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by Tim Zayatz, A.S.A.


After onset of a severe physical or mental impairment, a worker may become entitled to monthly disability insurance benefits under the Social Security Old-Age, Survivors, and Disability Insurance (OASDI) program, provided he or she:

A worker's cash benefit is classified as an award at the time of initial payment. Additional auxiliary benefits may also be payable to other family members based on the earnings record of the entitled worker. This study analyzes the activity of disabled workers of the Social Security Disability Insurance (DI) program as described under title II of the Social Security Act.

A. Definition of Disability

For purposes of entitlement to DI benefits, disability is defined as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment. The impairment must be expected to result in death or to last for a continuous period of at least 12 months. In addition, the disability must prevent the claimant from performing previous work, or engaging in any other kind of work in which a significant number of jobs exist. It is immaterial whether such work exists in the claimant's immediate area, or whether a specific job vacancy exists, or whether the claimant would be hired if he or she applied for work.

Several additional points are worth mentioning:

B. Disability Insured Status and Waiting Period

To be insured for disability benefits, a worker must earn a requisite number of quarters of coverage (QCs) in employment covered by Social Security. 2 The worker must accrue a sufficient number of QCs to be deemed fully insured 3 and, in addition, must have worked recently in covered employment. The number of required recent QCs varies by age, and ranges from 6 out of the last 12 quarters immediately preceding the onset of disability, to 20 out of the last 40.

The waiting period for DI benefits consists of 5 consecutive full calendar months beginning with the earliest full calendar month throughout which the worker satisfied both the definition of disability and the disability insured requirements. Benefits are not payable during the waiting period. However, the waiting period is waived for individuals who had a prior period of disability, which ended within 5 years of the current period of disability. In contrast, there is no waiting period for disability benefits under the SSI program.

1 Under present law, the normal retirement age is currently specified as age 65, and is scheduled to increase gradually to age 67 beginning with persons attaining age 62 in 2000.

2 In 1999, a worker receives one QC (up to a maximum of four) for each $740 of annual covered earnings. The $740 amount is indexed each year by increases in average wages.

3 Fully insured status is obtained by earning one QC for each year after attainment of age 21 and before the earliest of (1) attainment of age 62, (2) onset of disability, or (3) death.

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July 30, 1999