Many Social Security Disability Applicants Don’t Understand Role of Work History, Allsup Reports

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Thousands of SSDI applications are denied from lack of recent work credits

David Bueltemann

Though you have a disability, the type of work you’ve done before will factor into the SSA’s determination about your disability claim. First and foremost, you must have worked long enough and recently enough to be eligible to apply for SSDI.

Hundreds of thousands of people are denied disability benefits each year because they lack the work history needed for eligibility, according to Allsup, a nationwide provider of Social Security Disability Insurance (SSDI) representation and Medicare plan selection services.

The Social Security Administration (SSA) reported the number of technical denials among disability applications has grown from a little over 100,000 in 1999 to more than 650,000 in 2007.1 Technical denials are applications denied for nonmedical reasons. The most common reason for technical denials, the SSA said, is “insufficient number of recent work credits.”

“Work history plays an important part in your application for Social Security disability benefits,” said David Bueltemann, manager of senior claims representatives at Allsup. “Though you have a disability, the type of work you’ve done before will factor into the SSA’s determination about your disability claim. First and foremost, you must have worked long enough and recently enough to be eligible to apply for SSDI.”

SSA follows a five-step sequential process to evaluate applications for disability benefits, and examiners make decisions based on medical documentation, age and work history, among other factors. “Allsup often helps claimants with questions about work history because it can be a confusing area when applying for Social Security disability benefits,” Mr. Bueltemann said.

SSDI is a federally mandated insurance program overseen by the SSA that operates separately from the retirement and SSI programs. SSDI provides monthly benefits to individuals who are under full retirement age (age 65-67) and who can no longer work because of a disability (injury, illness or condition) that is expected to last for at least 12 months or is terminal. Individuals must have paid FICA taxes to be eligible. Find more about Social Security disability applications on Allsup.com.

Social Security Disability Benefits and Work History
To help applicants, Allsup explains four areas where work history plays a role in someone’s claim for Social Security disability benefits.

1.    Work history documents that you are currently insured. Working taxpayers contribute to the federal Social Security Disability Insurance program through their Federal Insurance Contributions Act (FICA) taxes. You paid these payroll taxes through your employer or as a self-employed worker. “You are probably aware that a portion of your taxes paid goes to the Social Security retirement and Medicare programs, as well as the SSDI program,” Mr. Bueltemann explained.

To be eligible for SSDI benefits, you must be “currently insured,” which means that you have made recent FICA payments. Specifically, you must have paid for 20 quarters in the past 10 years to qualify. You can “buy a quarter” by earning a certain amount during a specific calendar year. In 2010, workers buy a quarter if they earn $1,120; with a maximum of four quarters in one year. Those who experience disability and must quit working before age 31 have lesser requirements.

2.    Work history documents that you are fully insured. This is a second qualifier used to determine if you are eligible for SSDI benefits, and it’s also based on your quarters of coverage. If you have 40 quarters of coverage, you are fully insured. (Note: You can earn up to four quarters a year.) The SSA uses another calculation for younger workers—using six quarters of coverage, plus one quarter of coverage for each year after the year you reach age 21. For example, a person age 27 likely only needs 12 quarters of coverage to be fully insured.

3.    Work history details also factor into the SSA’s determination of whether you are disabled. “The disability examiner will look at your disability, medical condition and your work experiences when deciding your case,” Mr. Bueltemann said. They evaluate your ability to perform work you did in the past, as well as any type of work you may be capable of performing. Employment experiences from the past 15 years are relevant to your application. Read about general disability guidelines on Allsup.com.

4.    Work history also factors into your amount of benefits. The SSA tracks your earnings and taxes paid over time in order to determine your Social Security retirement and, separately, your SSDI benefits. This is based on records filed by your employer, who is required to send the SSA a copy of your W-2 form each year. Find more information about understanding your Social Security statement on Allsup.com.

If you’re not certain you are eligible for SSDI based on your work history, contact the Disability Evaluation Center at (800) 279-4357 for a free evaluation. An Allsup professional can help you determine if your work history and medical condition(s) may qualify you for SSDI benefits.

1 – Annual Statistical Report on the Social Security Disability Insurance Program, 2008; released July 2009.

ABOUT ALLSUP
Allsup is a nationwide provider of Social Security disability, Medicare and Medicare Secondary Payer compliance services for individuals, employers and insurance carriers. Founded in 1984, Allsup employs nearly 700 professionals who deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. The company is based in Belleville, Ill., near St. Louis. For more information, visit http://www.Allsup.com.

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Rebecca Ray
Allsup
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Allsup
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