Claims and Appeals
Title II
Title II cases are claims brought by workers who have a “paid up” federal disability insurance coverage. (The Title II program is literally disability insurance.) SSA considers an individual “insured” if he/she has 40 credits 20 of which were earned in the last 10 years ending with the year the person became disabled. (It is possible to be insured with fewer credits if the individual is under the age of 31.) The amount needed to earn a credit changes every year. For example in 2004 earning $900 was worth one credit. In 2005 earning $920 was worth one credit. In this year, 2006, earning $970 will be worth one credit. You can only earn up to four credits a year. Once a person is “fully insured” under the program, when they stop working, their credits allow them to have a fully paid up federal disability insurance policy for about 5 years from the date they stopped working. The date on which the claimant was last “insured” under the program is normally referred to as the date last insured or “DLI”.
In addition to the normal worker Title II claim, there are three variants of Title II cases. The first two base their claim upon the “insured” record of the worker. The first is the claim of a disabled adult child (“DAC”). In addition to being disabled, the DAC must be the child of an insured person who is either entitled to old-age or disability benefits or has died; the DAC must be unmarried and are 18 years old or older and have a disability that began before the age of 22. (See further 20 C.F.R. § 404.350.) The second is a claim of a widow(er). In addition to the widow(er) being disabled, he/she must have been married to a person who was fully insured at the time of his/her death; the marriage must have lasted for at least 9 months immediately before the insured died; the widow(er) must be at least 50 years old and the disability must have begun not later than 7 years after the insured died. (See further 20 C.F.R. § 404.335.) [A corollary to widow(er) benefits is the claim for widow(er)’s benefits by a surviving divorced spouse. Here, the requirements are the same as a widow(er)’s claim except for the length of marriage requirement which must be 10 years instead of 9 months. (See further 20 C.F.R. § 404.336.)]. The third is “statutory blindness” which is defined as central visual acuity of 20/200 or less in the better eye with the use of correcting lens. In addition to meeting the statutory definition of blindness, the claimant’s blindness must have latest or be reasonably expected to last for a continuous period of 12 months. Interestingly, SSA may award “a period of disability” to a claimant who is found to be blind (which means that a wage freeze occurs) but not award cash disability benefits. This nuisance occurs when the blind claimant is under the age of 55 and able to perform some substantial gainful activity. Conversely, if the blind claimant is over the age of 55 and not able to use the skills or abilities to do a job like before, then an award of cash disability benefits will be made. (See further 20 C.F.R. §§ 404.1581-1583.)
If you would like to know more about your rights, please read our guidelines on social security disability, or let us help you. Contact us today for a free initial legal consultation via our web site, or telephone us at (765) 644-8410 or 765-644-8410 in Indiana.