The Social Security Administration was formed in 1935 as part of President Franklin Delano Roosevelt’s “New Deal” to provide retirement benefits to American workers. Building on that, in 1956, Social Security Disability Insurance (SSDI) came into being to protect workers if they faced illness or injury that rendered them unable to work.
Social Security is funded by workers who pay in through mandatory wage withholdings via the Federal Insurance Contributions Act (FICA) taxes. Two trusts are funded by these monies: the Old-Age and Survivors Trust and the Disability Insurance Trust.
SSDI’s definition of disability
An individual is considered disabled if their physical or mental impairment is either terminal or has lasted or will last a minimum of 12 months and prevents them from engaging in substantial gainful activity (SGA).
Five-step sequential evaluation process
Disability claims are evaluated using a statutorily defined formula where the following factors are looked at:
- Current work activity level (i.e., SGA): If it exceeds the set threshold, the claim halts right there
- Severity of the medical impairment as substantiated by medical records
- Whether the impairment maps to the listings of medical impairments the program finds cognizable
- Claimant’s residual functioning capacity and ability or lack thereof to do work done in the past
- Claimant’s residual functioning capacity and ability or lack thereof to do some other type of work
In Massachusetts, there are over 30 Social Security Administration offices where an SSDI application can be filed. If initial criteria are met, the claim is forwarded to Disability Determination Services in Boston or Worcester for medical eligibility assessment.
It’s certainly possible to go through this claim filing process alone, but it’s akin to managing a complex tax return. Considering the many pitfalls and that many claims are denied, professional support is likely advisable.