October 2014

Are there conditions that automatically qualify for Social Security Disability?

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Serious disablement

Certain conditions are so debilitating that receiving Social Security Disability benefits may seem certain to victims. The Social Security Administration even recognizes some disabling conditions, which are invariably severe enough to merit benefits. However, even for Illinois residents who suffer from these conditions, a Social Security lawyer would tell them that approval for benefits is never automatic. Applicants must still meet non-medical criteria and provide sufficient medical documentation of the condition.

Disability evaluation process

Before considering whether a condition is disabling, the Social Security Administration determines whether an applicant meets income requirements. Applicants cannot have income greater than $1,070 per month, unless they are blind. Blind individuals may earn as much as $1,800 each month.

An SSD applicant also must have an adequate earnings record. The SSA gives an individual work credits based on his or her earnings. In 2014, every $1,200 earned counts as a credit, and 4 credits can be earned per year. Depending on age, an applicant must have between 6 and 40 credits. The applicant also must have earned half of these credits in the last 5 years.

If an applicant meets these criteria, the SSA then considers the applicant’s ability to work. If the applicant suffers from a condition listed in the SSA’s “Blue Book” of impairments, the condition is considered disabling. However, the applicant must meet a few requirements to receive benefits for the condition. These include:

  • Providing proper documentation, such as objective medical evidence and supporting statements from recognized medical professionals.
  • Proving the condition has lasted 12 months, is projected to last 12 months or is expected to result in death.
  • Establishing that the condition causes the symptoms or functional limitations outlined in the Blue Book.

Applicants who do not meet the third requirement may still receive benefits. The SSA may decide the applicant’s condition and its associated effects are equal in severity to a listed condition. If not, the SSA may evaluate the individual’s physical and mental capabilities to determine whether the condition is disabling.

Compassionate Allowances

The SSA has established a Compassionate Allowances program, which focuses on severe conditions that virtually always qualify for Social Security Disability coverage. This program allows applicants to provide basic medical documentation and qualify for benefits quickly, due to expedited processing.

The SSA currently recognizes 225 Compassionate Allowances conditions. Some of these are considered unconditionally disabling. Others must display certain characteristics, such as recurrence or inoperability. Conditions that lack these characteristics are evaluated under the Blue Book impairment listings or based on the functional limitations they cause.  

Seeking disability benefits with an ex-spouse’s record

Pulse being taking on a middle aged man's wrist

Ex-spouses and Social Security Disability

When some people go through a divorce, they rely on the ex-spouse for financial assistance. If the person receiving support or the ex-spouse becomes disabled, a Social Security attorney in Illinois may be able to help the recipient claim benefits through the Social Security Disability program. These benefits are awarded based solely off of the earnings record and eligibility of the ex-spouse. Thus, these benefits can be significantly easier to obtain.

Qualifying criteria

The Social Security Administration only awards disability benefits to ex-spouses if both spouses and the marriage meet the following requirements:

  • One of the individuals must be disabled and have enough of an earnings record to qualify for SSD benefits.
  • The other ex-spouse must be older than 62 and unmarried.
  • The ex-spouse must be incapable of collecting a greater benefit amount based on someone else’s earnings record.
  • The marriage must have lasted at least 10 years.

An ex-spouse may collect up to 50 percent of the qualifying spouse’s benefit amount. If the qualifying spouse remarries, the entitlement of the ex-spouse is not affected. Similarly, the ex-spouse’s benefit does not affect the benefit amount that the qualifying spouse’s current spouse and children receive.

To request benefits, the ex-spouse should contact the SSA by phone. The ex-spouse will need to supply his or her Social Security number and marriage certificate. People who have been married more than once should also be prepared to answer questions about the past marriages. These questions let the SSA ascertain whether a higher benefit award is available through a different ex-spouse’s earnings record.

Complicating factors

Ex-spouses lose their rights to the disabled spouse’s benefits if they choose to remarry. If the new marriage ends through annulment, divorce or death, however, the ex-spouse may be able to resume collecting spouse’s benefits. Before approving benefits, the SSA will consider whether the ex-spouse could qualify for a greater benefit amount through the earnings record of his or her most recent spouse.

If the qualifying spouse passes away, the ex-spouse can still collect benefits. Depending on the ex-spouse’s age, marital status and health, the survivors benefit may exceed the value of the spouse’s benefit. The maximum survivors benefit is 100 percent of the deceased spouse’s benefit.

Under certain circumstances, surviving ex-spouses who choose to remarry may continue collecting survivors benefits. Marriage after age 60 does not affect a surviving spouse’s right to a survivors benefit. Surviving ex-spouses who are disabled can remarry after age 50 without losing their survivors benefits.

Often, people who have remarried or lost an ex-spouse do not understand what kind of benefits they are eligible for. These individuals may want to consider working with a Social Security attorney to ensure that they receive any spouse’s or survivors benefits they are entitled to.