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E. Social Security Disability

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Social Security, formally the Old Age Survivors Disability Insurance (OASDI) program, is a federal program enacted in 1935 that protects eligible workers and their dependents against financial loss due to old age, disability, or death. With only a handful of exceptions, nearly every worker is covered by Social Security.

1. Qualifications for Disability Benefits

Social Security uses the Quarter of Coverage (QC) system to determine whether a worker qualifies for benefits. The type and amount of benefits available depend on the number of credits, or QCs, the worker has earned. Anyone working in a job covered by Social Security, or operating their own business, may earn up to a maximum of 4 credits per year of work.

A worker who has earned 40 quarters of coverage — the equivalent of 10 years of work — is considered fully insured, and is therefore entitled to Social Security retirement benefits, premium-free Medicare Part A, and survivor benefits. A worker entitled to premium-free Medicare Part A is automatically eligible for Medicare Part B as well, though a monthly premium applies to Part B.

A worker may instead attain currently insured status (sometimes called partially insured), qualifying for certain benefits if the worker has earned 6 credits during the 13-quarter period ending with the quarter in which the insured:

  • Dies;
  • Becomes entitled to disability insurance benefits; or
  • Becomes entitled to old-age insurance benefits.

For younger workers, the number of quarters required to qualify for benefits differs by age, according to a table established by Social Security.

2. Definition of Disability

Assuming a worker qualifies for Social Security disability benefits by being fully insured or currently insured, the worker must then also meet Social Security's own definition of disability. Disability, under Social Security, is the inability to engage in any substantially gainful activity because of a medically determinable physical or mental impairment that has lasted, or is expected to last, 12 months, or that is expected to result in death. This definition is considerably stricter than most definitions of disability found in policies sold by insurance companies.

3. Waiting Period

The waiting, or elimination, period for Social Security disability benefits is 5 months. Benefits begin at the start of the 6th month and are not retroactive to the actual onset of the disability.

4. Disability Income Benefits

The amount of Social Security disability benefits is based on the worker's Primary Insurance Amount (PIA), which is calculated from the worker's average indexed monthly earnings over the highest 35 years of the worker's earnings history. The lowest 5 years of income may be excluded from the calculation.

Social Security disability benefits will continue for 3 months after a person returns to work earning more than a set monthly amount, as an incentive to encourage disabled workers to return to the workforce.