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Social Security Disability: An Overview

The Social Security Administration (SSA) provides benefits for disabled persons under two separate programs; Social Security Disability Insurance Benefits, also referred to as Title 2 benefits, and Supplemental Security Income.

The qualifications for the two programs are different:

Disability Insurance Benefits (also referred to as SSD, SSDI,DIB or Title II). Eligibility for SSD is based on the person’s work history. Workers earn “Quarters of Coverage”, also known as “Work Credits” or “Credits.” Workers earn a maximum of four quarters in each calendar year. In order to be currently insured, you must have earned 20 quarters within the most recent 10 year period. On other words, to qualify for SSD, you must have worked the equivalent of five years out of the past ten years. (The eligibility formula is different for workers who became disabled at age 30 or younger.)

Supplemental Security Income (also referred to as SSI or Title XVI). Eligibility for SSI does not depend on the applicant’s work history, but rather is needs based. The applicant’s eligibility is based on his or her household’s gross income and resources not exceeding established levels. This typically means that the applicant has less than $2,000 ($3,000 if married) in resources, which include savings, cash, assets which can be turned into cash, etc. An exemption is made for the person’s residence and, to an extent, an automobile.

Medical Criteria. While eligibility criteria for the SSD and SSI programs are different, the analysis for determining whether an applicant is disabled is virtually the same. To be considered disabled, one must ordinarily establish that he or she cannot perform past work and also that he or she is unable to perform other types of employment. The rules are less stringent for older workers with limited education and job skills. Special rules apply in the case of a child’s claim for Social Security Income. The Social Security Administration defines a disability as the inability to engage in substantial gainful activity (SGA) due to an impairment or combination of impairments. The condition must last or be expected to last for at least 12 months or to lead to death. The evaluation is complex, and the vast majority of claims are initially denied.

The Attorney’s Role. While the help of a disability attorney can be an asset at any stage of the application process – especially if the claimant is medicated, in chronic pain, or mentally impaired – expert help becomes especially crucial once a claim has been denied. During the next step of the process – a disability hearing before an Administrative Law Judge – an attorney can help you make a stronger case by providing the expertise necessary to gather appropriate medical evidence and ensure that the claimant asserts the strongest possible claim based on the facts and the applicable law.

Attorney’s Fees and Expenses. In nearly all Social Security disability cases, attorneys seek payment through the Social Security Administration’s fee agreement process. This process requires attorneys to charge the same fee, which is limited to 25% of the retroactive benefits, before deduction for expenses, that you and your dependents receive, or $6,000, whichever amount is lower. If the case proceeds beyond the initial Administrative Law Judge level, the $6000 maximum will not apply. No fee is charged unless you win your case. Upon winning the case, reasonable out of pocket expenses are charged in addition to the attorney’s fee. Expenses in Social Security Disability cases tend to be much smaller than in typical civil litigation and are typically $200 or less.

Tom Lemley

Bridgepoint Law Firm, LLC

75 W. Lockwood Ave., Suite 222

St. Louis, MO 63119

TEL: 314.925.0730

FAX: 314.735.4391

The choice of a lawyer is an important decision and should not be based solely upon advertisements. is operated by Bridgepoint Law Firm, LLC, a St. Louis law firm serving clients in applying for and appealing denials of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefit claims throughout St. Louis City and County, including the Missouri communities of Ballwin, Brentwood, Chesterfield, Clayton, Creve Coeur, Des Peres, Glendale, Kirkwood, Ladue, Maplewood, Maryland Heights, Olivette, Richmond Heights, University City, Webster Groves, Wildwood and Town & Country, and the eastern Missouri counties of St. Charles, Franklin and Jefferson, as well as the Southern Illinois counties of Madison, St. Clair and Monroe, including the communities of East St. Louis, Belleville, Granite City, Alton, Edwardsville, Collinsville and Fairview Heights.