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While You Are Still Working, Preparing To File For An Income Due To Your Health

Learn How "Disability" Is Defined In Each Of The Private And Governmental Benefits For Which You Are Eligible

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Government Benefits

To learn how "Disability" is defined with respect to each government benefit for which you may be eligible, see the particular benefit. For instance: Social Security Disability Insurance (SSDI), or Supplemental Security Income (SSI). For additional government benefits, see: Government Benefits.

Employer Benefits, Group Disability Insurance Policies, Individual Disability Insurance Policies

Definitions of disability vary in their wording. Check each potential source of disability income for that particular source's definition of "disability."

In determining eligibility for benefits, every analyst will look to see if the records support whether you are "disabled" as defined in the particular situation.

A common definition contains the following three parts::

"You are totally disabled for our purposes if you are:

  • unable to perform
  • the material and substantial duties
  • of your regular occupation."

A common variation is to change the "of your regular occupation" to "any occupation for which you are reasonably suited through education, training and experience."

As you can see, these definitions raise a two-pronged investigation of your claim: the first is your medical condition and how it impacts your ability to work and the second is your job description.

Let's look at each part of the definition, one at a time:

Unable to perform

This is where the medical record discussed above is important. Your medical record must document medical problems that prohibit you from performing your job duties.

For example:

  • If the medical record shows that you can no longer see, then you clearly can't perform the duties of a bus driver.
  • If the record shows that you are unable to walk, then you are disabled from any occupation that requires walking.

Material and substantial duties

Under this measure, the question is whether the duties you are not able to perform are really important to your job, or whether they are just marginal.

For example:

  • If your thumb is broken and you can't write, but your job doesn't involve much writing, then it won't be considered a disabling condition.
  • If you're a schoolteacher who usually stands when teaching although you could sit if you chose to, then a broken leg won't be considered disabling.
  • If the job requires a substantial amount of travel and your symptoms are extreme fatigue along with stomach problems and diarrhea, then inability to travel could be considered disabling.
  • A secretary generally has to be able to use a computer and handle telephone calls. It's generally not a material part of the job to get coffee for the boss.

Your Regular Occupation

"Your regular occupation" means that you aren't measured against a desk job if you are a sanitation worker. By looking at your own occupation, the issue of disability is focused on your particular job.

For example:

  • A skilled surgeon might be totally disabled with a broken finger, even though he or she could still act as a doctor.
  • A computer programmer may have two broken legs, be confined to a wheelchair and still not be "disabled" within the policy definition.

As you can see, because disability is determined based on both your medical condition and your occupation, making sure the disability analyst gets an accurate job description is just as important as supplying a complete medical record.

Any occupation for which you are reasonably suited through education, training and experience."

Relating to what this change in definition means to the example used above:

  • The surgeon with the broken finger is not disabled if he or she can teach surgery or work as a doctor.


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