Amber has nearly 10 years with WK. Prior to that she worked for Social Security handling SSI claims.  Since she’s been at WK she represented nearly 2,000 people at hearing.

Are Your Considering Filing for Disability?

If you’re thinking of filing for Social Security Disability benefits, the first question to ask yourself is, “am I disabled?” Simple question, right? Not so fast—the answer may not be as straightforward as you might think. Depending on who you talk to, the word “disabled” can have different meanings. It can mean a physical or mental impairment. It can mean being unable to perform work that you used to do. It can mean being unable to do any work at all or being totally incapacitated. But if you are thinking about filing for Social Security Disability benefits, the most important meaning of the word “disabled” is how the Social Security Administration or SSA defines it. 

SSA’s Meaning of “Disabled”

In what I like to refer to as “SSA world,” (because it is its own little universe in terms of wording and definitions) “disabled” means unable to engage in substantial gainful activity by reason of any medically determinable impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of 12 months or more. You’re probably thinking, “okay, translate that gibberish, please.” Simply put, it is to have a medically documented condition which prevents a person from doing work, which SSA deems “substantial” for at least 12 months, or which will likely result in death. 

The 12 Month Requirement 

So, this can be confusing and begs the question: “does that mean that someone cannot file for disability if they have not been out of work for a year?” The answer is absolutely not. All this means is that the condition must not be expected to improve to a degree that would allow a person to return to work, within a year’s time. 

Still clear as mud? Here are a couple of examples:

Example 1: About 3.5 weeks ago, Jack suffered a severe injury which left him paralyzed from the waist down, and has not been able to work since. His doctors have said his condition will not likely improve over the next 12 months, and that it could take years for him to regain use of his legs. Should Jack file for Social Security Disability? Yes. Even though it has been less than 12 months since he stopped working, Jack’s condition is expected to prevent him from returning to work for at least 12 months, so he should definitely consider filing for disability benefits.

Example 2: Jack’s sister, Jill, had a pretty bad fall as well. She had some bumps, bruises and a broken wrist. She had to have two separate surgeries for her wrist injury and has been out of work for over a month. Jill’s physical therapist says she’s improving, and her orthopedic surgeon says her wrist looks great and should be as good as new in a couple of months. Jill believes she will be able to return to work within a matter of weeks. Should Jill file for disability? Probably not. Jill’s condition is not expected to keep her from working for 12 months or more, and therefore, is not disabling according to SSA’s definition.

Work That Is “Substantial”

If you are wondering what activity could be considered “substantial” or “gainful” you may have guessed that SSA has its own definitions for those terms, too. That’s a whole other blog for another day, but the short answer is: activities that are useful in the accomplishment of a job and have economic value. SSA has set monetary limits for what they consider substantial, which change each year.

When Being out of Work Isn’t Necessarily Enough

Just being unable to do the work you used to do may not be enough. Similarly, a lack of readily available jobs you can do in your immediate area will not satisfy the requirements for disability. Depending on the circumstances, including but not limited to a person’s age and/or past work, SSA rules require a showing that you are unable to perform any work that exists in the national economy. The takeaway: if you have a condition that prevents you from working a full-time job, you may want to consider filing a claim for disability, even if you just recently stopped working. Ultimately, it is up to SSA to decide whether you meet the definition of “disabled,” but this is why it is important to talk to a lawyer about your possible disability case. When SSA has trouble finding that you meet their definition of “disabled,” a lawyer can help present to them how and why you do!