A Look Into Social Security Disability, Claims, And Benefits

  1. Statutory Definition B Section 223 of the Social Security Act, Title 42 U.S.C. § 423:

(d)(1) The term disability means: 

(A) the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment 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 twelve months;

i. To determine whether a claimant is disabled, a five-step sequential evaluation is made.

A finding that the claimant is not disabled at any point in the sequential evaluation process is conclusive and terminates the Commissioner’s analysis.

ii. The Five Step Evaluation:

Step One: A claimant who at the time of his disability claim is engaged in substantial, gainful employment is not disabled.

Step Two: A claimant will not be found disabled unless he has a severe impairment.

Step Three: A claimant whose impairment meets or is equivalent to a listed impairment will be deemed disabled without the need to consider vocational factors.

Step Four: A claimant who is capable of performing work he has done in the past must be found not disabled.

Step Five: If the claimant is unable to perform his previous work as a result of his impairment, then factors such as his age, education, past work experience, and residual functional capacity must be considered to determine whether he can do other work.



— Title II of the Social Security Act provides for the payment of insurance benefits to persons who have contributed to the program and who suffer from a physical or mental disability.

— To receive Social Security Disability benefits, you must have earned at least 20 credits during the last ten years and you must be fully insured. Twenty credits are equivalent to 2-3-month periods of work in which you have paid into the Social Security system and have earned enough money to secure a credit. There are some exceptions to this rule for younger workers.

— To be fully insured for purposes of disability benefits, you must have earned at least one credit each year between the time you attained the age of 21 and the year you become disabled, and you must have earned at least six credits.

In general you are considered permanently insured and you will not lose your fully-insured status when you stop working if you have earned the maximum of 40 credits.

—  Before the age of 24 – You may qualify if you have 6 credits earned in the 3-year period ending when your disability starts.

—  Age 24 to 31 – You may qualify if you have credit for working half the time between age 21 and the time you become disabled. For example, if you become disabled at age 27, you would need credit for 3 years of work (12 credits) out of the past 6 years (between ages 21 and 27).


— The DLI is the date that coincides with the last possible day that a claimant is entitled to SS benefit under Title II. There is no DLI in SSI cases.

— Normally the DLI extents for 5 years after the day that a Claimant last worked, however this is not always the case.
A claimant may have not accumulated enough quarters of coverage, or he may be too young. Specific guidelines are governing these cases.


— These benefits are paid to the minor children of a wage earner that receives Social Security disability or retirement benefits. If the wage earner has paid more than a minimum amount of Social Security taxes, SSA will pay benefits to the wage earner’s minor children.

— If certain conditions are met, the adult child of a retired, disabled or deceased worker may also receive benefits under the worker’s account.


— Under certain circumstances a widow(er) of a wage earner can receive benefits under the wage earner account.

— The person must be between 50 to 60 years old to be eligible with the claim.

— To qualify the person must meet these required conditions:

– The claimant is the widow(er) of a deceased number holder if he or she was related to the number holder as the number holder’s legal spouse, putative spouse, or deemed spouse.


— These benefits provide assistance to a claimant in need without regard to the claimant’s coverage under the Act for disability insurance benefits.

— To be eligible for SSI benefits, a claimant must be disabled and must have sufficiently limited income and resources.

— In contrast to the insured status eligibility requirements for disability insurance benefits, there are no eligibility period requirements for SSI benefits.

Despite meeting all of the criteria, an individual is not eligible for SSI if he or she: 

— Fails to apply for all other benefits for which he or she may be eligible.

— Other benefits for which a claimant/recipient must file, upon written notification, include annuities, pensions, Title II benefits (e.g., retirement, disability, widow’s, parent’s benefits), and payments similar to Veterans Pension and Compensation payments, Retirement benefits, Workers’ Compensation payments, Pensions, and Unemployment Insurance benefits.

— These benefits have the following characteristics in common. They require an application or similar action; have conditions for eligibility; make payments on an ongoing or one-time basis; and are sources of income that reduce SSI payments.

— In some cases, a resident of a public institution throughout a month may not be eligible for SSI benefits due to the following reasons:

– Has been outside the U.S. for 30 consecutive days (except for a child of a military parent stationed overseas or certain students temporarily abroad). Once an individual has been outside the U.S. for 30 consecutive days that an individual is not eligible for SSI until he or she has been back in the U.S. for 30 consecutive days.

– Does not give SSA permission to contact any financial institution to request any financial records that the financial institution may have about him or her.

An individual is ineligible to receive SSI benefits for any month during which he or she:

— Has an unsatisfied warrant for his or her arrest for a crime that is a felony or, in jurisdictions that do not define crimes as felonies, is punishable by death or imprisonment for a term exceeding 1 year regardless of the actual sentence imposed under the laws of the place from which the warrant is issued.

— Has an unsatisfied warrant for avoiding custody or confinement after conviction for a crime which is a felony or, in jurisdictions that do not define crimes as felonies, is punishable by death or imprisonment for a term exceeding 1 year regardless of the actual sentence imposed under the laws of the place from which the person flees; or

— Is violating a condition of probation or parole imposed under Federal or State Law.


A married couple’s income will be considered when an individual applies for SSI.

Two individuals are married for SSI purposes if they are:

— Legally married under the laws of the state where they make their permanent home (Note: all states must permit and recognize same-sex marriages);

— Entitled to Title II benefits, one as the spouse of the other; or

— Living together in the same household and holding themselves out as a married couple to the community in which they live.

— An individual must meet certain requirements with respect to the United States residency and citizenship or alien status to qualify for benefits.


An eligible individual must be a resident of the United States and,

Must be:

A citizen or national of the United States or

An alien lawfully admitted for permanent residence (LAPR) in the USA or

An alien permanently residing in the United States under one of the qualified alien categories.


Once you have all the requirements settled, head on over to an SSID office near you to file a claim.

You can also get a social security lawyer who can help you run down everything you need to know such as social security taxes, receiving benefits, and more.

Our attorneys at Workers’ Compensation LLC are always ready to assist you with social security disability benefits.

Call us at 504-608-6776 or visit our office at 3045 Ridgelake Drive, Suite 203, Metairie, LA 70002

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