The federal government added the Social Security Disability regulations to the regular retirement system in 1958. This added a layer of protection to workers who are under age 65 and who -- due to a disabling impairment -- are no longer able to work. Most American workers pay for this insurance through automatic payroll deduction at work, as well as the hospital portion of Medicare (Part A). This insurance is known as Title 2, or sometimes DIB or SSDI. It is intended to benefit disabled adult workers and their dependants. Later, in 1974, the government added a needs-based program to benefit disabled children and adults who had not worked enough to obtain coverage under Title 2. This is known as Title 16, or SSI (Supplemental Security Income), according to the legislation which initiated it. The medical qualifications for both programs are the same. The only difference between them is the needs-based rules for SSI, which require the claimant to fall below a certain level of income and resources. If an individual qualifies for Title 2 based on their disability, they may also receive a supplemental benefit from SSI based upon their low income and resources as well. SSI also provides for additional medical benefits and help paying for treatment, as administered through each state.

To qualify for Title 2 benefits, a worker must perform substantial gainful activity (SGA) for at least 20 out of 40 quarters. The government's definition of SGA is adjusted yearly based on the national average wage index, and also to the worker's age, so that people in their mid-twenties, for example, would not have to work a full 40 quarters. SGA will be set at $940.00 per month for the upcoming year (2008).

SGA is an important figure, not only because it adds to your quarters of coverage going forward, but it is used both before and after you become disabled to "prove" whether you can or can not work, and it is also the basis for your ultimate monthly retirement check. In addition, the government uses somewhat higher figures which pertain to individuals who are blind, both for receiving an income, and for work activity once placed on disability.

The process used to determine disability under Social Security is complex, and each of the 50 states uses separate offices to process this caseload. SSA's local offices are not staffed to handle medical issues, and so disability examiners and doctors are hired and trained to do this work exclusively, accurately, and in a timely manner. In many states the DDS's are a division of that state's Vocational Rehabilitation department. The rationale here is simple: if you are going to deny a person's disability claim, you should have counselors readily available and trained to assist that person in finding a suitable replacement job.

Many factors go into the decision, not the least of which is the severity of the person's illness(es). Age, educational background and training, and work history also play important roles. By nature of the system, it is weighted in favor of older workers. This is true whether you are an engineer, plumber, teacher, or mechanic. However, some impairments are so severe that all that is needed is a diagnosis and the claim will be allowed. This is because there is a process called "sequential evaluation", and, believe it or not, it is intended to speed up each claim.

Many claimants would state to me that the VA, or Worker's Comp., for instance, had already declared them to be "60% disabled", or "80% disabled". SSDI does not work this way. It is an "all or nothing" thing -- you are either "disabled", or you are "not disabled". In making this decision, the examiner and doctor at the DDS will consider (in this order): your impairment(s), your age, your educational level, and your work history. Without getting too technical here, the DDS uses a Listings book which describes each body system and impairment, and uses your medical records to see if you meet the severity of any of these listed impairments. SSDI is intended only for severe impairments which will last more than one year and/or result in death, so about 60 - 70 % of all first-time claimants (initial level) are denied. People apply for SSDI for all kinds of reasons, ranging in severity from terminal cancer to depression to colds and the flu.