Definition of Disability
An individual must be unable to engage in any substantial gainful work activity because of a medically determinable physical or mental impairment which is expected to last for 12 continuous months or result in death.
- Partial or temporary disabilities which are recognized in many other benefit programs do not qualify for Social Security Disability Insurance - SSDI, Supplemental Security Income - SSI or Non-Grant Medical Assistance - NGMA.
- A doctor's opinion that an individual is unable to work is not enough for a determination of eligibility. The impairment must be demonstrated through medical signs, symptoms, and laboratory or other test findings.
- The documentation of the medical impairment must be sufficiently complete for the DDS to evaluate severity, functional restrictions, and expected duration of the impairment.
Applications for SSDI and SSI are filed at local Social Security Administration - SSA offices. Applications for NGMA disability are filed at Community Social Service offices - CSO.
How Do I Get Copies of My Records?
The DDS can send a copy of any examination. You may contact your adjudicator for instructions on completing the proper authorization. Once a decision is made, all requests for information must be submitted to the Social Security Administration. For Non-Grant Medical Assistance records, contact your Social Worker at the DSHS Community Service Office.
How Do I Apply?
Call 1-800-772-1213 or visit www.ssa.gov/disability or find a social security office near you.
Director: Jacki Russell Disability Determination Services (DDS) is a division of the NC Department of Health and Human Services. Funded
primarily by the federal government’s Social Security Administration (SSA), DDS makes medical determinations for Social Security and state Medicaid Disability claims.
People can apply for Social Security disability benefits in person at a local SSA field office, by telephone or by filing online. Social Security Disability claims are initially processed at local SSA field offices.
The application and related forms ask for a description of the person’s impairment(s), treatment sources and other information that relate to the disability that is being claimed.
The field office is responsible for verifying non-medical eligibility requirements, which may include age, employment, marital status or Social Security coverage information. The field office then sends the case to DDS to evaluate the disability. DDS is responsible for obtaining medical evidence and making the initial determination on whether that person, or a claimant, is disabled or blind under the law.
DDS works to obtain evidence from the claimant's own health care providers first. If that evidence is unavailable or insufficient to make a determination, DDS will arrange for a consultative examination (CE) to obtain additional information. The claimant's treatment provider is the preferred source for the CE, but DDS may obtain the CE from an independent source. Trained staff at DDS then makes the disability determination.
After a determination is made, DDS returns the case to the field office for appropriate action. If DDS finds the claimant is disabled, SSA completes any outstanding non-disability development (such as current income and resources), computes the benefit amount, and begins paying benefits to the claimant. If the claimant was found not to be disabled, the file is kept in the field office in the event of an appeal. The local SSA field office will assist claimants with completing paperwork to begin an appeal if applicable.
DDS also processes Medicaid disability claims for the state of North Carolina. Medicaid disability claims can be filed by contacting a county Department of Social Services office. Once a Medicaid disability application is received, DDS will develop medical evidence and make a determination on disability using the same protocols as outlined for Social Security Disability benefits.
General Information: 1-844-259-8985
Disability Claim Status: 1-866-542-8113
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Frequently Asked Questions
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To qualify for Social Security Disability Insurance, SSDI you would need to meet the eligibility for both medical and non-medical qualifications for SSDI. The most common reason for denial is not being able to meet the medical qualifications but an inability to meet the non-medical criteria. This happens simply because not many people are aware of it.
While you might be chronically ill and meet all the medical requirements, you may still be denied SSDI claims because you do not have enough work credits or haven’t paid the FICA taxes.
How does your work history affect SSDI qualification?
Ever wondered where does your hard earned money go when you receive deducted net salaries? You must have noticed that often the amount you receive in your monthly paycheck may always be lesser than the amount initially stated on your work contract from the employer. This is because many companies pay the social security taxes on their employees. In short, all individuals who work have FICA taxes deducted from their paychecks automatically.
Since the SSDI is an insurance program it is funded by the Federal Insurance Contribution Act, FICA taxes collected from people who work and redistributed to those in need. If you pay FICA taxes, you basically pay into the Social Security Disability Insurance program. To be able to claim your social security you need to have worked and paid enough taxes into the system to retain coverage along with meeting the medical requirements.
How does your income impact your eligibility for SSDI?
The good news is, the SSDI does not consider the number of assets you may have or how much other family members contribute to the household, while analyzing your case for eligibility. The assets and income from other sources are only considered for the supplemental security income, SSI.
On the other hand, the SSA does take into account how much money you earn through your job. You can’t earn an income equal to or more than the income stated in the ‘substantial gainful activity’, or otherwise your claims would be straight away denied.
The specific dollar amount stated as substantial gainful activity in 2019 is $1220 for non-blind claimants and $2040 for blind claimants. If your income is above the stated threshold, you will not be labeled as disabled by the SSA.
Talk to a social security attorney
An experienced social security attorney will be able to analyze whether you will qualify for social security on your medical and non-medical terms or not. While you can always re-appeal your claims if you think you are denied unjustly on medical basis, you can never re-appeal if you do not qualify under the non-medical requirements.
A disability lawyer can not only determine your eligibility but also guide you on how you can become eligible in certain situations. Hence, it is highly recommended that you consult with a social security attorney while submitting your application.
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