Disability Benefits: How to Qualify

Qualifying for SSDI Benefits

There are two classifications of disability benefits under the Social Security Administration: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). In this article, we will discuss the relevant differences between the two as well as the criteria that must be met in order to qualify for benefits.

Qualifying for SSDI Benefits

In order to qualify for SSDI benefits, you must have worked in jobs that were covered by Social Security and have a medical condition that meets Social Security’s definition of disability. In order to evaluate the length of your work history, Social Security assigns work credits based on your total yearly wages or self-employment income. You can earn up to four credits every year.

The amount you need to earn to qualify for one work credit changes yearly. In 2019, one work credit is given for every $1,360.00 you earn. Once you have reached $5,440.00 for the year, you will have earned four credits.

To determine how many work credits you need in order to qualify for SSDI benefits, Social Security looks at how old you were when you became disabled. Generally, however, most people need forty credits in order to qualify, and twenty of them must have been earned in the ten years ending in the year that you became disabled.

Social Security has an extremely strict definition of disability, and SSDI benefits are not awarded for short-term or partial disabilities. According to Social Security, you are considered disabled if: 1) you cannot perform the work you did before you became disabled; 2) you cannot adjust to other work because of your medical condition; and 3) your disability is permanent or is expected to last for at least twelve consecutive months or result in your death. Once approved, there is a five-month waiting period before you can receive benefits.

It is not enough to simply prove that you cannot perform the job functions of your former employment; you must also demonstrate that you cannot do other related work because of your impairment and, thus, are incapable of engaging in any substantial gainful activity (SGA). When Social Security looks at your ability to do other kinds of work, it will look closely at your ability to walk, sit, stand, and remember facts. It will also consider your age, work experience, education, other medical conditions, and any transferable skills you may possess.

Some conditions are so severe, however, that merely receiving that condition’s diagnosis is enough to expedite the review of your case and will almost certainly qualify you for SSDI benefits. There is a list of approximately 200 conditions that fall into Social Security’s Compassionate Allowances program, including pancreatic cancer, ALS, and acute leukemia.

When calculating your monthly benefit amount, Social Security assumes that you have access to other financial resources that will provide you with support during the time of your disability, such as savings, investments, insurance, and workers’ compensation. Of course, those resources are not always available to everyone receiving disability benefits. Nevertheless, if you are working and your average monthly income is greater than $1,220.00, you will generally not be considered disabled for SSDI purposes. For individuals who are blind, the 2019 monthly earnings limit is $2,040. Social Security considers you legally blind if your vision cannot be corrected to better than 20/200 in your stronger eye or your visual field is twenty degrees or less, even with the use of corrective lenses.

Qualifying for SSI Benefits

The qualifications to receive SSI benefits are slightly different than those for SSDI because, unlike SSDI, SSI is a means-based program for those who are unable to work and are of extremely limited financial resources. To qualify, you need to be: 1) at least 65-years-old OR blind OR disabled; and 2) have limited income and resources. As an individual, you cannot have more than $2,000.00 in assets ($3,000.00 if you are part of a married couple). Once approved, you can begin receiving monthly payments the first month you are approved.

The Listings

Social Security has a Listing of Impairments that describes impairments that Social Security considers severe enough to prevent you from having any substantial gainful activity, and the list is broken down by each major body system. Most of the conditions on the list are permanent or are expected to result in your death, so meeting the specified criteria can be difficult.

Part A of the Listings is used to evaluate impairments in individuals age eighteen or older, and Part B includes criteria used to evaluate impairments in those under age eighteen. Just because you do not meet the Listings does not mean you will not qualify for disability benefits; rather, it means that you will need to qualify the traditional way by proving your inability to engage in any substantial gainful activity.

Part A of the Listings is broken down into the following systems (with examples): 1) musculoskeletal system (degenerative disc disease); 2) special senses and speech (hearing and vision loss); 3) respiratory disorders (asthma, lung infections); 4) cardiovascular system (heart failure, high blood pressure); 5) digestive system (Crohn’s disease, hepatitis); 6) genitourinary disorders (renal disease, dialysis); 7) hematological disorders (chronic anemia); 8) skin disorders (cellulitis); 9) endocrine disorders (thyroid disorders); 10) congenital disorders that affect multiple body systems (Fetal-Alcohol Syndrome); 11) neurological disorders (epilepsy); 12) mental disorders (PTSD, Schizophrenia); 13) cancer (malignant neoplastic diseases); and 14) immune system disorders (Lupus, HIV).

If you think you are entitled to disability benefits, consider speaking with an experienced disability attorney who can help you evaluate your options and guide you through the whole process.