Disability is defined in the Social Security Act as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.

Medically determinable impairment is an impairment that results from anatomical, physiological, or psychological abnormalities which can be shown by medically acceptable clinical and laboratory diagnostic techniques. A physical or mental impairment must be established by medical evidence consisting of signs, symptoms, and laboratory findings - not only by the individual's statement of symptoms.

Under the Social Security Administration's (SSA) disability insurance program (title II of the Act), there are three basic categories of individuals who may be able to qualify for benefits on the basis of disability: ~ A disabled insured worker under the age of 65; ~ A person who became disabled before age 22 who is a dependent of a deceased insured parent or a parent entitled to title II disability or retirement benefits; and ~ A disabled widow or widower age 50-60 if the deceased spouse was insured under Social Security. Under title XVI, Supplemental Security Income (SSI), there are two basic categories under which a financially needy person can get payments on the basis of disability: ~ An adult age 18 or over who is disabled and ~ A child (under age 18) who is disabled.

Title II provides for payment of disability benefits to individuals who are "insured" under the Act by virtue of their contributions to the Social Security Trust Fund through the Social Security tax on their earnings, as well as to certain disabled dependents of insured individuals. Title XVI provides for SSI payments to individuals (including children under age 18) who are disabled and have limited income and resources. SSI is not the same as Social Security, even though the program is run by the SSA. Supplemental Security Income (SSI) is the first federally administered cash assistance program in this country available to the general public. It is designed to provide a floor of income for the aged, blind or disabled who have little or no income and resources. The program establishes that payment may be received as a right by those U.S. Citizens or legally admitted aliens residing in this country who qualify as aged, blind, or disabled and who meet income and resource criteria. No work credits are necessary for entitlement under this program.

A sequential review is made of the claimant's current work activity, severity of the impairment(s), age, impact of impairment on work related abilities, past and current work experience, age and education. A disability claims adjudicator obtains any existing medical evidence. If that evidence is unavailable or if further examination or testing is needed to make a determination, the Disability Determination Service (DDS) will, at its expense, arrange for a consultative examination. The claimant's treating source is usually the preferred source for performing the examination on his /her own patient.

The law provides that, under the Social Security disability program, disability benefits for workers and widows usually cannot begin for 5 months after the established onset of the disability. The 5 month waiting period does not apply to individuals filing as children of workers. Under SSI, disability payments usually begin the first month following the month of application.

An "onset" date is the date the DDS determines a claimant was eligible for disability benefits.

Social Security rules make it possible for people to test their ability to work without losing their right to cash benefits and Medicare or Medicaid. These rules are called "work incentives." The rules are different for title II and title XVI, but under both programs they may provide: ~ continued cash benefits; ~ continued help with medical bills; ~ help with work expenses; or ~ vocational training.

In some cases, yes; however, title II payments may only be made 12 months prior to the application date. For title XVI, payments may begin the first month after the month of application.

The DDS agency has a staff of trained people, including disability adjudicators and doctors, who decide if Social Security's criteria for eligibility is met.