The SSA’s Social Security Disability Insurance (SSDI) program provides monthly financial help to individuals who cannot work at a substantial level because of a disability. To qualify for this financial help each individual must go through the SSDI eligibility process. The process consists of 5 criteria the SSA evaluates to determine if a claimant reaches their standards of being unable to work due to a disability.
If you are considering filing for disability benefits, you may want to understand about these 5 criteria. It could help you better prove your eligibility for disability benefits.
5 Things the SSA Looks at to Determine SSDI Eligibility
Have You Worked Enough in the Past and Are You Working Too Much Now?
The SSDI program works as an insurance program. It is available to those who have worked and paid FICA taxes into the Social Security system. However, eligibility to receive benefits depends upon the number of “work credits” you have earned.
The number of work credits you have depends on the number of years you have worked and the amount of work you have done in the recent past. If the SSA says you do not have enough work credits, you will not qualify for disability benefits. Learn more here about how the SSA calculates work credits and how many you need to qualify for benefits.
After determining if you have worked enough, the SSA will look at your current employment situation. The SSA wants to know if you work or will be able to resume work within one year at what they call a substantial gainful activity (SGA) level. SGA is any work you can perform and earn a monthly income greater than a certain income level the SSA determines as “substantial.” In 2020, the SGA is $2110 for blind individuals and $1260 for non-blind individuals.
How Severe is Your Condition?
To qualify for SSDI benefits, medical records must show your condition is severe enough that it interferes with your ability to perform daily living activities and basic work-related activities such as
- pulling or pushing
- lifting or carrying
- simple cognitive reasoning
Also, records must show that your condition has lasted or is expected to last for at least 12 months or expected to result in death.
Does Your Condition Meet Criteria in the SSA Listing of Disabilities
The SSA maintains a list of medical conditions that are so severe they automatically mean you can qualify for disability benefits if records show your condition meets the specified criteria for a listing.
Not all medical conditions are listed by the SSA. If your condition is not listed or you don’t meet every criteria of a listing, the SSA may look to see if your condition meets the criteria of a different listing similar to your condition.
If you still do not qualify under the listings, the SSA will then look at the final two criteria of their evaluation process to see if you may still qualify for benefits.
Can You Do Any Work You Have Done in the Past?
If your condition did not qualify under the SSA impairments list, the SSA will look closer at how your condition affects your ability to perform work-related activities you may have done in previous jobs. They will use vocational documentation describing the general activities needed to perform each job you may have had and assess your “residual functional capacity” (RFC) to perform those activities despite your condition.
Your medical records and information from your treating physician must show your condition will not allow you to perform the activities as you once did.
Can You Do Any Other Work?
If the SSA determines you cannot perform work you have done in the past, they will look to see if you can perform different, but related, work. To make this determination, they will consider your mental and physical capabilities (shown in your RFC) along with:
- your age
- your education
- your prior work experience
- your transferable skills
If the SSA believes this medical-vocational evaluation shows you could adjust to other work, your claim will probably be denied.
Getting Help with Your SSDI Claim
As you can see, a lot goes into determining eligibility for Social Security disability benefits. Don’t let all this information overwhelm you or deter you from filing for benefits. You do not have to go through the process alone. In fact, statistics show that those who file with the help of an experienced disability attorney get approved at a higher rate.
Contact Brock & Stout for a free evaluation of your disability claim. Our disability attorneys have been helping clients navigate the Social Security disability system for over 20 years. Let our family help your family.