Are You Eligible for Social Security Disability?​

How the SSA Determines Whether You Are Eligible for Social Security Disability Benefits

The SSA determines whether you're eligible for disability payments based on non-medical and medical criteria. Each program has different non-medical eligibility requirements:

• For SSDI eligibility, you must have worked long and recently enough. You must have “paid into" the system through Social Security taxes and have enough qualifying work credits. The government bases your Social Security work credits on yearly wages or self-employment income.
• For SSI eligibility, you must have limited income and resources.
• You cannot earn more than $1,470 per month in 2023 for either program. This amount is $2,460 for people who are blind. These amounts are "substantial gainful activity" levels.

Say you meet the non-medical eligibility requirements. What happens next? The SSA forwards your disability application to a state agency. This agency is the Disability Determination Services (DDS). The DDS looks at medical criteria to decide whether you are disabled based on the SSA's definition of disability.

Disability under the SSA's rules is more than short-term disability or partial disability. For the SSA to find you disabled, you must meet the following medical criteria:

1. You must be unable to work because of a physical or medical condition. This condition must have lasted or will last for a continuous period of not less than 12 months or is expected to result in death.
2. Your condition must be “severe," which more than minimally limits your ability to perform basic work activities. Basic work-related activities include sitting, standing, walking, lifting, and reaching. They can also include dealing with changes, using judgment, and responding to supervision.
3. Suppose you have a medical condition in the SSA's listing of impairments, and you meet the severity levels. In that case, SSA may grant you benefits earlier in the process.
4. You must be unable to perform your prior work and other types of work.

Besides the listing of impairments, the SSA maintains another disability qualifications list. The SSA allows certain cases as soon as it confirms your diagnosis. These "compassionate allowances condition" include acute leukemia, certain bladder and breast cancers, and mixed dementias.

Proving Your Disability

You are responsible for providing written evidence in support of your disability. You have an ongoing duty to provide evidence, such as medical records, which applies to every stage of the appeals process. If you have an appointed representative, this person must assist you in submitting relevant evidence.

There are some circumstances in which the SSA will help you develop medical evidence. The SSA must develop your complete medical history if you or your representative cannot get the evidence. This means the SSA will make initial and follow-up requests for evidence from sources. It may also pay for you to attend a consultative examination for more information.

If the SSA finds you not disabled at the initial level, you can go through the appeals process. The first level of appeal is reconsideration. The next level is a hearing before an Administrative Law Judge. The final level of appeal before the SSA is a review by the Appeals Council.

If the SSA finds you disabled, certain family members, such as dependent children, may qualify for benefits based on your work history.

Getting Help With the SSA Benefits Application Process

Proving your disability claim may seem like a complex process. But help is available. You can contact your local Social Security office for questions during the application process. You can also call SSA toll-free at 1-800-772-1213 or 1-800-325-0788 (the TTY phone number).

Get Help With Your SSDI or SSI Claim from an Attorney

Remember that qualifying for monthly benefits from the SSA depends on presenting the best evidence. A legal professional can ensure a smooth process and few surprises. It's a good idea to contact an experienced Social Security disability attorney. A disability lawyer can answer questions. They can also help you throughout the benefits application process.