How Does Social Security Define Incapacitated?

How Does Social Security Define Incapacitated?

To receive Social Security benefits, you must have worked jobs that are covered by Social Security as well as have a medical condition that meets Social Security’s definition of “incapacitated.”

Social Security has a strict method to define incapacitated. Unlike other programs, to receive Social Security disability benefits, you must typically be incapacitated (disabled) and have done insignificant (non-substantial) work for the past 12 months.

How does the Social Security Administration (SSA) define incapacitated? In order, to be considered incapacitated, the Social Security Administration (SSA) requires that you be unable to perform substantial gainful activity (SGA).

More On Substantial Gainful Activity

According to the SSA, substantial work activity means you are doing significant physical or mental activities even if it is part-time or your income is less than when you became incapacitated.

Gainful activity is something that you get paid to do or could get paid to do, even if you are not getting paid to do those activities. We are talking about volunteering, home business, babysitting (potentially) and similar.

Moreover, there is also a wage component to SGA. You might be able to do minimal work but not earn a basic minimum wage in doing so, due to your disabling conditions or incapacity. For 2017, that amount is $1,170 for non-blind applicants and $1,950 for blind applicants. If you are making over this amount per month from your job, then the SSA believes that you are not disabled and can engage in competitive employment.

Finances Do Factor into Some Disability Discussions, But Not All

The SSA does not take into consideration any money you bring in from outside sources such as interest, investment, or gifts when looking at SGA for SSDI. However, low earnings do not necessarily constitute low SGA. For example, if you are working as a substitute teacher, you can still be found as doing SGA though you are not likely getting paid very much, or very regularly.

In that example, your low-income rate is not due to being disabled, but rather due to the on-call nature of your job. In this same vein, volunteer activities could also be considered SGA if they are something that could be considered a paying job, even if irregular, or non-paying. The fact that others earn a living doing the work could leave the impression that you are not incapacitated from doing the same.

On the other side of the coin, high earnings do not necessarily mean you were doing SGA either. For instance, if you are working under certain special circumstances, your wage might not have any correlation with your incapacity. Here are some examples:

  • You required assistance for co-workers to complete your tasks
  • You were able to take a frequent rest break or able to work irregular hours
  • Special equipment was provided to assist you in your tasks
  • Work was assigned specifically to you based on your disability
  • You relied on other people to transport you to and from work
  • A lower standard of productivity or efficiency was allowed due to your disability

Incapacity and SGA

You can probably see at this point how the SSA looks at SGA to define “incapacitated” and apply it to your situation or to state that you are not incapacitated. If the SSA sees that you are making SGA, your claim will be likely be denied barring special circumstances (as listed above). This is the point where you want to reach out for help if you have not done so already.

So what if you recently quit working but are not sure you cannot work elsewhere or perform SGA? If you apply for benefits and then stop working due to your disability, you can keep looking for opportunities to earn work. In fact, if you are successful in becoming gainfully employed, that is great! If however, you are unsuccessful, those can be considered unsuccessful work attempts and with the help of a good advocate, they will help to make your SSDI case stronger with the SSA.

SGA Helps to Define Incapacitated!

Substantial gainful activity plays a considerable part in the Social Security Administrations approach to define incapacitated; though there are many grey areas involved. In fact, we covered just a few above. There are most certainly more. If you have questions about how to define incapacitated as it relates to your specific situation, please reach out to us today, and we will give you a clear assessment of your situation.

Disability Hearing: Tips From a Disability Lawyer

Disability Hearing Tips From a Disability Lawyer

Are you ready for your disability hearing? You are going to be side by side with your attorney, in front of an administrative law judge. Experts will be commenting on your desire and ability to work. And, you will have many things on your mind.

What if they think I am faking my injury?
How will they make a decision?
When will I be able to move past this appeal!?
Is this Social Security nightmare almost over?

This period before your hearing is an uncomfortable time for most people. You are not alone in wondering how everything is going to proceed when you finally get your day in front of the ALJ. Here are a couple of tips to help you get yourself in a mindset that will reduce, though not likely eliminate, your anxiety.

Review Your Challenges & Barriers

At this point, you are bar-none the expert on knowing what your challenges are. How they impact you on a daily basis, and how you are unable to establish and maintain employment because of them. However, you should not be complacent and feel that you can “wing it” when asked.

Even before meeting with your disability attorney for your pre-hearing discussion, you should go over all the issues at least one more time by yourself. Take an hour or so and write down, exactly what challenges you face every day.

Start your review with thinking about how you get up in the morning, make breakfast, your daily routine, evening routine, leisure, chores, nightly routine, and sleep/rest.

This tip sounds simple, almost to the point of unnecessary, but often, we get so busy doing things that we forget the challenges we have to overcome to accomplish them. Taking a couple of minutes to review your day, and write things down, often results in a better personal understanding of your challenges, and puts you in a better frame of mind to recall them for others.

If you have been keeping a disability journal – you have 90% of this covered already.  You just have to simply review it.

Review Your Disability Claim

Now that you have considered your daily barriers, you should examine your disability claim. Make sure to look at things like, when you filed your disability claim. Who helped you file your disability claim? Also, what has the experience been like since you filed your claim?

Try to get a basic timeline put together of your current disability application status. Include application dates, appeals, doctors’ appointments, and even disability lawyer visits if that applies. All of these items are no-doubt already facts of the case, and readily available for both your disability lawyer and the judge, but you should strive to have an accurate and easily recallable understanding of how your disability claim has ended up at the hearing level too.

At worst, going through this exercise will be a bit of time out of your day. However, it might help you to be more effective in telling your story in context during the upcoming hearing, or in conversation with your disability lawyer before the hearing.

Show Up Early to Your Disability Hearing

If there was/is ever a time to be early for something this is it. It is very possible, your disability lawyer set up a prehearing conference with you, just to avoid this. However, regardless of why you should plan to be early, make it happen.

Plan for traffic to be the worst traffic in history. Plan for your vehicle to break down in your driveway. Realize that the bus will miss your stop. Understand that your alarm will break in the middle of the night while you are fast asleep. In the worst of all possible scenarios, how will you make it to your hearing?

Talk to Your Disability Lawyer

This last tip should be obvious, assuming you have a good disability lawyer. However, it is not uncommon to hear stories about claimants who meet their disability lawyer for the first time just prior to their hearing.

If you have a disability lawyer that has given you very little information or even ideas on how to prepare for your hearing, now is the time to be proactive. It may already be very difficult to change horses so far downstream, but that does not mean you have to be completely passive in regards to your disability claim.

Ask your disability lawyer, or their assistant, how you can best prepare. Ask them what info you should bring, whether you are going to be meeting with them, and what to expect. A great disability lawyer will not throw you to the wolves, they will prepare you for your hearing, and will help you so that you do not get blindsided during it.

If you are only now retaining a disability lawyer, keep in mind how well they communicate. We have talked about this before, and the particular threat of going to a disability hearing unprepared is a poignant example of why communication and working with a great disability lawyer matters.

Talk To A Lilac City Law Disability Lawyer Today!
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