Published on: September 26, 2022
Suffering from the pain of Lupus is a burden few people can appreciate unless they too know the pain. Those who are receiving or have filed a claim to receive Social Security Disability (SSD) benefits based on Lupus deserve to know as much as possible about the details of their claim.
If you are considering filing an SSD claim for a Lupus-related impairment and you want to know how much you can expect to receive in monthly benefit payments, this blog post will explain exactly how the Social Security Administration (SSA) determines the amount of every SSD claimant’s monthly benefit payment.
Our team of professional disability advocates at Disability Experts of Florida (DEF) have over 100 years of experience guiding our clients through the disability claims process and fighting to make sure they get all the benefits to which they’re entitled. Call us if you need help or information about getting disability benefits for your Lupus impairment.
How Social Security Disability Determines Your Benefit Amount
You may be surprised to learn that your disability benefit amount has nothing to do with which illness, disease, or injury caused your disability. The amount of the monthly benefit payment is entirely determined by the SSD claimant’s lifetime earnings record.
The Social Security Administration’s rules and regulations are designed to focus on two issues:
- Is the person claiming SSD benefits disabled? and
- What amount shall that disabled person receive in monthly benefits?
The disability claimant’s case will be reviewed and assessed to decide if they are totally disabled or not. There is no “partial” disability with Social Security. Under the Social Security laws, a person is totally disabled if they have
“a medically determinable physical or mental impairment that lasts, or is expected to last, for 12 months (or result in death), and that prevents the person from performing substantial gainful activities.”
By that standard, the progressive nature of Lupus would meet the standard. As an autoimmune disease that turns the body’s own immune system on the body’s tissues, joints, and nerves, records of the claimant’s medical treatment should easily satisfy the SSA’s measure.
Calculating the Amount of Your Disability Benefits
The Social Security Administration applies the same formula in every SSD case to find the dollar value that each benefit recipient will be paid. The formula is based on the taxable income the claimant earned in the 35 highest earning years.
Step 1. Finding the 35 years in which you earn your highest reported taxable income
The Social Security Administration has the records of every annual income you reported since you started working. The government takes your highest 35 annual incomes and then “indexes” them to adjust to national income levels. Then it adds the indexed figures together and divides them by 35 to find your average indexed annual income. That figure is then divided by 12 to arrive at your Average Indexed Monthly Income (AIME).
Step 2. Apply the formula to the AIME figure to determine the monthly benefit level, the Primary Insurance Amount, or PIA:
- Take 90 % of the first $1,024 of the AIME, plus
- 32 % of the AIME between $1,024 and $6,172, plus
- 15 % of the AIME above $6,172.
- Then round down to the nearest $0.10 unless the figure is already divisible by 10.
The resulting figure is the amount of that claimant’s monthly SSD benefit payment, their Primary Insurance Amount (PIA).
Example of how the PIA formula works:
Let’s take an imaginary disabled SSD claimant named Sal. Sal’s 35 highest earning years were indexed, added together, and divided, first by 35 and then by 12 to find Sal’s Average Indexed Monthly Income, their AIME.
Sal’s AIME is $5,284.00.
- 90 % of the first $1,024 = $921.60, plus
- 32 % of the AIME between $1,024 and $6,172 = (5,284 - 1,024 = $4,260 x .32 = $1,363.20)*, plus
- 15 % of any part of the AIME above $6,172 = 0.
$921.60 + $1,363.20 + 0 = $2,284.80
- Rounded down to the nearest $0.10 = $2,284.80 = Sal’s monthly SSD benefit.
*(note that the AIME does not go up to $6,172; the AIME stops at $5,284. Therefore, the 32% of the difference between $1,024 and $5,284 is the figure we needed)
As you can see, the nature or severity of Sal’s impairment did not enter into the equation at all. This example is merely an exercise to illustrate how the SSA’s formula for determining SSD benefit payments works. Every case is different because every worker’s annual income over their 35 highest earning years is different.
Annual Cost of Living Allowance (COLA)
Each year, the Social Security Administration is required by law to provide a cost of living allowance (COLA) so that inflation occurring in the previous year does not have the effect of shrinking the buying power of SSD recipients’ benefits. These annual COLA increases help, but they are usually fairly small. However, in 2022, the increase was substantial because 2021’s inflation rate rose substantially. At the tie of this writing in September 2022, inflation is as high as it’s been in many years. That should mean another substantial COLA increase beginning in January 2023.
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