There are two types of disability benefits under the Social Security Act. One is Supplemental Security Income (SSI) which is for people with little or no income who are 65 or older, blind or disabled. The other is Social Security Disability (SSDI) or what is commonly referred to as Section 223 of the Disability Act. Unlike SSI, SSDI is for people who are "insured." That is, those who have worked and paid Social Security taxes and who have not yet reached retirement age and are disabled.
Disability Insurance Benefits
Section 223(a)(1) sets forth the basic requirements for eligibility including being a citizen of the USA or a lawfully admitted resident alien with a valid Social Security Number and has not reached retirement age, is insured (has paid Social Security taxes or F.I.C.A.), and is disabled. The subsection also establishes a five-months waiting period for the payment of benefits after the filing of an application for disability benefits.
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Filing of Application
Section 223(b) provides that benefits can be paid retroactively for up to 12 months preceding the filing of an application for benefits if all the other requirements are met during that retroactive period.
Definition of Insured Status and Waiting Period
Section 223(c) defines what insured status means and further defines the waiting period and its implications. To be insured, an applicant for benefits must have paid Social Security taxes or F.I.C.A. For at least 20 of the 40 quarters right before the time in which the disability manifests itself. The five-months waiting period means five consecutive months following the filing of the application for benefits.
Definition of Disability
Section 223(d) defines disability under the act and provides for physical and mental impairments but excludes disabilities where alcoholism or drug addiction are contributing factors. In addition, any disability caused or aggravated during the commission of a felony offense for which the individual is convicted shall be excluded from coverage under the act. This subsection also mandates that the Social Security Commissioner set forth rules identifying the medical and other evidence needed for the establishing of a disability. Disabilities arising during a time when an individual is in confinement as a result of a felony conviction are also excluded from coverage.
Section 223(e) provides that benefits shall terminate after the third month in which a claimant "engages in substantial gainful activity" and places restrictions on self-employment income.
Standard of Review for Termination of Disability Benefits
Section 223(f) provides for the termination of benefits where the disability has ceased or where a claimant has returned to substantial gainful activity (either via employment or business or some other form of earning money) or where technological or other developments indicate that the disability is not as disabling as it was once thought to be.
Continued Payment of Disability Benefits During Appeal
Section 223(g) provides that a person receiving benefits and who has been informed that those benefits will be terminated or reduced may file a request to continue receiving benefits until his or her appeal is decided provided the claimant complies with the requirements stated in the section which includes filing a request for such continued benefits within the time prescribed by the commissioner.
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