The SSA defines a disability as a medical condition that prevents you from performing any substantial gainful activity (SGA). Your condition must have lasted for at least one year to be eligible for disability benefits. The SSA maintains a list of qualifying impairments; however, you may still qualify if your condition is not listed but is medically equivalent to a listed impairment. 

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What types of disability benefits are available?

 

The SSA offers two disability programs – Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI):

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• Social Security Disability Insurance (SSDI) – To qualify for SSDI, you must (1) meet the medical criteria, (2) have paid into the Social Security system through income tax deductions, and (3) have earned sufficient work credits based on your employment history. 

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• Supplemental Security Income (SSI) – This program is only available to individuals who are blind, disabled, and over 65 years of age, as well as children under 18 with a qualifying medical condition. SSI is a means-tested program, meaning your income and financial resources cannot exceed a specific threshold. 

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The Challenges of Obtaining Disability Benefits in Metro Detroit

 

Applying for disability benefits can be complex. The application requires accurate answers to numerous questions and the correct completion of various forms. In addition, your application must include medical evidence, such as doctor’s reports, exam history, lab tests, radiological exams, and other relevant medical information about the diagnosis and prognosis of the impairment. Ultimately, you must prove that your medical impairment prevents you from performing your job or another type of work. 

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Completing the application is not the only challenge; getting a disability benefits claim approved is not easy – the SSA denies nearly two-thirds of initial claims. Common reasons for denial include insufficient work credits, a non-qualifying medical condition, or errors in the application. Despite these challenges, working with our experienced St. Clair Shores disability attorney improves your chances of having your claim approved.

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Disability Benefits Appeals Attorney

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When the Social Security Administration (SSA) denies a disability benefits claim, they will send you a letter explaining the denial and your right to appeal the decision. To begin the appeals process, you must file a Request for Reconsideration with the SSA within 60 days of receiving the denial notice. 

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During the reconsideration process, a medical consultant and disability examiner not involved in the initial decision will re-evaluate your claim. However, they will only approve your claim if there is a new diagnosis or evidence that the medical condition has worsened. 

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If they deny your reconsideration, the next step in the appeals process is to request a disability hearing. The hearing is not a court proceeding but an informal meeting overseen by an administrative law judge (ALJ). The ALJ is not a “judge” but an SSA attorney who will uphold or overturn the denial. 

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If the ALJ denies your claim, you can seek a review by the Appeals Council. They will decide whether to overturn the decision, remand it to the ALJ for further reconsideration, or deny the claim. Let our team help you navigate the appeals process and fight for the benefits you deserve. 

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Who can get Social Security disability benefits?

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Social Security pays benefits to people who can’t work because they have a medical condition that’s expected to last at least one year or result in death. Federal law follows this very strict definition of disability. While some programs give money to people with partial disability or short-term disability, Social Security does not. Certain family members of disabled workers can also receive money from Social Security.

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Social Security Disability Insurance pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes.

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The law defines disability as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental 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 not less than 12 months. 

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A medically determinable physical or mental impairment is an impairment that results from anatomical, physiological, or psychological abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic techniques. 

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Can my family get benefits?

 

Certain members of your family may qualify for benefits based on your work. They include; 

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• your spouse, if he or she is age 62 or older;

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• your spouse at any age, if he or she is caring for a child of yours who is younger than age 16 or disabled;

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• your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild (the child must be younger than age 18, or, younger than 19 if still in high school); and

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• your unmarried child, age 18 or older, if he or she has a disability that started before age 22. 

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How are Social Security Disability Insurance (SSDI) benefits calculated?

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SSDI benefits are calculated according to how much you’ve earned from work over your lifetime. After you start receiving benefits, you will generally get a small increase in your benefits amount each January to account for changes in the cost of living.

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Does SSDI come with health coverage?

 

You will automatically qualify for Medicare after you get SSDI benefits for 24 months. Medicare coverage continues as long as you’re getting SSDI benefits, and for up to 93 months after your SSDI Trial Work Period ends.