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Survivors Old-Age and Disability Insurance

Disability Benefits

A person who becomes unable to work and expects to be disabled for at least twelve months or who will probably die from the condition can receive Social Security payments before reaching retirement age. A worker is eligible for disability benefits if she or he has worked enough years under Social Security before the onset of disabilities.

A disability is any physical or mental condition that prevents the worker from doing substantial work. Examples of disabilities that meet the Social Security criteria include brain damage, heart disease, kidney failure, severe arthritis, and serious mental illness.

The SOCIAL SECURITY ADMINISTRATION (SSA) determines whether a person's disability is serious enough to justify the awarding of benefits. The SSA determines whether the impairment is so severe that it significantly affects "basic work activity." If the answer is yes, the worker's medical data are compared with a set of guidelines known as the Listing of Impairments. If the claimant is found to suffer from a condition contained in this list, payment of the benefits will be approved. If the condition is less severe, SSA determines whether the impairment prevents the person from doing his or her former work. If not, the application will be denied. If so, a determination is made as to whether the impairment will prevent the applicant from doing other work present in the economy.

At this point SSA uses a series of guidelines that attempt to combine consideration of the applicant's residual functional capacity with the factors of age, education, and experience. The guidelines classify work into three types: sedentary work, light work, and medium work. If the SSA determines that an applicant can perform one of these types of work, it will deny benefits. A claimant may appeal this decision and ask for a hearing in which to present further evidence, including personal testimony. If the recommendation of the ADMINISTRATIVE LAW judge conducting the hearing is adverse, the claimant may appeal to the Social Security Administration's Appeals Council. If the claimant loses the appeal, she or he may file civil action in federal district court seeking review of the agency's adverse determination.

Three types of benefits are available to persons who meet the OASDI disability eligibility requirements: monthly cash payments, vocational

rehabilitation, and medical insurance. Cash payments begin, provided proper application has been made, with the sixth month of disability. The amount of the monthly payment depends on the amount of earnings on which the employee has paid Social Security taxes and the number of eligible dependents. The maximum for a family usually equals roughly the amount to which the disabled employee is entitled as an individual plus allowances for two dependents.

Vocational rehabilitation services are provided through a joint federal-state program. Persons receiving cash payments for disability may continue to receive them for a limited time after they begin to work or near the end of a program of vocational rehabilitation. This period is referred to as the "trial work period" and may last as long as nine months.

Medical services are available through the MEDICARE program in which a recipient of OASDI disability benefits begins to participate twenty-five months after the onset of disability.

Additional topics

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