Q. My doctor says that I am too disabled to work anymore. How disabled do I have to be to get Social Security?
A. It is difficult to qualify for Social Security Disability benefits: The Social Security Administration turns down 60 percent of disability applicants. Many people who have been declared disabled by their doctors, or even by other federal agencies, will fall short of Social Security's definition of disability.
Why is it so difficult to qualify? Congress--the one in office in 1956--wrote the definition of disability so that only severely impaired people would receive benefits. According to the Social Security Act, disability is "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to last for a continuous period of not less than 12 months".
In plain English, substantial gainful activity means a job. Usually, a disabled person who is still working and earning more than $740 per month has a "substantial" job and can't get disability benefits. After a disabled person stops working, he or she should apply for benefits.
Because of the above definition, Social Security doesn't pay partial disability benefits. Many applicants are too disabled for jobs they've held in the past. But if they are still able to work at other substantial jobs, then Social Security must, by law, deny their applications for disability benefits. It doesn't matter whether appropriate job vacancies exist, or whether employers are actually willing to hire particular workers.
Social Security doesn't pay short-term disability benefits either. If an applicant's condition will improve enough to allow a return to work within 12 months, Social Security must deny the disability application. That doesn't mean that disabled people wait a year to get benefits: If Social Security expects the disability to last for at least a year, benefits start after a five-full-month waiting period.
The Social Security Administration pays each state government to operate a Disability Determinations Service. Although local Social Security offices take applications for disability benefits, specially trained disability examiners at the state DDSs make disability decisions.
The disability examiner contacts the applicant's doctors and other medical treatment sources to compile a medical history including lab findings, diagnosis, prognosis and other observations. If necessary to complete the picture, the government pays for additional medical examinations of the applicant. These "consultative examinations" are conducted by independent physicians practicing in the community.
Applicants have the right to request appeals if they disagree with DDS's decisions.