An unexpected injury or illness can leave you wondering how you will pay bills and purchase basic necessities. You may wonder if you should take your chances filing a disability claim. Are you wondering if you qualify for disability? Several factors contribute to whether you qualify for disability and how much disability pay you may get in Georgia.

How to Qualify for Disability

Qualifying for social security disability insurance (SSDI) benefits is not a given. You must meet specific criteria to qualify. Among those are:

• You must have worked in SSA-approved jobs.
• Your medical condition must meet the Social Security Administration’s definition of a disability.

Generally, people who aren’t able to work for a year or more because of a disability are possible candidates for disability pay. If you are awarded benefits, you will typically receive them until you are able to work again. Several special rules exist to provide people with continued benefits and health care coverage as they transition back into the workforce.

If you are receiving SSDI benefits when you reach retirement age, those benefits will convert to retirement benefits. If your benefits convert, you will receive the same amount each month.

What About Work Criteria in Georgia?

Meeting the definition of disability isn’t enough to qualify you for benefits. You must also have enough recent work experience under Social Security rules to be eligible for benefits. You can earn up to four work credits each year, and the credits are based on your total yearly wages or your self-employment income for the year.

The amount of earned income that qualifies you for a work credit varies yearly. In 2022, you earn a single work credit for $1,510 in wages or self-employment income. So, you will have earned all four of your possible work credits when you earn $6.040.

The number of work credits you must have to qualify for disability varies depending on your age when your disability begins. Typically, you must have 40 credits. Twenty of those credits must be earned in the ten years immediately before when you filed for disability. Younger workers can sometimes qualify with fewer credits depending on the circumstances.

What the SSA Means by Disability in Georgia

The Social Security Administration has a different definition of disability than most other programs. Social Security will only pay for total disability. There are no benefits for short-term or partial disability.

Social Security rules consider following criteria:

• Your medical condition prevents you from working and engaging in substantial gainful activity (SGA).
• Your medical condition makes it impossible for you to do the work you did before or to adjust to other kinds of work.
• You have had your condition for at least a year, or it is expected to last a year or result in your death.

The definition of disability is strict. The SSA assumes that working families have other methods of providing for needs during times of short-term disability. The resources the SSA uses assume you have on hand include workers’ compensation, savings, insurance, and investments.

How the SSA Decides If You Have a Qualifying Disability

If you have enough work credits to qualify for disability benefits, a five-question step-by-step process determines if your condition qualifies. The five questions that will be asked are:

1. Are you currently working? The SSA has earnings guidelines that determine if you are engaged in a substantial gainful activity (SGA). As of 2022, if you make more than $1,350 a month, you can’t be considered as having a qualifying disability. If you aren’t working or you are determined not to be earning SGA, your application will be forwarded to the Disability Determination Service for further review.
2. Do you have a severe condition? Your condition must limit your ability to complete specific work-related activities. Some of the activities that are considered are standing, walking, lifting, sitting, or remembering. If those activities are limited for a minimum of one year, the SSA will move to the next question.
3. Is your medical condition on the approved SSA list of disabling conditions? The SSA has a list of medical conditions that it considers severe enough to keep someone from earning an SGA. If your particular condition is not on the list, the SSA must determine if your condition is as bad as a condition that is on the list. If your condition is on the list or is as severe as one that is, the SSA will likely rule you have a qualifying condition. If not, move to step four.
4. Can you perform the same work you did before? This is where it’s determined if your current condition keeps you from doing the job, or any part of it, that you did in the past. If you can still perform your original job, the SSA will decide your condition isn’t a qualifying disability. If you can’t perform your job, go to the next question.
5. Can you do any other work? If you can’t do what you did before, the SSA will attempt to determine if there is some other kind of gainful employment you could successfully have. Considerations when determining if you can still do other work are your medical condition, age, past work experience, education, and any skills you have that can benefit you in a job. If you can’t do any other work, the SSA will decide your condition is a qualifying disability. However, if you can do other work, your claim will be denied because it will be determined your condition isn’t a qualifying disability.

Disability Determination Process

Disability claims typically begin the process in a local Social Security field office. The field office verifies nonmedical eligibility requirements such as age, citizenship, residency, and employment. Once the information has been verified, the field office sends the information to the Disability Determination Service (DDS) for that office to evaluate the disability claim.

The DDS is a state agency that develops medical evidence and makes the initial decision regarding the claimant’s disability claim. Typically, the DDS will obtain evidence from the claimant’s personal medical sources first. If there is insufficient evidence to make a decision, the DDS may arrange for a consultative examination (CE) to get additional evidence. The person’s medical source is the preferred CE source for evidence, but the DDS can decide to use an independent source.

After the DDS gathers its evidence, the DDS makes a decision regarding disability. The DDS forms an adjudicative team that has a medical or psychological consultant and a disability examiner. This team either makes the determination based on the evidence already provided or requests more information or evidence from the medical source.

Once the DDS makes a determination regarding disability, the field office will take the case and complete the appropriate actions based on the DDS decision. If the DDS finds the claimant to be disabled, the SSA will complete the final paperwork, compute the benefit amounts, and start paying benefits. If the DDS denies the claim, the field office will keep the file so they are prepared if the claimant files an appeal.

The process for an appeal is basically the same as the initial determination process. The main difference is a different adjudicative team will make the determination regarding disability.

How Benefits Are Calculated in Georgia

Social Security Disability Insurance (SSDI) benefits are based on the income that was subject to social security taxes. Your average earnings, called the Average Indexed Monthly Earnings (AIME), are used to calculate your Primary Insurance Amount (PIA). The PIA is calculated by taking a percentage of your AIME based on the amount of income, and the final PIA calculation is the maximum amount of SSDI benefits you are entitled to receive.

Supplemental Security Income (SSI) is not dependent on your past work history. Instead, it’s a needs-based program. The maximum amount of SSI benefits you can receive is $841 as a disabled person and $1,261 if both you and your spouse are disabled. If you currently have an income, half of any amount you earn above $85 a month will be subtracted from your maximum benefit amounts to determine how much SSI you are eligible for.

Denials Are Common

Often, people who apply for disability will receive a denial at first. It should be understood that an initial denial is not proof that the person isn’t entitled to benefits. Many people who get denied walk away from their claim rather than attempt an appeal.

The appeals process can be intimidating to applicants. It’s essential to have a qualified disability attorney in your corner if you’ve been denied Social Security disability benefits. An attorney who is experienced in presenting disability claims can help you with both your initial application and with the appeals process.

Get in Touch with Our Experienced Disability Attorneys Immediately

If you’ve filed a disability claim and been denied, know that you aren’t alone. Many claims are denied at first. You have the right to appeal the decision. However, it isn’t something you want to tackle on your own.

Before you file your appeal, consult with a qualified disability attorney. The professionals at Morgan & Morgan have experience navigating Social Security disability law. If you have questions about your rights and responsibilities when it comes to filing a claim or an appeal, contact the team at Morgan & Morgan to learn how they can help you.

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