The process for determining a veteran's eligibility for Social Security disability benefits involves several steps and considerations. The Social Security Administration (SSA) follows a specific evaluation process to assess whether a veteran meets the criteria for disability benefits. This process includes gathering relevant medical and non-medical evidence, assessing the severity of the veteran's impairments, and determining if the impairments prevent the individual from engaging in substantial gainful activity (SGA).
To initiate the evaluation process, veterans must first file a claim for disability benefits with the SSA. This can be done online, over the phone, or by visiting a local SSA office. The application requires providing detailed information about the veteran's medical conditions, work history, and military service. It is crucial to include all relevant medical evidence, such as medical records, test results, and treatment history, to support the claim.
Once the application is submitted, the SSA reviews the information provided and determines if the veteran meets the basic non-medical requirements for disability benefits, such as having enough work credits. For veterans who served after September 16, 1940, there are additional requirements based on the length of their military service.
After meeting the non-medical requirements, the SSA forwards the application to the Disability Determination Services (DDS) office in the veteran's state. The DDS is responsible for evaluating the medical evidence and making the initial determination regarding disability eligibility. The DDS may request additional medical records or consultative examinations if necessary.
During the evaluation process, the DDS considers the severity of the veteran's impairments and their impact on their ability to work. The SSA uses a five-step sequential evaluation process to assess disability claims. This process includes:
1. Substantial Gainful Activity (SGA) Evaluation: The SSA determines if the veteran is currently engaged in SGA. In 2021, if a veteran earns more than $1,310 per month ($2,190 for blind individuals), they are generally considered to be engaged in SGA and are not eligible for disability benefits.
2. Severity of Impairments: The DDS evaluates the medical evidence to determine the severity of the veteran's impairments. To be eligible for disability benefits, the impairments must significantly limit the veteran's ability to perform basic work-related activities.
3. Listing of Impairments: The SSA maintains a Listing of Impairments, also known as the Blue Book, which outlines specific medical conditions and criteria that automatically qualify individuals for disability benefits. If the veteran's impairments meet or equal the criteria in the Listing of Impairments, they are considered disabled.
4. Past Relevant Work: If the veteran's impairments do not meet or equal the criteria in the Listing of Impairments, the DDS assesses whether the veteran can perform any of their past relevant work. Past relevant work refers to work performed in the past 15 years that lasted long enough to learn the job and was substantial gainful activity.
5. Other Work: If the veteran cannot perform their past relevant work, the DDS evaluates whether there is any other work in the national economy
that the veteran can perform, considering their age, education, work experience, and residual functional capacity (RFC). RFC refers to the maximum level of work-related activities that a person can perform despite their impairments.
If the DDS determines that the veteran meets the criteria for disability benefits at any step of the evaluation process, they will be considered disabled and eligible for Social Security disability benefits. However, if the DDS determines that the veteran is not disabled, they have the right to appeal the decision and request a reconsideration or a hearing before an administrative law judge.
In summary, determining a veteran's eligibility for Social Security disability benefits involves a comprehensive evaluation process that considers both medical and non-medical factors. By assessing the severity of impairments and their impact on the veteran's ability to work, the SSA aims to provide financial support to disabled veterans who are unable to engage in substantial gainful activity.