The Social Security Administration (SSA) has a complex definition for qualifying disabilities. These are not always easy to understand. As such, someone with a partial disability may wonder whether they are qualified for Social Security Disability Insurance (SSDI) benefits.
Social Security disability benefits are not available for partial disabilities. Applicants must be unable to engage in any kind of work to be eligible for SSDI benefits. However, partially disabled workers can still obtain benefits through workers’ compensation benefits.
Continue reading below as we talk more about benefits for partially disabled workers.
Partial vs. Total Disability
Before we understand whether workers can get Supplemental Security Income (SSI) and SSDI benefits for partial disability, let us first understand what the term means and how it is different from total disability.
Partial Disability
Partial disability is defined in different ways depending on the policy or program providing the benefits. For instance, the term “partial disability” may have a different meaning in a private insurance policy compared to a government program like worker’s compensation.
Because of this, it is essential to review the rules of the particular program before applying to it in order to determine whether or not you match its eligibility requirements.
When you’re partially disabled, it generally implies you can’t work full-time or carry out all the essential duties of your job (or another profession that’s comparable to your education, work experience, or training) at all.
Partial disabilities can be either temporary or permanent.
Some of the medical issues that could leave you partially disabled are:
- Cancer
- Heart attack
- Back injuries
- Orthopedic injuries
- Carpal tunnel syndrome
- Hearing or vision loss
- Amputation
A cancer patient, for instance, might be able to do everything required of them at work, but they might only be able to work part-time because of their illness and its treatment. This situation also fits the definition of temporary partial disability because the individual can return to full-time work once their therapy is finished.
In another situation, a person who is employed in a warehouse and has had a back injury might not be able to lift and move boxes after the injury, but might still be able to manage inventories and transport boxes after they have been placed onto a forklift.
If they were excused from those specified tasks that they could not do, they may keep working full-time. This sort of partial disability could be either temporary or permanent.
Total Disability
For a person to be considered totally disabled, they must be unable to do any job-related tasks at all, including lifting, standing, walking, sitting, remembering, or performing any of the other fundamental duties associated with their current position (or the essential duties of a comparable position, given their education, experience, and training).
Total disability, like partial disability, may be either temporary or permanent.
Social Security disability benefits are only available to people who have a total disability. The following conditions must be met for the Social Security Administration to classify an individual as totally disabled:
Have a disability that prevents you from engaging in Substantial Gainful Activity (SGA). In 2023, the Social Security Administration will consider an individual capable of SGA if they have a monthly income of at least $1,470 ($2,460 for people who are blind).
- Have a disability that makes it impossible for you to do your essential job duties.
- Have one of the over 100 disabilities or medical conditions the Social Security Administration recognizes as debilitating or have an unlisted impairment or impairment that is equivalent to or more severe than those on the list.
- Not be able to do any work you’ve done before or any work that’s equivalent to it, given your current level of education, skill set, and age. For instance, if you work in construction but do not have a college degree, the Social Security Administration will not consider you capable of doing a job that requires a degree.
- The disability or medical problem must have lasted for, or be expected to last for, at least 12 months or result in death. Even if you satisfy all of the conditions listed above, you won’t be eligible for SSDI benefits if the Social Security Administration determines that your medical condition or disability will improve in less than a year.
You can be considered totally disabled by the Social Security Administration and still not qualify for SSDI benefits. An amputation, for instance, would qualify as a total and permanent disability. But, based on the type of amputation and the job the person had before the amputation, they might still be able to work.
A surgeon who lost an arm in the line of work would be out of work for good, while a teacher may go back to the classroom after some time off to heal.
Social Security Benefits for Partial Disability
Generally, Social Security disability benefits are not available for partial disabilities. This is because, in order to qualify for Social Security benefits, applicants must prove that they are unable to engage in any kind of work (and, hence, are totally disabled).
In contrast, a person who is partially disabled can still execute some of their job responsibilities despite the injuries.
To put it another way, a person does not qualify as totally disabled simply having sustained an injury, if they are still able to perform some form of gainful employment.
An accident that leaves a neurosurgeon with a broken hand may prevent her from doing procedures, but she may be able to continue working as a consultant and in the field.
Workers Compensation Benefits for Partial Disabilities
Partial disability benefits are offered when an employee gets back to work or is medically able to do currently available work as agreed upon or decided by a judge but at a lower wage than they were making before the accident.
The maximum period that an injured worker can get compensation for a partial disability is 500 weeks. The 500 weeks need not be successive; instead, they could be spread out over a larger time frame. However, the combined total of all the weeks must be exactly 500.
The amount of money an employee gets for being partially disabled from the day of the accident is two-thirds of the difference between their average weekly pay and their average weekly pay after going back to work. An employee can’t get more pay and compensation than they would have made before they got injured.
Specific Loss Benefits
If you lose your sight or your hearing due to an accident on the job, you may be entitled to compensation. Additionally, the inability to use limbs or parts of limbs (such as fingers and toes), mainly as a result of injury, can qualify you for benefits.
Payment for specific loss benefits is made regardless of the length of time an employee is out of work or whether they eventually return to their previous position.
Disfigurement Benefits
Benefits are given if the head, face, or neck has a major, permanent, and unsightly disfigurement. Payment periods for benefits start at one week and go up to 275 weeks. Disfigurement benefits do not have a standard payment amount.
In some cases, an employee and their employer or the insurer representing the employer may come to terms with the benefit amount by way of a formal agreement. If the worker and the employer are unable to come to an agreement, the worker may request a hearing before a workers’ compensation judge.
Death Benefits
If the employee passes away due to a work-related injury, their family members may be eligible for benefits. Additionally, reasonable funeral expenditures up to a maximum financial amount of $3,000 are provided to the beneficiaries.
Employers have up to 48 hours from the time a death is reported to file a death claim (Form LIBC.-344) with the Bureau of Workers’ Compensation. Death benefits can be paid to:
- The surviving spouse if they resided with the employee at the time of death and were relying on them.
- Children under the age of 18 who are dependent on their parents. Benefit eligibility for full-time students can be extended until the age of 23. If the child is a dependent with a disability, there is no age restriction. The spouse receives the money unless there is no surviving spouse, in which case the money goes to the children or guardian.
- Dependent parents and siblings. In the event of the employee’s death, there are no surviving spouse or dependent children, any parents who were dependent on the employee during their period of disability are eligible to receive compensation. If the deceased worker had no surviving spouse, children, or parents, then financially dependent brothers or sisters would be eligible for payments.
The spouse will get 51% of the employee’s average wage as of the date of injury or illness. Spouses with one dependent are eligible for 60%, while those with two or more dependents are eligible for 66%. The payments can’t be more than the average weekly wage across the state.
Establishing Partial Disability
In order to qualify for partial disability benefits, a worker must first establish or prove the disability via medical evidence.
Providing Objective Evidence
Submitting a diagnosis alone will not be sufficient to substantiate your disability claim. Instead, you’ll need to provide both objective and subjective medical documentation that details the illness and its detrimental effects from the perspective of medical professionals.
Subjective evidence includes things like your own statements about things like exhaustion, pain, or other difficulties. A disability lawyer can help you determine what kind of medical records and diagnostic tests are required to prove your case.
Establishing the Date of Disability
There are a few reasons why it’s crucial to establish the accuracy of this date. First, if your insurance company has a waiting period before it begins paying benefits, you don’t want them to pick a later date.
When applying for workers’ compensation benefits, the start date is used to calculate any retroactive payments that may be due to you. This is why you need to provide evidence of the precise date your disability began.
The date you stopped being able to work (for total disability) or do some of your essential job tasks (for partial disability) should be noted in your medical files, chart notes, tests, and treatments.
If your medical records do not include a particular date, you must submit additional documentation that demonstrates the severity of your disability at a specific point in time.
You may be able to ask your healthcare provider about previous diagnoses and records so that they can give you an unbiased assessment of when your disability began.
Providing Documentation That You Are Unable To Work
Getting monthly disability insurance benefits depends on more than just getting a medical diagnosis. You must also be able to show that your ailment and its effects restrict you from being able to perform the essential duties of your job and hence maintain your former level of employment or income.
In many cases, you should begin with the assessment that your medical professional has made regarding the severity of your condition. For instance, if your back injury is severe enough that you are unable to lift anything or stand for extended amounts of time, your doctor may recommend that you only engage in work that requires you to sit for the majority of the time, also called sedentary work.
However, if your back injury is severe enough to keep you from sitting for an hour or more, your doctor may conclude that you are unable to even undertake sedentary work. You could use the results of a functional capacity test to show what you can and can’t do because of your disability.
Conclusion
So, if you have a partial disability, unfortunately, you will not be eligible for Social Security disability benefits. However, there are other kinds of benefits you can apply for. A disability lawyer can help you find out which benefits you can obtain for a partial disability.
