Since Veterans can apply for both VA disability and Social Security disability benefits, they may assume the process is roughly the same. This is not the case.
Those who apply for both programs may be surprised to receive up to a 100% disability rating from Veterans Affairs, and yet, proving their disability for Social Security is much more difficult.
In reality, these are two completely separate programs run by different agencies.
Some key major differences unique to each program include:
- the application process
- medically proving your disability
- appealing an unfavorable decision
- how the level of benefits is decided
Here’s a brief rundown.
Veterans with service-connected disabilities can apply for monthly benefits for themselves and their families through the VA.
There are other circumstances for which a Veteran may qualify for benefits, such as when they suffer a secondary condition or an existing condition worsens.
A main distinction for VA disability is that a primary disability must be related to a veteran’s service in one of the following ways: a disability sustained before joining the military that’s worsened, a disability sustained while serving, or a disability that appeared after discharge from service.
You will need to medically prove your disability is service-related and will receive a disability rating based on the severity of all service disabilities combined.
Social Security Disability
Social Security disability benefits are determined based not on a service connection, but rather how your condition impairs your ability to work in the U.S. economy.
There are two primary benefits programs overseen by the Social Security Administration (SSA). These include:
Social Security Disability Insurance (SSDI): SSDI is an earned benefit. You must earn a certain amount of total credits to qualify. In general, you need 40 credits, 20 of which were earned in the last 10 years, ending with the year you become disabled, according to the SSA.
Supplemental Security Income (SSI): SSI is a means-tested program for people 65 or older, or blind or disabled at any age, and who have limited income and resources. In 2020, you must not exceed $803 of monthly unearned income per individual and $1,195 per couple; or $1,651 of earned income per individual or $2,435 per couple.
Here are some of the key differences VA disability and Social Security claimants face.
Do You Qualify?
The standard of how you qualify for benefits varies between VA disability and Social Security.
The VA will largely be looking to prove a service disability—or multiple disabilities—connected to your service in the Armed Forces. If this connection is proven through medical evidence and service records, you’ll receive a disability rating from 0% to 100%.
When seeking VA disability benefits, your ability to work is not a primary consideration. Your disability rating will determine the benefits you and your family receive. For instance, a Veteran and their families would receive a higher benefits amount with a 50% rating than a 10% rating.
The VA has established a burden of proof for disabilities which favors the Veteran. Veterans should be awarded benefits when their conditions are “at least as likely as not” to be service disabilities.
For Social Security disability benefits, medically proving your disability can be difficult, and is an “all or nothing” proposition. Whether you win benefits is based on proving your impairments prevent you from working within the U.S. economy. They must fall within strict disability listings, or else your Residual Functional Capacity (RFC) must show you can’t work, as determined by disability claims examiner and medical consultant.
While you can apply for both programs, a high disability rating from the VA doesn’t necessarily translate into an approval for SSDI or SSI.
Proving Your Disability
While proving your disability for each benefits program shares the same goal, the process itself differs.
VA Disability Medical Evidence:
- You may have a “presumptive” disability, or a condition the VA assumes is a disability, and don’t have to medically prove it beyond that.
- You file an initial claim, an increase in benefits, a new or supplemental claim, or a secondary claim. Each requires its own types of evidence and paperwork.
- You must provide detailed service and medical records, as well as a “nexus letter” from a medical provider linking your condition to your service.
- You may need to file a Disability Benefits Questionnaire (DBQ) and undergo a Compensation and Pension (C&P) Exam.
Social Security medical evidence:
- You must provide medical evidence such as records, test results and imaging, medication and therapy details, as well as written doctors’ opinions proving how your condition prevents you from working.
- You may need to file additional paperwork, such as an Adult Function Report. The SSA should communicate with you about what paperwork is required at each stage of your claim.
- You must either fit a narrow disability listing, or else you must otherwise medically prove your condition’s severity prevents you from participating in the U.S. economy.
- You must not be currently earning above a certain amount of income or be considered capable of earning above that threshold, either from past jobs or other positions for which you are determined qualified.
- For SSI, which is means-based, the amount you can earn is lower than for SSDI.
Appealing an Unfavorable Decision: How Disability Lawyers Can Help
For both disability programs, there is a chance you will either be initially denied or receive an otherwise unfavorable decision. For instance, the VA may assign you a lower disability rating that you wish to appeal. A vast majority of Social Security applicants are initially denied and must appeal.
The appeals process varies between the two programs.
The VA will offer three levels of appeal, including filing a supplemental claim with new evidence, requesting a higher-level review, or having a board appeal.
Social Security claims can be reconsidered by the SSA, but this is unlikely to alter the decision of your claim unless there has been an error in the review process. Statistically, you’re most likely to reverse a benefits decision at the hearing level, where an Administrative Law Judge (ALJ) will consider your claim.
The right disability attorney can advocate on your behalf and guide you through this crucial appeals stage of a benefits claim, as well as all stages of a claim. They will have the experience and legal wisdom to anticipate expectations from the agencies determining benefits, as well as judges and other court personnel, and communicate a clear plan with you and your family.
If your disability claim has been denied, or you’re thinking about filing and don’t know where to start, Affleck & Gordon can help. We’ve been helping people in Georgia just like you for over 40 years. Sign up for a free case evaluation here, or call us (404) 795-7449.