Traumatic accidents often lead to Social Security disability claims. When involved in a severe accident, the initial goal is to file a claim against the responsible party’s insurance carrier while focusing on recovery. The idea is to regain good health and return to work.
Recovery and Work Status
However, injuries may take longer to heal than expected or heal with reduced function. Attention then shifts to whether the injured person can return to work or should file a Social Security disability claim. Filing a claim for disability means the person cannot do their past work and has lost the function to perform any other work that exists in significant numbers in the national economy for at least 12 months.
Example Scenario
Consider a 45-year-old construction worker who suffers a traumatic spine injury requiring fusion surgery. The medical records might show adequate healing, and within 12 months, they could recover enough to perform a sedentary job with accommodations. Although construction work is no longer possible, many sedentary jobs fit this residual functional capacity. In this case, disability regulations will direct a finding of Not Disabled.
Duration Requirement
If a traumatic injury heals and the person returns to work or is expected to return within 12 months, the claim will be denied for not meeting the disability law’s duration requirement. Conditions like simple bone fractures with uncomplicated healing processes fall into this category.
Considering Impairment and Settlements
First, determine if the remaining impairment will likely prevent a successful return to most work, assuming a 40-hour work week. Next, consider whether the personal injury settlement will interfere with filing a Social Security disability claim. Social Security looks at technical issues before medical evidence to decide eligibility for disability benefits.
Disability Insurance and SSI Programs
Social Security Disability pays benefits from two programs: disability insurance and Supplemental Security Income (SSI). You must meet technical eligibility requirements for at least one program to apply for benefits. The disability insurance program doesn’t consider a person’s financial status but checks if they have worked long enough at high enough earnings to be insured for disability benefits. Generally, insured status is met when the person has worked seven of the last 10 years.
Eligibility and Income Considerations
If the disabled person worked under the table without taxes taken out, there is no coverage for Social Security disability. SSI places a limit on the amount of income and resources available to a person. It acts like a poverty-based disability program, with limits of $2000 for single individuals and $3000 for married couples. If income and resources exceed these limits, the SSI benefit decreases accordingly. Filing a claim while having a substantial settlement will lead to a technical denial, meaning the claim won’t be processed on its merits. Once the settlement is spent down, eligibility returns the following month.
Seeking Help
Social Security Disability can be confusing. For assistance with similar issues, call the Social Security disability law firm Hall & Rouse at 1-866-425-5347, or fill out a contact form on our website, hall-rouse.com.
