Social Security's rules are different for people in different age categories. I want to talk about how age will affect your disability claim.
Social Security divides claimants into the following age categories:
- YOUNGER INDIVIDUAL (Under age 50)
- CLOSELY APPROACHING ADVANCED AGE (50 - 54)
- ADVANCED AGE (55 or over)
Younger individuals are not going to meet a Medical-Vocational Guideline that finds them disabled based on a combination of their age, impairment, education and past relevant work. Persons under 50 have the highest burden: they must prove that they are unable to perform any of their past relevant work, as well as any other work which exists in the national economy. If a younger person is judged able to perform unskilled, minimum wage work that can be performed at the sedentary (sitting down) exertion level, or any other work, they will be found not disabled.
Persons age 50 through 54, may meet a Medical-vocational guideline, especially if they have limited education, no transferable skills and their past relevant work was at a medium or higher exertion level.
Persons age 55 and over will more likely meet a guideline or "grid rule." If this claimant is judged unable to perform any of his/her past relevant work, he/she will probably be approved, even if other work is available. Claimants in this advanced age category will have the relatively lowest burden of proof and thus, the greatest chance of being found disabled.
Age is only one of the things Social Security looks at; however, it is a major factor.
Here are a few of the more commonly mis-understood things about Social Security disability (SSDI).
1. Everyone is covered by Social Security disability.
Actually not everyone is. You have to accumulate a minimum number of work credits to be covered by the Title II program. Also, the work credits must be recent enough.
2. Once you work enough to be covered by Social Security disability, you are always covered.
Also not true. Work credits must be recent enough. As a rule, work credits expire about 5 years after you stop working, after which you are no longer covered for Social Security disability.
3. Social Security denies everyone at first.
It may seem that way but they actually approve about 25 percent of claims initially. Still, a denial rate of nearly 75 percent is very high. The truth is that most disability claims are won during the appeal, not just with an application.
4. The Social Security office will help me with my claim, so I won't benefit from an attorney/representative.
A dangerous half-truth. Social Security will provide you with the correct forms and provide general information about its programs and services. They will not become your advocate. They will not fight to help you get benefits. It will be up to you to prove that you are disabled. The burden of proof always rests on the claimant. Claimants who are represented have a higher success rate than those who are not.
--The Forsythe Firm
Huntsville, AL 35806
PH (256) 799-0297
WEBSITE FOR MORE INFORMATION
Social Security disability is one of the most regulated, codified and legislated programs in the country. It's rules are found in the Social Security Act, the 20 Code of Federal Regulations, numerous Social Security Rulings (SSRs) and hundreds of federal court cases.
The following facts will play a major role in whether an individual can qualify for disability benefits:
- Age at the time of disability onset
- Residual Functional Capacity*
- Types of past relevant work**
- Sufficient work credits to be covered***
- Level of education and training
- Availability of medical records
- - - - - - - - - -
EXPLANATION OF TERMS
* Residual Functional Capacity (RFC) means the most that a person can do, in spite of his or her impairment(s). For example, how long can the claimant sit, stand, walk; how much can he/she lift, carry, etc.? What is the claimant's exertional limitation: very heavy, heavy, medium, light or sedentary?
**Past Relevant Work (PRW) refers to substantial work that the claimant performed within the most recent 15-year period prior to filing a disability claim. Only work during the most recent 15 year period is counted as PRW. This rule usually favors the claimant because skilled work that he/she performed 20 or 30 years ago will not be used to deny the claim at Step 4 of the sequential process.
*** Work Credits. To be covered by the Social Security Act, Title II, a person usually needs to have worked at least 5 years out of the most recent 10-year period, or to have accumulated at least 40 quarters of covered work. This rule may vary for young individuals who aren't old enough to have accumulated 40 quarters of work. Your local Social Security office can tell you whether you have enough work credits to be covered by Title II (Two).
Do you really have to be disabled for 1 year before you can apply for Social Security disability? The answer is: No, No and No.
Must you be off work for 1 year before applying for disability? The answer is: No, No and No.
This is a misunderstanding of the duration rule. The rule says that you must have a medical impairment that has lasted for at least 12 consecutive months, is expected to last for 12 consecutive months, OR to end in death.
What does this actually mean? It means that Social Security does not pay for short term injury or sickness that will probably not last for at least 12 months. So the question becomes: How long is my condition expected to last? If the answer is 1 year or longer, go ahead and apply for disability benefits. If the answer is "Certainly less than a year," then you should not apply.
Here are some examples of cases that Social Security will not approve because of the duration rule:
EXAMPLE 1: Jennifer breaks her right arm in a car accident and it requires extensive orthopedic surgery to repair damage. She can't work because her right arm is going to be in a cast for about 3 to 4 months. However, her doctor says that after about 4 months, he will release her to return to work. Jennifer will not qualify for SSDI because she is not going to be disabled for at least 12 consecutive months.
EXAMPLE 2: Arthur is having surgery for a heart condition that is expected to keep him off work for about 6 months. But, his doctors expect him to recover fully and be able to return to his job as a customer service supervisor at a department store. Arthur does not qualify for SSDI because his impairment is not expected to last for at least 12 consecutive months.
EXAMPLE 3: Mr. Citizen has just been diagnosed with multiple sclerosis and severe neuropathy in his legs and feet. This obviously is going to be a long-term problem and Mr. Citizen does not believe he can continue working as a heavy equipment operator. He should apply for disability. Although he has only been off work for 2 weeks, his medical condition is not expected to improve within 1 year to a point that he can go back to work. He meets the 12 month duration rule.
There is NEVER a requirement that an individual must wait 1 year to file for SSDI. The question is: Will the disabling impairment last for at least 1 year (even if that one year is in the future)? If there is a probability that it will, then a disability application should be filed right away (not a year from now).
Any unnecessary waiting to file an application for disability benefits may cost the claimant money, in some cases a lot of money. There is also a danger that SSDI eligibility (work credits) may expire if you wait too long.
If your disabling condition is medically expected to last at least 12 consecutive months, file now.
One final thought. The rule says that the disabling condition must last for 12 CONSECUTIVE MONTHS. It can't be intermittent or on-and-off disability. And it can't be a combination of different conditions that begin at different times. Let me illustrate with one more example:
EXAMPLE OF NON-CONSECUTIVE IMPAIRMENT:
McKinsey had to have a kidney removed in January. She was unable to work for 7 months, then recovered fully. However, just before she went back to work after the kidney surgery, she had a wreck and injured her neck. The neck injury kept her off work another 5 months. Taken together, both impairments disabled her for 12 months. However, this does not meet the 12 month rule because there was no single impairment which lasted for 12 CONSECUTIVE months. McKinsey has 2 short-term impairments that were not related.
I realize that Social Security rules are confusing. That's why we are here--to help you make sense of it, answer your questions, and guide you in filing for benefits. I like to speak to people who have potential claims, whether I actually end up representing them or not. And I will answer your questions free without any obligation. To contact me, simply pick up the phone and call my office.
___________________
Charles W. Forsythe
Social Security Disability Consultant
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across from Bridge Street
PHONE (256) 799-0297
Consultations are Free!
VISIT MY WEBSITE
Social Security does not automatically withhold federal income tax from benefit checks. But they will if you ask them to.
If you would like to have federal income tax withheld from either a pension or disability check, simply contact your local Social Security office and file a W-4 form.
You may choose the rate you want to be deducted: 7%, 10%, 12% or 22%.
You can also increase or reduce the tax withholding at any time by filing an amended W-4. You can even choose to discontinue the withholding.
Social Security benefits are generally taxable for individuals with total annual income of at least $25,000 and for couples who have annual income of at least $32,000.*
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*Tax information is given for general information only and is provided in Social Security public statements; not intended as tax advice. For information or specific advice on your tax situation, you should consult an accountant, CPA, tax attorney or other tax professional.
If Social Security income is a key source of your retirement or disability income, you need to know the financial health of the Social Security trust funds.
There are actually two trust funds that pay benefits: the retirement or pension trust fund and the disability trust fund. Together, they are called the combined trust fund.
Social Security has just released the financial report card for these trust funds.
The Disability Trust Fund (DI Fund) is projected to deplete it's resources in 2032 (just 14 years away). After that date, however, 97 percent of benefits would still be available through current FICA tax income.
The combined fund is projected to become depleated in 2032, with only 79 percent of benefits payable after that date.
This assumes, of course, that no action is taken by the government to change course--such as higher withholding tax, increase in the eligibility age for retirement benefits, etc.
Social Security has asset reserves totaling $2.89 trillion as of 2017 with an annual increase of $44 billion in 2017.
The financial health of the disability trust fund depends partly on how many people file new claims in the coming years. For the first time in ten years, new claims actually declined slightly in 2017.
Also, Social Security has tightened the screws, making it increasingly more difficult to get new disability benefits. Ten years ago 69 percent of claimants who appealed their denials were eventually paid benefits. Today, that percentage has dropped to about 42 percent. That's based on national averages.
Factors that continue to force approval rates downward, I believe, are as follows:
1. Social Security's obsessive fear of fraud. Talk to any government official, elected representative or Social Security employee, and fraud prevention is the first thing on their minds. That's one of the reasons it takes 2 or 3 years to get approved. And that long waiting period is by design.
2. Social Security's declining trust fund and the projected future difficulty in making benefit payments. It's belt tightening time.
3. A media assault. The media constantly shell us with the message that Social Security is "the new welfare," that fraud and abuse is rampant, and Social Security is giving away trillions of dollars to persons who don't deserve it...etc., etc. Politicians and bureaucrats fight back by making it slow and very difficult for qualified and deserving claimants to collect on their I.O.U. from Social Security. The waiting times have become obscene and, honestly, Social Security could significantly reduce waiting times if they really wanted to. They don't.
Social Security will often allow you to bring a friend, family member, or even a co-worker to give testimony at your hearing. Sometimes this can help your case. But not always.
I have some of my own guidelines I use when deciding whether having a witness to testify is potentially more helpful than damaging:
1. Testimony of a close family member can be useful if the claimant is a child, a person with severe mental impairments or who has a difficult time expressing themselves.
2. How well does the witness know the claimant and what is their relationship? Is the witness in a position to have observed the claimant closely and regularly?
3. Does the witness know what will be expected?
4. Is the witness going to be credible?
5. What are possible ways testimony by the witness can backfire or hurt the case?
6. Do we really need a witness to win this case?
In short, there needs to be a reason for calling a witness to testify. I need to understand the reason for having a witness. I also need to spend enough time with the witness to verify credibility and help them understand their role in the hearing.
Not every hearing needs testimony from a spouse, family member or friend. The judge is also going to be thinking, "Why do we need this witness?" Unless there is a clear answer, a witness probably should not be called.
