Social Security Disability

In addition to disability benefits, the North Carolina workers’ compensation system allows for medical compensation.

Both programs are disability programs. SSDI is an insurance program that requires a work history. For those individuals that are no longer insured, SSI is available if they are disabled and qualify financially.

Not necessarily. SSDI is an insurance program that requires workers to pay taxes in order to be insured for disability benefits. However, the general rule is that a worker must typically have worked 5 out of the last 10 years to be eligible for disability benefits. Having some gaps in your work history does not prevent being eligible for benefits.

Yes. SSDI has a trial return to work program for those people who are able to work. In order to be eligible for disability benefits initially, the disability must last for at least one year.

Yes. The Social Security Administration does not view the receipt of workers’ compensation benefits as substantial gainful activity. Individuals receiving workers’ compensation benefits may still apply for Social Security disability benefits. However, if approved, their Social Security disability benefits will be offset by the periodic payments of workers’ compensation.

Not necessarily. The Social Security Administration does not have to accept your doctor’s opinion on your inability to work as determinative. The Administration is usually more interested in how an individual’s impairments affect their ability to perform work tasks. A physician’s opinion about a patient’s specific work restrictions will often be stronger evidence – especially if those opinions are supported by objective medical testing.

The Social Security Administration employs a five stop process to decide whether a claimant is disabled. Step 1 looks into whether the claimant is actually performing substantial gainful activity. If the claimant has been earning more than about $1,200 a month, they will not be eligible for disability benefits. Step 2 looks into whether the claimant has severe medically determinable impairments. These impairments can be physical or mental impairments but must be more than a minimal effect on work activity. Step 3 looks to see whether the severe impairment or impairments meet a listing. Listings lay out the standards that medical impairments must meet in order to result in a finding of disability. Step 4 looks into the claimant’s past relevant work. If the claimant is able to perform any of their jobs within their past relevant work (work they performed during the last 15 years), then they are not disabled. Finally, in Step 5, a determination is made whether the claimant can perform any other work in the national economy.

Yes. Claimants can file a “Request for Reconsideration.” If that is denied, then the claimant can “Request a Hearing” before an Administrative Law Judge (ALJ). Quite often, a claimant’s best chance for approval is before an ALJ.

The hearing is an opportunity for the claimant to provide their testimony about their impairments and how those impairments affect their activities of daily living and work activity. It is also a chance for the Administrative Law Judge to make a decision on the claimant’s credibility and attempt to get more information about any of the information in the record. The Administrative Law Judge will usually consult a vocational expert in determining whether the claimant’s specific limitations will make full time work impossible.

Yes. Claimant approved for Social Security disability receive Medicare after receiving disability benefits for two years (24 months). All claimant approved for benefits receive nothing for the 5 months after their onset date. After five months benefits begin and after two years of receiving benefits they will become eligible for Medicare. For many disabled individuals, Medicare is the more important benefit because without it there is no chance to obtain medical coverage.