Baby boomers (like me) aren’t just getting old. Some of us are also getting frail. I’m probably a pretty good example. After a lifetime of essentially good health, I’ve recently had to deal with issues as severe as blood clots and as minor as a bum knee and arthritis.
And judging from my emails, I’m not alone. Many older folks are asking me about getting disability benefits from Social Security. I'll offer some tips on how to go about doing that in a minute. But first, here are some ground rules.
If you are over your full retirement age, forget about it. Once you reach that age, disability benefits are no longer payable. Or to put that another way, the retirement benefit you are getting pays the same rate as any disability benefits you might be due.
If you are under age 62 and disabled, then you should definitely file for Social Security disability. If you are over 62 and not yet on Social Security, then you should file for retirement and disability benefits at the same time. The Social Security Administration can start your retirement payments right away. Then if your disability claim is eventually approved, they will switch you to the higher disability rate.
But if you are between age 62 and your full retirement age, and are already getting Social Security retirement benefits, you may or may not be eligible for disability payments. Or to be more precise, the closer you are to your full retirement age, the smaller your disability boost will be—and you may decide it’s just not worth all the hassle.
That’s because your disability rate (normally equal to your full retirement age benefit) must be reduced for every month you’ve already received a Social Security retirement check. And you will eventually reach a point where you simply gain very little by filing for Social Security disability.
Here is a quick example of that. Sam filed for retirement benefits at age 62. His benefit was reduced roughly one-half of 1 percent for each month he was under his full retirement age. He is getting 75 percent of his FRA rate. At 65, he had a heart attack. If he files for disability benefits and if his claim is approved, his regular disability rate, again equal to his FRA benefit, must be reduced by about one-half of one percent for each month he’s already received a retirement benefit. At age 65, he’s received 36 retirement checks, so his disability rate must be cut by about 18 percent. So instead of a 100 percent disability rate, he'd get about 82 percent. Sam would have to decide if it is worth all the hassle of filing for disability just to get bumped up from his current 75 percent rate to 82 percent.
I’ve used the phrase “all the hassle” twice already. Let me tell you what the hassle is by giving you a quick rundown of the Social Security disability application process.
First, you will fill out a bunch of papers. The primary one is a form that asks you to describe your disability and how it prevents you from working. That latter point is the key. You don’t get disability benefits simply because you have some kind of physical or mental impairment. You get disability benefits because you have a physical or mental impairment that keeps you from working. So, you must describe in detail how your disability prevents you from doing your job.
That same form also asks you to list your medical providers. The government can’t make a decision about your case without having the evidence to back up your claim. So, make sure you thoroughly list the names, addresses, phone numbers and any other contact information you have for every doctor, hospital, clinic, or other medical professional from whom you’ve received treatment.
The Social Security Administration contracts out disability decisions to an agency in each state that is staffed with doctors and other medically trained personnel. They are the folks who decide if you meet the legal definition of “disability” for Social Security purposes. In a nutshell, the rules say your impairment must be one that will keep you from doing any kind of work for which you are suited and one that is expected to last at least 12 months.
There is a pretty good chance you will be asked to go to a Social Security doctor for additional evaluation. Make sure you don’t miss that appointment.
Your disability claim will usually take about three months to process. If it’s approved, you'll start getting disability checks six months after they say your disability began. (That six-month waiting period is built into the law.)
If your claim is denied, you will have to decide if it is worth it to appeal that decision. If you decide to do that, the first appeal is usually just a review of your case by the state agency that made the first decision. If your claim is denied again, then you can file for a hearing before a Social Security judge. Because of backlogs, those hearings can take about a year to set up.
By the way, the “word on the street” is that all disability claims are denied the first time and that it takes a year or more to get a final decision. That’s just not true. About 35 percent of all disability claims are approved the first time in that three-month window I mentioned earlier. Another 15 percent or so are approved after the first appeal. It’s only those claims that end up in the hearing judge’s backlog that take a long time to process.
Do you need a lawyer to handle your disability claim? Quick answer: not right away. You certainly don’t need legal help to file a disability claim or to file for the first review if the claim is denied. But if you find yourself heading for a hearing before an SSA judge, many folks feel more comfortable having a lawyer there to represent them. Just be aware that they are usually going to take about 25 percent of any back pay benefits you receive if they win the case for you.
Also, let me make a quick point about Supplemental Security Income disability benefits. So many people confuse the SSI program with Social Security disability benefits. They are two completely different government programs. SSI is a welfare program. Only the poorest of the poor will qualify for SSI benefits. My guess is that almost everybody reading this column would not be eligible for SSI benefits. But if you are disabled, and if you meet the eligibility criteria explained in this column, then there is a pretty good chance you will qualify for Social Security disability benefits.
