GrúaMany people in Chicago apply for Social Security Disability benefits after experiencing severe workplace injuries that prevent further employment. These workers often believe they will easily qualify for SSD benefits if they are classified as “totally disabled” in the workers’ compensation system. Unfortunately, the two systems use markedly different criteria to evaluate disability.

Definitions of disablement

Workers’ compensation and Social Security Disability benefits are both awarded based on the applicant’s ability to work. However, each system uses different standards to evaluate employability. The SSA’s standards are often stricter.

Illinois workers may receive Temporary Total Disability benefits if an injury prevents work but will soon heal or improve. The SSA does not consider a condition disabling unless it lasts continuously for at least 12 months. Many conditions that qualify for TTD benefits may not meet this length requirement.

Under Illinois workers’ compensation laws, an employee may be deemed capable of work and still receive benefits, if the work is sporadic and unstable. Illinois workers also automatically qualify for Permanent Total Disability benefits on the basis of injuries that may not preclude work. Qualifying injuries include the loss of use of two prescribed body parts, including feet, legs, hands, arms or eyes.

The SSA might not view these injuries as inherently disabling. For instance, someone who has lost both feet might be capable of sedentary work with accommodations. Rather than automatically awarding benefits to people who receive PTD, SSA claims evaluators consider several factors to determine whether an injury is disabling.

Criteria for SSD benefits

If an individual’s condition or impairment does not match an SSA impairment listing, the individual must seek a medical vocational allowance. When deciding whether to grant the allowance, the SSA considers the following factors:

  • The effects of the injury and the resulting functional limitations. These are often highlighted by a Residual Functional Capacity form, which is filled out by a treating physician.
  • The education and employment history of the applicant. If an applicant is not fit to perform a current job, the SSA will consider whether returning to a past line of work is physically feasible.
  • The applicant’s ability to switch to a new line of work. People under 50 who can perform sedentary work are generally considered capable of finding employment, regardless of their skill sets. People applying after age 50 who have few transferrable skills are more likely to be considered disabled.

People classified as “totally disabled” in the workers’ compensation system may not receive benefits if they are younger, experienced in sedentary jobs or otherwise capable of gainful employment. Rather than making assumptions, people who collect PTD benefits should work with an attorney to improve the likelihood of SSD claim approval.