Social Security Disability for the Injured

Traumatic accidents often precede Social Security disability claims. When a person is involved in a severe accident, the initial goal is to file a claim against the responsible party’s insurance carrier while the victim focuses on recovery. The idea is to get back to good health and return to work. 

 

However, as time goes on, injuries can take longer-than expected to heal, or heal but leave function worse than anticipated. Attention turns to whether the injured person can return to work, or whether they should file a Social Security disability claim. 

It is important to remember that filing a claim for disability means not only that the injured person can no longer do their past work, but that the person has lost the function to perform any other work that exists in significant number in the national economy, and will be in that state of health for at least a 12 month period.

 

Here is an example: While a 45 year old construction worker may clearly be unable to return to past work after a traumatic spine injury that required a fusion back surgery, the medical records may show adequate healing which, within 12 months, would recover to the capacity to do a sit down job, with ability to sit and stand for comfort accommodated during regular breaks in an eight-hour work day, to complete a 40-hour work week. Construction work is out of the question. However, there are a significant number of sedentary jobs in the national economy that fit this residual functional capacity. In this particular set of facts, the disability regulations will direct a finding that this person is Not Disabled. 

 

(If a traumatic injury heals and the person returns to work- or is expected to be able to return to work- before 12 months have elapsed, the claim will be denied for failure to meet the disability law’s duration requirement. Medical conditions like simple bone fractures with uncomplicated healing processes would fall in this category.)

 

The first thing to consider is whether the remaining impairment will likely prevent a successful return to most work. This presumes work as a 40-hour work week. 

 

Next, consider whether the personal injury settlement will interfere with filing a Social Security disability claim. Before Social Security looks at medical evidence to decide whether an injured person qualifies for disability benefits, there are technical issues that can impact the eligibility to even file a claim for benefits.

 

Social Security Disability pays benefits from two programs, disability insurance (this is what people frequently refer to as Disability) and Supplemental Security Income. You must meet technical eligibility requirements for at least one of the programs to be able to apply for benefits. 

 

The Social Security disability insurance program does not care how much money a person has. The question is whether the injured person worked long enough, and at high enough earnings, so that he is “insured” for disability benefits. Insured status is generally met when the person has worked seven of the last 10 years. To think about it like other types of insurance: the Social Security taxes taken out of your wages act like paying insurance premiums. If you don’t pay a premium then there is no insurance. If you paid premiums in the past but stopped, then the period of insurance coverage will begin to tick away until it ultimately “expires.” If the injury happens after the date last insured, Social Security can not pay this type of benefit. 

 

If the disabled person worked, but it was under the table and no taxes were taken out, then there is no coverage for Social Security disability. 

 

Supplemental Security Income, or SSI, places a limit on the amount of income and resources are available to a person. Think of it like a poverty-based disability program- the person must be found disabled but payment of benefits is means-tested. Generally, for single individuals the allowed amount is $2000 and for married persons the amount is $3000. Any amounts in excess would begin to count down from their SSI benefit. For example, a person can be found disabled but get $0 benefit due to excess income and resources. A settlement will likely outresource clients. If the injured person attempts to file while the settlement is still plentiful then they will receive a technical denial, meaning Social Security will not process the case on its merits- it will be screened out because, technically, the person is not eligible to file. This is not a permanent situation. Once the settlement is spent down then eligibility returns the month after the change in assets takes place.

 

This can be confusing. For help with a problem similar to this, you can call the Social Security disability law firm of Hall & Rouse at 1-866-425-5347, or fill out a contact form at our website, hall-rouse.com.