What Factors Are Considered When Determining Disability Benefits?

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The Social Security Administration (SSA) and the Disability Determination Service (DDS) will examine several aspects of your claim to see if you are eligible for benefits. They’ll use that information to figure out how much money you’ll get in benefits.

They will assess whether you are employed or able to work, the severity of your medical condition, and if it is listed in the Social Security Administration’s Blue Book, which is a list of medical conditions that qualify for disability payments.

They’ll also check your record to see how much disability insurance you have through your employment credits and whether they’re enough to qualify you for Social Security Disability Benefits (SSDI).

If you don’t have enough credits, you could still be eligible for a benefit, but it will be through Supplemental Security Income (SSI), which is means-tested, meaning that the amount you receive will be determined by your assets and any income you generate.

Do you have a job?

Because one of the requirements for Social Security Disability Benefits is that your medical condition prevents you from working a job for a minimum of 12 months, the SSA will look at whether you’re working or not.

Is your ailment classified as “severe”?

Your illness must be so severe that you are unable to work in any capacity.

If you are unable to provide sufficient medical evidence that your disability is serious, the SSA may ask you to participate in a Residual Functioning Capacity (RFC) test, which is conducted by your doctor and assesses your physical and mental capacity, such as your ability to move around, sit and stand in one position for extended periods of time, how much you can lift, and how well you can concentrate on various tasks.

Is there a reference to it in the Blue Book?

The Social Security Administration will check to see if your ailment is listed in the Blue Book, since if it is, your disability benefits claim is more likely to be accepted. A medical issue may not be included separately but rather as one of numerous lists, making it more difficult to determine your eligibility for disability benefits.

Are you able to work?

The Social Security Administration will assess whether you can accomplish the work you’ve done before or whether there is any other work you might be able to do. If it is discovered that you can still work, your claim is less likely to be approved.

The Social Security Administration (SSA) sometimes analyzes your age, assuming that if you are older, you are less likely to be able to learn new skills and hence are more likely to have your disability application approved.

Find out if you’re eligible for assistance.

A lawyer or social security advocate may be able to assist you in determining your eligibility for benefits. They can check your disability insurance record to see if you’ve accumulated enough work credits. Take a free case evaluation, contact an attorney or advocate if you need assistance understanding your disability insurance record.

For Social Security Offices in San Antonio, Texas, there’s plenty of offices to choose from to complete your Social Security Disability Benefits application if you prefer to do it in person instead of online.

Social Security Disability Family Benefits Explained

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Some of you have applied for disability benefits and learned that some family members might be eligible to receive benefits as well. We wanted to break down exactly what family benefits are so you’re well versed to begin maximizing the amount of the benefits that you can receive for not only yourself but for your family. To start, here is who can receive benefits on your record:

  • spouse
  • divorced spouse
  • children
  • disabled child
  • adult child disabled before age 22

When any eligible member of your family goes to apply for benefits, be prepared to submit their Social Security numbers as well as their birth certificates.

The Social Security Administration (SSA) may ask for proof of marriage and dates of prior marriages, if available when your spouse applies for benefits.

Maximum Allowed Family Benefits

Each member of your family can qualify for a monthly benefit of up to half of your disability benefit amount. However, the SSA imposes a limit on the amount paid to your family in benefits.

The total amount allowed is dependent on your benefit amount and the number of family members eligible for benefits. The amount varies, but typically the total amount allowed for your family to receive is between 150 and 180 percent of your disability benefit amount.

If the total of benefits paid to your family is larger than the family cap, the benefits paid to your eligible family members will be reduced accordingly. Your personal benefit amount will not be changed.

If you have a divorced spouse who is eligible for disability benefits, their amount will not alter the benefits paid to your or your family.

Spousal Benefits

Your spouse is eligible for your spouse when:

  • Your spouse reaches age 62 or older unless your spouse decides to collect a higher Social Security benefit based on their earnings record. The benefits paid to your spouse will be reduced by a percentage dependent on the number of months until their full retirement age, this reduction cannot be appealed or reversed.
  • At any age where your spouse is caring for your child under age 16 or disabled. Your spouse will be paid benefits until the child reaches age 16. When that happens, the child’s benefits continue, but your spouse’s benefits are stopped unless they are old enough to receive retirement benefits (minimum of age 62) or survivor benefits as a widow or widower (age 60).

If Your Spouse Also Worked Under Social Security

If your spouse qualifies for retirement benefits on their own record, the SSA will always pay that amount before anything else. However, if the spouse benefit that is paid on your record is larger, your spouse will receive a combination of benefits that sums to the higher amount.

Your spouse’s Social Security benefit on your record may also be affected if your spouse will receive a pension based on work that is not recognized by the Social Security Administration, such as foreign or under the table work.

Benefits For Your Divorced Spouse

Even if you remarried, your divorced spouse might still be eligible for benefits on your account.

As stated previously, if your divorced spouse will receive a pension based on work not recognized by the SSA, their Social Security benefit on your account may be affected.

To become eligible for benefits on your account, your divorced spouse needs to:

  • have been married to you for a minimum of 10 years
  • be at a minimum of age 62
  • be unmarried and,
  • ineligible for an equal or higher benefit on their own Social Security account, or one someone else’s Social Security account.

Keep in mind, the benefits paid to your divorced spouse do not affect the benefits that you or your current spouse may earn.

Benefits For Your Children

When qualifying for Social Security disability benefits, your children may also be eligible to receive benefits on your Social Security account. Your qualifying child can be either your biological child, adopted child, or stepchild. A dependent grandchild may also be eligible to receive benefits.

To receive benefits, the child must be unmarried and be:

  • younger than 18, or
  • between 18 and 19-years-old and a full-time student (no higher than grade 12), or
  • 18 or older and possess a disability that began before age 22.

Typically, the SSA stops paying benefits when children become 18 unless they are disabled. However, if the child is still a full-time student at a secondary (or elementary) school at age 18, their benefits will continue until they graduate or until two months after the child becomes 19, whichever is first.

You can learn more about Benefits For A Disabled Child by clicking here.

Applying for Social Security Benefits

The several ways of which you can apply for Social Security disability benefits include:

  • Online
  • Calling the toll-free telephone number 1-800-772-1213. If you are deaf or hard of hearing, you can call  TTY 1-800-325-0778.
  • Scheduling an appointment with a Social Security representative by contacting your local Social Security office.

Social Security Disability Family Benefits

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Family benefits

After you claim Social Security disability benefits, particular family members could meet criteria to receive benefits based on your earnings record. Benefits could be given to your:

  • spouse;
  • divorced spouse;
  • children;
  • disabled child; and/or
  • adult child disabled before age 22.

Once a qualifying member of your family submits an application for Social Security benefits, the Social Security Administration will request their Social Security numbers as well as their certificates of birth. The SSA could request proof of marriage and dates of any prior marriages when applicable if your spouse submits an application for benefits.

Maximum Family Amount

Every member of your family could be eligible for a monthly stipend of up to 50% of your disability rate. Make a note; the SSA imposes a limit on how much they will pay your family.

The amount paid is based on your disability benefit amount and the number of family members who are qualified due to your record. The amount differs, but typically the total you and your family can earn is around 150% to 180% of your disability benefit.

If the total amount of benefits that are paid based on your record is larger than the family limit, the benefits to the members of your family will be lowered appropriately. Your actual benefit will not be reduced or increased.

If you have a divorced spouse who can submit an application for benefits, it will not influence the total benefit amount you or your family can be paid.

Benefits For Your Spouse

When benefits are payable to your spouse:

  • Age 62 or older, unless they receive an increased Social Security benefit due to their earnings record. The spouse benefit amount will be permanently reduced by a percentage determined on how many months up to their full retirement age.
  • At any age, if they are caring for your child under age 16 or disabled and receiving Social Security benefits.
  • Your spouse would receive these benefits until the child reaches age 16. At that time, the child’s benefits continue, but your spouse’s benefits stop unless he or she is old enough to receive retirement benefits (age 62 or older) or survivor benefits as a widow or widower (age 60).

If Your Spouse Also Worked Under Social Security

If your spouse qualifies to receive retirement benefits based on their own earnings record, the SSA will always award that amount first. However, if the spouse benefit that is paid based on your earnings record is a larger amount, they will receive a combination of benefits that total that larger amount.

Regardless of your spouse begins receiving benefits before, after, or during the same time as you; the SSA will review both earnings records to determine that your spouse gets the larger amount whenever they become entitled to receive it.

If your spouse expects to get a pension that’s determined on work not covered by Social Security, such as government or foreign work, their Social Security benefit on your earnings record could be affected.

Benefits For Your Divorced Spouse

If you are divorced, regardless if you’ve remarried, your ex-spouse could qualify for benefits based on your record.

If your ex-spouse expects to receive a pension determined by work not included in Social Security, such as government or foreign work, their Social Security benefit based on your earnings record may be affected.

To be eligible for benefits based on your earnings record, your ex-spouse needs to:

  • have been married to you for at least 10 years;
  • be at least 62 years old;
  • be unmarried; and
  • not be eligible for an equal or higher benefit on his or her own Social Security record, or on someone else’s Social Security record.

The total of benefits that can be paid to your divorced spouse has no influence on the total of benefits you or your current spouse may be paid.

Benefits For Your Children

When you’re eligible to receive Social Security disability benefits, your children could also be eligible to earn benefits based on your earnings record. Your qualifying child can be your biological child, adopted child, or stepchild. A dependent grandchild could also qualify.

To receive benefits, the child must be unmarried in addition to being:

  • under age 18; or
  • 18-19 years old and a full-time student (no higher than grade 12); or
  • 18 or older and have a disability that started before age 22.

Typically, benefits stop being paid when the child reaches age 18 unless they are disabled. But if the child is currently a full-time student at a secondary or elementary school at age 18, benefits won’t stop until the child graduates or until two months after the child reaches age 19, whichever comes first.

In your family, every qualifying child could receive a monthly benefit up to one-half of your full disability rate; keep in mind, there is a limit to how much the SSA will pay your family members.

Visit www.disability.help to get more information about Social Security Disability Benefits.