DI (Disability Insurance) vs. Severity of the Condition

by | Published on Feb 9, 2015 | Medical Record Review

Social Security disability benefit is calculated based on the amount of a person’s lifetime earnings before the onset of the disability, and not the degree of severity of the condition. A disability claim is approved on the basis of a comprehensive medical review to establish the seriousness of the disability. Disability requirements include:

  • Claimant must have been employed for the adequate number of years
  • Must meet a stringent medical definition of disability based on the inability to work

As regards the definition of disability, the claimant cannot do the work he/she was previously doing, cannot do other work because of the disability, and the disability must have lasted or is expected to last at least for a complete year. Detailed information is provided on the SSA website www.socialsecurity.gov.

People receiving DI will become eligible for Medicare after 2 years. The monthly disability benefit paid depends on the number of years a person has been working and the amount he/she paid to Social Security in the form of payroll deductions. A person who earned more would have paid more into Social Security and therefore the benefits granted will also be larger. Disability benefits do not increase with increasing severity of a condition. The benefits will increase though in keeping with the periodic COLA (Cost of Living Adjustment) increase.

Social security disability lawyers provide valuable support to people applying for disability benefits. They review the applicant’s medical records, typically with the help of reliable medical record review services, to decide eligibility and help prepare the disability claim. Moreover, if a claim is denied they also appeal on the claimant’s behalf and strive to get it granted. Though the administration approves only just more than a quarter of the applicants, an additional 13% or so qualifies on appeal.

The SSI (Supplemental Security Income) program administered by Social Security is a different program that is need-based. SSI benefits change with changes in income, living arrangements and marital status. It is a welfare program for disabled, aged and blind individuals and couples who do not qualify for Social Security and do not have sufficient income/assets. SSI benefit is a fixed amount that is the same for everyone. For the year 2015, the monthly maximum federal amounts are $733 for an eligible individual, $1,100 for an eligible individual with an eligible spouse, and $367 for an essential person. More comprehensive details are available here.

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