Understanding Social Security Disability
The Social Security Disability (SSD) program—also known as SSDIB for Social Security Disability Insurance Benefits and SSI for Supplemental Security Income—pays benefits to disabled Americans and certain family members of the disabled individual. When you apply for SSD benefits, it’s imperative that you meet all the criteria and your application is fully completed. With the help of our trusted legal team, we can help you understand the Social Security Disability eligibility requirements.
Initial SSD applications have about a 67 percent chance of denial; however, it is essential that you not let this number dissuade you if you are disabled and unable to work! Many initial applications are denied because the proper supporting documents are not included, or the application was improperly completed. Those who start the process with an experienced Social Security Disability attorney from Schaffer & Associates stand a much better chance of approval, either at the initial stage or later on, in the appeals process. The attorneys at Schaffer & Associates believe you deserve SSD benefits when you are disabled and unable to work and will fight for your rights and your future.
Five Things to Know Before Applying for Social Security Disability
What Is Considered a Disability?
Disability is defined in § 404.1505 of the Code of Federal Regulations as the inability to complete any “substantial gainful activity” due to a physical or mental impairment that may either result in death or lasts for a period of 12 continuous months or more. A person must have a serious and severe impairment such that they are unable to normally complete work or other substantial gain activity.
While disability as a whole is very multi-dimensional, the Social Security Administration has their own strict definition of disability. Therefore, the opinion alone of one or more of your medical providers is not sufficient to gain SSDI benefits. While medical evidence can help you prove your disability to the SSA, the evidence still must show you meet their definition. One can be considered disabled based on one medical diagnosis, but more often, disability is caused by the combined effect of several conditions.
What Is Substantial Gain Activity?
One of the primary elements of disability is the inability to work or complete any “substantial gainful activity.” To be considered disabled, a person must be deemed unable to do more than a minimal amount of work. Substantial gain activity (SGA) is a threshold used to assess this. If a person earns more than the SGA limit, they are not able to collect disability benefits. For 2024, the SGA limit is $1,550 for a non-blind person and $2,590 for a statutorily blind person. Under this definition, for example, work can be considered substantial even if it is part-time.
What Makes Someone Eligible for Social Security Disability?
There are two main criteria that must be met to determine Social Security Disability eligibility. To qualify for disability benefits, you must:
- Worked in jobs that are covered by Social Security long and recently enough
- Possess a medical impairment(s) that meets the Social Security Administration’s specific definition of disability
While these eligibility requirements may seem straightforward and obvious, it is can incredibly difficult to prove that you meet both criteria. To understand these requirements, it can be helpful to break them down into parts.
Worked in Jobs Covered by Social Security
The majority of jobs in the United States are covered by Social Security. A report from Congress states that approximately 176 million Americans are projected to work in covered employment and that 94% of employed and self-employed workers are covered under the program. Generally, those who have worked 5 out of the last 10 years while paying into Social Security meet this criteria.
Some categories of employment that are not considered covered by Social Security include the following:
- Civilian federal employees who were hired before 1984
- Certain state and local government employees
- Railroad workers
- Specific work done by students
- Some members of clergy and other religious practitioners
These categories of employment often maintain their own system for insurance and retirement, excluding them from the Social Security system. If you are unsure whether or not you meet this criteria, the best course of action is to call your local Social Security office. Your local office can tell you your “date last insured” (DLI). If this date has not passed, you should be eligible for SSDI benefits.
Have a Disabling Medical Condition or Impairment
The Social Security Administration maintains a comprehensive list of conditions and impairments that are considered a disability for the purposes of Social Security Disability eligibility. This listing of impairments, found in the Blue Book, can be overwhelming. Some of the most common conditions that are listed in the Blue Book and therefore render a person legally disabled include:
- Musculoskeletal issues, including arthritis, back pain, fibromyalgia, etc.
- Some mental disorders, such as depression, PTSD, schizophrenia, and mood disorders.
- Cardiovascular diseases, including angina, hypertension, and heart failure
- Cancer
- Neurological disorders, such as Parkinson’s disease, epilepsy, cerebral palsy, and blindness
- Immune system disorders, including Sjögren’s syndrome, lupus, and rheumatoid arthritis
If you suffer from a condition listed in the Blue Book, you may be considered to have a disability and therefore eligible for Social Security benefits. Similarly, if your condition is not listed in the Blue Book but is medically equivalent to a listed condition, you may still qualify for benefits. An experienced attorney at Schaffer & Associates LPA can provide a better understanding of Social Security disability eligibility and whether your condition qualifies you for benefits.
Am I Eligible for Social Security Disability?
The application for Social Security Disability is accessible online to everyone, or by making an appointment with your local SSA office. If you believe that you are eligible for Social Security Disability, it can be helpful to seek guidance from an experienced attorney beforehand. Over 60% of initial claims are denied, indicating that determining eligibility is more complex than many people assume. If you are disabled and have a qualifying work history, you may be able to obtain benefits, depending on the strength of your application.
Social Security Disability Eligibility Requirements to Qualify for Benefits
Before applying for benefits, it is helpful to know whether you meet the Social Security Disability eligibility requirements. This will save you time with an application and supporting documents if you do not qualify. First of all, understanding whether you should be filing for SSDIB or SSI benefits (or both) is imperative. Please see our SSA page regarding the differences between SSDIB and SSI.
To be eligible for SSDIB, you must have sufficient work credits. Work credits are earned by working in jobs that are covered by Social Security. This means that Social Security is taken from your check, or, if you are self-employed, you pay into Social Security. Work credits are based on your total yearly wages or self-employment income. You can earn four work credits per year. However, the amount of wages necessary for a work credit changes from year to year.
For example, in 2020, you earn one credit for each $1,410 in wages or self-employment income. Once you have earned $5,640 in wages in 2020, you have earned your four credits for the year. The number of work credits you need to qualify for benefits will depend on your age when you become disabled. Generally speaking, SSD requires you to have 40 work credits. Twenty of those 40 work credits must be earned within the past ten years. Younger workers who become disabled may qualify for SSD with fewer work credits. This does not apply to SSI benefits.
Other Qualifications
To qualify for SSD, you must have a medical condition that is considered severe and meets the definition of a disability. Generally speaking, SSD will pay monthly benefits to those unable to work for at least a year due to a disability. It is important to note that, unlike some other programs, Social Security Disability does not pay benefits for short-term disability or partial disability.
Social Security considers you to have a permanent disability if:
- You are unable to do work you did before your disability,
- You are unable to adjust to other work due to your medical condition(s), and your disability has either lasted a year or is expected to last for at least one year or to result in death.
The assumption by Social Security is that working families typically have access to other resources to provide support during periods of short-term disability (savings, insurance, investments, workers’ compensation, etc.). Consider the following when determining whether you will qualify for SSD benefits:
- If working while filing for disability, are your earnings at “SGA” sustained gainful activity, which for 2020 is gross earnings of $1,260 or more per month? If so, you are not eligible for disability through the Social Security Act, regardless of the severity of your condition.
- Do you have a medically determinable severe impairment(s) that limits your ability to perform basic job functions, and has it done so or will it do so for at least twelve months?
- Can you do the work you previously did?
- Can you do any other type of work?
Additionally, the Compassionate Allowances initiative grants disability as soon as a diagnosis is confirmed. Examples of illnesses that qualify under the Compassionate Allowances initiative include pancreatic cancer, ALS, and acute leukemia. Social Security also has special situation programs for the blind or those with low vision, a disabled worker’s widow or widower, a disabled child, or a wounded warrior or veteran.
Common Misconceptions Regarding SSD Requirements
There are many misconceptions regarding Social Security Disability, including the following:
- All applications for SSD are initially denied. While a significant number of SSD applications are denied, not all are denied. Approximately 1/3 of all initial SSD applications are approved, depending on the state. Of course, you want to do everything you can to maximize your chance of approval. Having an experienced attorney can help. In addition, you have the right to appeal if your initial SSD application is denied.
- If you appeal and have a hearing with an “ALJ” Administrative Law Judge, your claim will automatically be approved. While this is not true, you do stand a chance of having your SSD claim approved at your ALJ disability hearing.
- You cannot claim SSD benefits until you have been disabled for a year. While you must have an injury or illness that prevents you from working for at least one year, this doesn’t mean that you have to wait a full year to start the process. If you have a medical diagnosis that suggests your condition will last for an entire year or result in death, you can immediately file your initial application.
- If you continue to reapply, eventually you will be successful in getting SSD benefits. Actually, reapplying after being denied is typically a more difficult hurdle to overcome and be successful with than having your initial application approved. Discussing your options with an experienced attorney can provide you support to ensure the best possible outcome for you.
Contacting an Attorney Near You to Help Determine Your Eligibility for Social Security Disability
Determining eligibility for Social Security Disability is rarely clear or straightforward. The Social Security Administration reviews each application carefully and thoroughly, making it helpful to ensure that you are eligible for benefits before submitting a claim. An experienced attorney near you will be able to handle the following matters:
- Completing an initial review of your case
- Determining Social Security Disability eligibility
- Tailoring your application to address potential pitfalls in your claim
- Request and compile necessary medical evidence to strengthen your case
- Navigate the appeals process in the event of a denial
How a Schaffer & Associates Attorney Can Help You Through the SSD Process
If you are disabled and unable to work, you need help in the form of Social Security Disability benefits. To receive those benefits, you need a highly skilled legal professional from Schaffer & Associates to guide you through an often complicated and challenging process. At Schaffer & Associates, we are experienced, compassionate, and fully dedicated to you and your future. At Schaffer & Associates, LPA, we have extensive experience helping injured individuals and their families living with disabilities. We can help you file your claim and will remain accessible to you throughout the life of the claim. Contact Schaffer & Associates today!
