Social Security…Understanding the Puzzle


ssi_applicationBy Guest Blogger Molly Clark
Writer for Social Security Disability Help Blog

Social Security Disability and Spinal Cord Injury
After sustaining a spinal cord injury, it can be very difficult to return to work and earn a living. The resulting loss of income can be financially devastating. If you find yourself facing similar circumstances, you may be eligible to receive Social Security Disability benefits. These benefits can help offset lost income due to unemployment and can help cover your daily expenses. Continue reading to see if you or a loved one qualifies for Social Security Disability benefits.

Step 1: Qualifying for SSD Benefits
The two largest federal benefit programs in the US are maintained by the Social Security Administration (SSA). These are the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. Individuals who have spinal cord injuries may be eligible to receive benefits from either program.

SSDI is intended to offer financial assistance to disabled workers and their qualified family members. To be eligible for SSDI benefits, an applicant will need to have worked and paid Social Security taxes for a significant amount of time.  This program is generally suited to older individuals.

SSI is intended to provide financial assistance to disabled individuals who earn little to no income. To qualify for SSI, applicants must fall within the specific financial limits set by the SSA. Because SSI has no work or tax-related requirements, it is generally the best fit for children or adults who haven’t had the opportunity to work.

To learn more about each of these programs, visit the following page:

Step 2: Meeting the SSA’s Medical Requirements
In addition to meeting the technical eligibility requirements above, applicants will also have to meet certain medical requirements.  These requirements are listed in the SSA’s official guide of qualifying symptoms and conditions—the Blue Book.  The requirements for an applicant with a spinal cord injury are listed under section 1.04 of the Blue Book.  These are explained below.

An applicant must experience the compromise of a nerve root or the spinal cord with one of the following:

– Evidence of nerve root compression characterized by pain, limited motion of the spine, motor loss, and sensory or reflex loss; OR
– Spinal arachnoiditis; OR
– Lumbar spinal stenosis

View this complete listing, here:

If you do not understand the technical or medical language used in the SSA’s Blue Book, it may be in your best interest to review this listing with your doctor. He or she can explain the requirements and can potentially provide you with the medical records needed to prove your eligibility.

Step 3: Preparing for the Application Process
Once you have reviewed the technical and medical requirements for disability benefits, you should begin preparing for the application process. This will include collecting the necessary medical and non-medical documents to support your claim. Medical documentation may include:

– A history of diagnoses
– Findings of physical and mental examinations
– Medication/ treatment and prognosis
– Laboratory tests and results
– Emergency room visit logs
– Surgical history
– MRI’s/X-rays
– Written statements from the applicant’s treating physicians

Non-medical documentation may include:

– Information about the circumstances surrounding your injury (specific incident, date, injury occurred)
– Statements from past employers about the effect your injury has had on your ability to work
– Different forms of identification
– Financial statements
– Employment records

For a complete list of requirements, visit the adult disability checklist.

Step 4: Applying for Benefits
After gathering all relevant documentation, you can submit your application online or in person at your local Social Security office.  It is important to note that if an applicant is unable to fill out the necessary forms, a family member or caregiver is allowed to file a claim on his or her behalf.

When completing the application paperwork, be sure to include all relevant details about your symptoms and conditions. The information you provide should give the SSA insight into your day-to-day life with a spinal cord injury.  Any missing or incomplete information could potentially cause your claim to be delayed or even denied.

Typically it takes around 3-5 months to receive a decision regarding your claim for benefits. Unfortunately, nearly 60% of initial claims are denied. If your claim is denied, do not give up. You are allowed to appeal the SSA’s decision within 60 days. Be sure to file your appeal within this time period. If you don’t, you will be required to start the application process over again.

Although it can be disheartening to be denied, the appeals process is often a necessary step toward receiving disability benefits. Many more applicants are approved during the appeals process than during the initial application.

For more information about applying for Social Security Disability benefits with a spinal cord injury, visit the following page:

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