WHICH DISABILITIES ARE NOT COVERED BY SOCIAL SECURITY?

WHICH DISABILITIES ARE NOT COVERED BY SOCIAL SECURITY?

The Social Security Act covers a wide range of physical and psychiatric impairments which may result in disability payments if they are severe.

However, there are certain impairments which are not covered by the Social Security Act.  Here are 4 examples.

(1) Short-term impairments that will not last at least 12 consecutive months.  A condition that is not reasonably expected to last for at least 12 consecutive months is not covered by Social Security.

(2)  You have a severe impairment but are still working on a full-time basis or engaging in substantial gainful activity.  If you are now working at substantial gainful activity (SGA) such as a full-time job, you are not eligible for disability benefits, regardless of your age or the severity of your impairments.  In short, you may not engage in substantial gainful activity (SGA) and apply for Social Security disability at the same time.  (You may need some help in defining "substantial gainful activity").  Be sure you understand this term before deciding whether you may or may not qualify for benefits.

(3)  An impairment that begins after the claimant's date last insured.  A worker will generally cease to have insured status with Social Security about 4 years after he/she stops working.  Impairments that begin after the date last insured are not covered by SSDI (Title 2).  Check with Social Security to see if you have insured status for Title 2 benefits before filing a claim.  Also, check to see if you may qualify for SSI (Title 16) which does not require a work history.

(3)  Impairments that primarily result from alcoholism, illicit drug or substance abuse.  If your impairment is alcoholism or substance abuse, or both, SSDI or SSI benefits are not available.  In 1996, Congress passed Public Law 104-121 which discontinued SSI and SSDI benefits for beneficiaries whose primary impairment was drug addiction, alcoholism or both.  On 2/20/13, the Social Security Administration issued SSR 13-2p which excludes benefits for which alcoholism or substance abuse is a materially contributing factor.  This can be a complicated issue for which expert counsel should be obtained.

• If it is determined that alcoholism or substance abuse does not cause or materially contribute to the impairment(s), then disability benefits may still be available. It is possible for an individual to suffer from alcoholism and an unrelated impairment at the same time.  We would advise professional consultation in dealing with this matter--to get a more clear understanding of whether alcoholism or substance abuse is material to a claim.  This issue is more complicated than can be totally addressed here. A qualified attorney or non-attorney representative will be able to provide more information on this subject.