Resources & Links > Social Security/ Disability Information
Social Security/ Disability Information
- Joan Passmore, Former Communications & SSA/ Government Liaison Officer, Board of Directors
Mast Cell Disease, which includes Mastocytosis, Mast Cell Activation Syndrome/ Disorder (MCAS or MCAD), and Idiopathic Anaphylaxis, has a broad range of symptoms and manifestations. For some, mast cell disease is little more than an inconvenience. For others it can be severely disabling, limiting a person’s ability to work or even leave their home. Many people with Mast Cell Disease also have other health conditions such as auto-immune disorders, Irritable Bowel Syndrome (IBS), and Interstitial Cystitis (IC) which further compromise their ability to function. When you and your physician determine that you are no longer able to work due to one or more disabling medical conditions, you should determine if you are eligible for Social Security Disability benefits and apply as soon as possible.
Do you qualify for Social Security Disability?
Social Security guidelines require that you are unable to work or that you are unable to obtain or maintain substantial gainful employment to be considered disabled. If your 2004 earnings average $810.00 per month or more, you are not considered disabled. There are no benefits available for partial disability.
Your health condition must result in a disability which the Social Security Administration (SSA) considers severe, meaning it must significantly interfere with work-related activities. It also must have lasted or be expected to last at least 1 year, or be expected to result in your death. You must be unable to do the type of work that you have done in the past or other types of work for which the SSA determines you are qualified.
If you meet the above criteria and have worked long enough to obtain the required number of credits, you may be eligible for benefits. For example, in 2004 you earn one credit for each $900.00 of wages or self-employment income to a maximum of 4 credits per year.
The SSA maintains records to determine the number of credits earned for each individual. At least half of the credits must have been earned in the past 10 years to quality for benefits. The following chart is used by the SSA to determine eligibility:
AGE |
CREDITS NEEDED TO QUALIFY FOR DISABILITY |
31-42 |
20 |
44 |
22 |
46 |
24 |
48 |
26 |
50 |
28 |
52 |
30 |
54 |
32 |
56 |
34 |
58 |
36 |
60 |
38 |
62+ |
40 |
For each additional year of age, you need one additional credit to qualify.
Example, if you are 53 you need 31 credits, if you are 55 you need 33 credits, etc. Older persons need more credits to qualify than a younger person does, theoretically because they have had more years to actually work and should have actually earned more credits.
Between the ages of 18 and 23 you may qualify if you have earned 6 credits in the 3 year period preceeding the date your disability starts.
For ages 24-31 you may qualify if you have credits for working 1/2 the time between age 21 and the time you become disabled. For example, if you become disabled at age 27, you would need credit for 3 years of work, out of the past 6 years, or 12 credits (27 minus 21 equals 6 years of possible work).
Younger persons may qualify with fewer credits. Benefits are also available for children.
Once you have determined that you are eligible for benefits, you can begin the application process.
Younger persons may qualify with fewer credits. Benefits are also available for children.
Once you have determined that you are eligible for benefits, you can begin the application process.
How does Social Security determine if I am disabled?
The SSA maintains a list of disabling conditions that are so severe that they automatically qualify you for disability. At this time, Mast Cell Disease is not on the list. Please be aware that The Mastocytosis Society (TMS) is currently working towards having Mast Cell Disease classified as a disabling condition.
If your conditions(s) are not on the list, the SSA will determine if your medical conditions are of equal severity to those on the list. If the SSA makes this determination, you will be considered disabled.
How do I apply for benefits?
There are several ways to apply for benefits:
1. Online-go to https://s3abaca.ssa.gov/pro/isba3/irib.cgi?WFORM=A
2. By telephone. Call 800 772-1213 (800 325-0778 if you are deaf or hard of hearing) and state that you do not want to apply for benefits online, but you do want to set up an appointment to apply for disability benefits at your local SSA office. There is a representative available Monday - Friday from 7 am - 7 pm. If you are too ill to actually go to the social security office, your claim can be handled by telephone and through the mail.
3. In person. Go to your local SSA office and pick up form SSA-3368.
What records and documents will I need to provide the SSA?
Beginning in April 2004, each disability applicant will receive a Disability Starter Kit. This kit will contain a factsheet that answers frequently asked questions regarding the disability process. It also contains a checklist of the documents and information you will need to provide the SSA and a worksheet to help you gather and organize this information. Copies of the documents included in the starter kit may be viewed online at www.socialsecurity.gov.
You will need to provide proof of U.S. citizenship, last year’s W-2 (if applicable), your family’s social security numbers, checking or savings account info, as well as medical and job information. You will need to provide detailed information regarding your health and the names of the doctors and medical facilities where you have received treatment. You should list all of your medical conditions, even those that may seem less significant, as your entire health profile will be used to determine if you are disabled.
A disability appointment will be arranged for you, this can be done in person or by telephone. Keep your appointment even if you do not have all of the required documents available. SSA will assist you in obtaining these documents if necessary.
What happens after I apply?
You may be asked to see a physician selected by the SSA. If so, make sure you do not miss your appointment.
It normally takes 3-6 months to obtain a decision regarding your disability claim. Making sure that you submit all of the requested documentation in a timely manner may shorten the waiting time. You will be notified in writing of the decision once a determination has been made.
Please be aware that a very large percentage of initial applicants are denied. If this happens, you have the right to appeal the decision. Many chronically ill persons are approved in the appeals process. Although this can be a very time-consuming and frustrating process, a favorable determination may result from your patience and persistence. You have 60 days to appeal a denial. Your appeal and the request must be in writing. If you need assistance with your appeal, you should contact the SSA. There are four levels of appeal - reconsideration, hearing by an administrative law judge, review by the Appeals council, and federal court review. Additional information on appeals can be found on the SSA website or by contacting the SSA. You can hire an attorney to help you handle your appeal.
If you are approved, the SSA will determine a beginning date of disability and they will issue a check beginning with the sixth full month after the date your disability began. You will be awarded back pay if it applies to your situation. Benefits are paid the month after they are due. Example, a check for February will be sent to you in March.
Your benefits will vary depending on your income history.
Ideas to help now and in the future
Make sure that your physicians keep detailed records of your office visits, including clearly stating your symptoms.
Ask your doctor to clearly state your diagnosis in his office notes.
Keep a diary or journal or your symptoms and take it with you to your doctor’s appointment. Ask the doctor to review the diary and to may it a permanent part of your medical record.
Keep track of any visits to the emergency room or urgent care clinics. You will want to be sure that those records are included in your application.
This is a brief overview of the disability process. More detailed information is available at the SSA website, www.socialsecurity.gov, or by calling the SSA at the toll free numbers listed above and requesting information on applying for disability.