also, 20 C.F.R. § 416.905(a) (SSI).

To meet this definition, you must have a severe impairment(s) that makes you unable to do your past relevant work . . . or any other substantial gainful work that exists in the national economy." 20 C.F.R. § 404.1505(a); see also, 20 C.F.R. § 416.905(a) (SSI).

Under the Medical-Vocational Guidelines (a/k/a Grid Rules)[link "Medical-Vocational Guidelines" to http://www.ssa.gov/OP_Home/cfr20/404/404-app-p02.htm], the definition of disability can be modified for individuals age 50 and over depending on their education and work history.

Insured Status under the Act

Insured status is obtained by earning sufficient quarters of coverage under the Social Security Act through payment of FICA taxes, which are typically deducted from one's paycheck (6.2%) or are paid directly if self-employed (12.4%).

Insured status can be checked by creating a "my Social Security" account at www.socialsecurity.gov/myaccount or by checking with your local Social Security Office.

The most important thing to know about insured status is that for purposes of disability insurance benefits, insured status expires. Once you leave the workforce and stop contributing FICA taxes, your insured status for disability insurance benefits will expire at some point in time; the longest your insured status will extend beyond your departure from the work force is five (5) years. The expiration of your insured status is referred to by SSA as your date last insured or DLI. Applying for benefits or proving you are disabled after your DLI is possible but it creates significant procedural and evidentiary hurdles that make success less likely.

Receipt of Disability Insurance Benefits

Disability Insurance Benefits provide for retroactive cash benefits up to twelve months before the date of application. DIB also will pay additional auxiliary benefits if you have a spouse or dependent minor children.

Once eligible for DIB and after receiving DIB benefits for 24 months, you become concurrently eligible for Medicare coverage. The total waiting period for Medicare coverage is actually 29 months as for the first five months you are eligible for DIB, you do not receive any cash benefits. This is referred to as the 5-month waiting period. Once the 5-month waiting period passes and after you receive 24 months of DIB benefits, you are eligible for Medicare.