“Back pain” covers a broad spectrum, from the morning ache and stiffness many people experience with age to injury-related pain that makes it impossible to engage in normal daily activities. According to the Health Policy Institute at Georgetown University, nearly 65 million Americans report recent issues with back pain. Obviously, they aren’t all eligible for Social Security disability (SSD).
In most cases, it isn’t the back pain itself that qualifies a person for SSD benefits, but the underlying injury or condition that is causing the pain.
Listed Conditions Causing Back Pain
To qualify for SSD benefits, an applicant must show that their medical condition is so severe that they are unable to engage in substantial gainful activity (SGA). There are two ways to do that. One is to meet or equal the criteria for one of the conditions listed in the Social Security Blue Book. The other is to show that your residual functional capacity is too limited to allow you to engage in SGA.
The Blue Book section on musculoskeletal conditions contains listings for some back conditions, but you may not immediately recognize whether your condition is listed. For example, the listing refers to “conditions of the skeletal spine resulting in compromise of a nerve root.” That may include conditions such as herniated discs, spondylosis, and spinal stenosis. But, they aren’t listed by name, and not every incidence of these conditions will be sufficient to meet the listing.
An experienced SSD benefits advocate can help you determine whether your condition falls within a listing, and what type of documentation will be required to establish that you meet that listing. If you don’t meet or equal a listing, you may still qualify for SSD.
Establishing Disability Outside the Listings
Sometimes, a person will meet the SSA’s definition of disability, but won’t fall within listing criteria. That may be because the medical condition is rare or newly discovered, or because it isn’t usually as serious as the applicant’s case. Or, it may be because the applicant suffers from two or more medical conditions, and is disabled by the combination rather than a specific condition.
If you don’t qualify based on a listing, the SSA will look at a combination of factors, including the level of work you are currently able to perform (residual functional capacity), your educational background, the type of work you’ve done in the past, and your age. These factors will help them determine whether there is still work you can do in spite of your medical limitations.
Medical Documentation is Critical
Whether you are aiming to show that you meet a listed condition or based on the grids, having thorough medical documentation will be critical. One challenge in securing SSD benefits for back pain is that pain doesn’t show up on an x-ray, and it can be difficult to prove how much pain limits your activities. Tests documenting the underlying condition, doctors’ notes, and other medical information is critical.
Get Help with Your SSD Claim for Back Pain
The success or failure of your SSD claim may depend on the quality of information you provide. Fortunately, you don’t have to navigate the process alone. To learn more about how our experienced disability benefits advocates can help, call 800-800-3332 or fill out our contact form here.
The Social Security Blue Book includes numerous types of cancers as listed conditions. Each of the different type listed has its own specific criteria. But it’s also possible to receive SSD benefits for cancers that aren’t listed, or when your type is listed but you don’t meet the listed criteria. It’s also possible to have an active diagnosis and not qualify for SSD because you don’t meet the Social Security Administration (SSA) definition of “disabled.”
The best way to find out whether you may be qualified for SSD and how to submit the strongest application possible is to talk to an experienced disability benefits advocate.
Cancer Claims are Similar to Other Types of SSD Claims
While the Blue Book lists criteria for many specific conditions, including many specific types of cancer, the underlying eligibility requirements for SSD are the same for everyone.
To receive SSD benefits for any condition, you must show that:
You have accrued sufficient Social Security work credits to be eligible for disability,
Your disability has lasted or is expected to last for at least 12 months or to be terminal
Like most other types of SSD claims, cancer-related claims rely heavily on medical evidence.
Some types of evidence that may be required to establish an SSD claim for cancer include:
Diagnostic records
Treatment records
Blood tests, scans, and other test results
Doctors’ notes
It can be difficult to know what information is necessary to support your SSD application. You may find that additional testing or exams are required to establish your claim. On the other hand, a records dump can be counterproductive. An experienced disability benefits advocate can help you put together the strongest documentation possible without overwhelming the reviewer.
Expedited SSD Processing
The SSA maintains a list of conditions that may qualify an SSD applicant for “compassionate allowance.” That list includes several types of cancer. The compassionate allowances program aims to identify certain types of claims and deliver a quicker decision, which can mean benefits are received sooner.
Supporting Cancer Patients Seeking SSD Benefits
Our advocates know how daunting the SSD application process can be. We also understand that the added stress is the last thing you need if you’re fighting cancer or managing another debilitating medical condition. We’ve developed an in-depth knowledge of the SSD application and appeals processes so you don’t have to. To learn more about how we can help, call us today at 800-800-3332 or fill out our contact form here.
You probably know that a U.S. worker who is medically unable to work may be eligible for Social Security disability (SSD) benefits. If a worker meets the SSA’s definition of “disabled” and has accumulated sufficient work credits, they may receive a monthly benefit in the same amount they would have received in retirement benefits. After two years, a disabled worker on SSD is also eligible for Medicare coverage.
What you may not know is that certain family members of an SSD recipient may also be eligible for benefits. Here’s what you need to know about who qualifies and how benefits are determined.
Who Can Get SSD Family Benefits?
Under certain circumstances, the following family members of disabled workers may receive benefits:
A spouse who has been married to the SSD recipient for at least one year
A former spouse who was married to the SSD recipient for at least 10 years
An unmarried minor child of the SSD recipient
An unmarried child of the SSD recipient who is 18 or 19 years old but still in high school
An unmarried disabled adult child of the SSD recipient
Under certain limited circumstances, other family members may be eligible for benefits.
In the most recent year reported, the Social Security Administration (SSA) paid SSD family benefits to more than 90,000 spouses and former spouses and more than 1.1 million children of SSD recipients. The vast majority of those children were under the age of 18.
There are some additional requirements for a spouse or former spouse to be eligible for SSD family benefits. The spouse or former spouse must also either:
Be at least 62 years of age
Be disabled
Be caring for a child younger than 17, or
Be caring for a child 17 or older who is disabled
How are SSD Family Benefits Determined?
Unlike many other types of benefits, SSD benefits are determined based on the individual disabled workers’ past earnings and contributions. Since SSD family benefits are based on the disabled workers’ benefits, that means those benefits also vary based on the SSD recipient’s past earnings.
An eligible family member may receive up to 50% of the SSD recipient’s monthly benefit amount. However, total family benefits are capped. So, if there are multiple family members who qualify for benefits, the benefit amounts may be reduced so as not to exceed the cap. However, benefits paid to a former spouse don’t count toward the family maximum.
Disability Help Group is Here for You
The seasoned advocates at Disability Help Group work hard every day to make sure disabled workers and their families have access to the benefits they’ve earned. To learn more about how we can help your family, call 800-800-3332 or fill out our contact form here.
Better customer Service for SSD Benefit Applicants
If you’ve tried to apply for Social Security disability (SSD) or other benefits through the Social Security Administration (SSA), you might have been frustrated by the process and the customer service. If you felt like it took too long to process your claim or had trouble getting someone on the phone when you needed help, you’re not alone. Big changes may be on the horizon.
In the spring, SSA Commissioner Martin O’Malley appeared before a subcommittee of the U.S. House Ways & Means Committee to discuss a variety of issues, including “the efficiency and operation of the Administration itself.”
Understaffing and Other Hurdles Have Created Backlogs
O’Malley said that despite having more “customers” than ever before, SSA staffing was at a 27-year low. That reduced staff handled about 81 million calls last year–no surprise when you consider that more than 10,000 people become eligible for Social Security benefits every day. That’s created delays in getting customer service, delays in initial SSD determinations, and delays in SSD appeals.
Based on data shared at the hearing, the average wait time when someone called the SSA at the beginning of 2024 was 39 minutes, with some callers waiting more than an hour. While O’Malley said the average wait time was down to 31 minutes by spring, he called that figure “nothing to write home about” and said the SSA continued to work to get that time down.
He said the average SSD applicant was waiting nearly 8 months for an initial determination, and another seven months if they had to appeal. Now, the SSA is carving out time regularly to meet on several key performance areas, including:
Operations
Human resources
Initial disability determinations
ALJ hearings
Fraud
Notices
Overpayments
O’Malley Seeks to Change the Culture at the SSA
During the hearing, O’Malley was asked if he could change one thing that would last beyond his role at SSA, what it would be. He responded that he would like to change the culture at SSA to realize that all of the huge numbers they deal with are real people. He also said the agency is looking toward more sophisticated information-sharing processes to streamline procedures, reduce overpayments, and speed up processes. An improvement in the customer service at the SSA could make a big change in the experience each person has.
O’Malley is still relatively new in the role, and some changes to the system would be subject to formal rulemaking procedures or require Congressional approval. So, the exact nature and extent of the changes haven’t fully been determined. However, improved efficiency and customer service have the attention of the new Commissioner and others in government.
Delays Aren’t the Only Problem with the SSD Process
Improved customer service can make the SSD application and appeals process less frustrating, but it won’t necessarily improve outcomes. If you need help securing SSD benefits or fighting a denial, an experienced disability benefits advocate can be your best resource. To learn more, call Disability Help Group at 800-800-3332 right now or click here for a FREE consultation.
Will I Lose My SSD Benefits if I Move to a Different State?
Social Security disability (SSD) is a federal program based on your work history and contributions to the program through payroll taxes. Your eligibility for SSD won’t change if you move from one U.S. state to another. In fact, you can often continue to collect SSD benefits while living in a foreign country. However, Medicare benefits are generally only available to those in the United States.
While earned income is considered in determining SSD eligibility, other types of income and resources are not. So, if the SSD recipient is moving to another state because they inherited a $500,000 house or because they can live rent-free with a family member, that won’t have any impact on their benefits. However, there is one way a move–whether in-state or outside the state–can hurt the benefits you’re receiving from the Social Security Administration (SSA). That’s if you neglect to inform them. You must keep the SSA up to date on your whereabouts. Fortunately, the SSA makes it easy to update your contact information.
Supplemental Security Income (SSI) is Different from SSD
SSD and SSI are both administered by the SSA. However, the two programs are very different. While SSD benefits are based on the work credits you earned across your career, SSI is a need-based public benefit.
Like SSD, SSI is a federal program. However, some states offer supplemental payments to elderly and disabled residents who qualify for SSI. That means that the total amount of benefits an SSI recipient gets may change if they move from one state to another. It’s also worth noting that because SSI eligibility is based on income, certain changes in living arrangements may affect eligibility. For example, if an SSI recipient moves from one state to another to move in with a family member who will provide lodging and food at no cost, that may affect the SSI calculation.
Know Your SSD Rights
Whether you’re just applying for SSD benefits, are receiving benefits, and are concerned about how a change in your circumstances may affect your eligibility or are appealing a denial of SSD benefits, the process can be complicated and confusing. An experienced disability benefits advocate can be your guide. To learn more about how the knowledgeable advocates at Disability Help Group can assist with every stage of the SSD application and appeals process, call 800-800-3332 right away or click here to get a FREE evaluation of your case.
