The Social Security Administration (SSA) designed the Social Security Disability Benefits (SSD) or Social Security Disability Insurance (SSDI) program to pay individuals monthly payment benefits that are unable to work due to a medical condition. There are specific Social Security Disability criteria to qualify for disability insurance under social security. A person has to have a disability that has lasted over one year, is expected to last for more than one year, or is expected to cause death.

The Federal law dictates a rather strict definition of what qualifies as a disability to be eligible for this benefit and does not extend to partial or short-term disability. The SSA only provides benefits for total disability.

The SSA designed the SSDI for those individuals who have not only worked but who have also paid Social Security taxes for years before becoming disabled. If an individual is qualified and deemed disabled, they will receive SSDI benefits regardless of the individual’s assets or family income.

Social Security Disability Eligibility

The first requirement to be eligible for the SSD benefits is to have worked in a job covered by Social Security. If you’ve met that requirement, you must then determine whether your disability meets the disability criteria specified by the SSA.

What Medical Conditions Qualify for Social Security Disability?

The medical conditions that usually fall under one of the categories eligible for social security disability benefits are:

  • Cardiovascular System Issues
  • Digestive System Issues
  • Endocrine System Issues
  • Genitourinary Impairments
  • Hematological Disorders
  • Immune System Disorders
  • Malignant Neoplastic Diseases
  • Mental Disorders
  • Multiple Body System Impairments
  • Musculoskeletal System
  • Neurological Problems
  • Respiratory System Issues
  • Skin Disorders
  • Special Senses and Speech Issues

If your disability does not fall under one of the above categories, you may still be eligible if you qualify under one of the following categories:

  • You are blind or have low vision
  • You are the worker’s widow or widower
  • You have a disabled child
  • You are considered a part of the Wounded Warriors & Veterans organization

What Qualifies as Disability for Social Security?

The SSA considers a person as disabled if:

  1. They cannot do the work that the individual did before;
  2. It is deemed that they are unable to adjust to other work because of the medical condition; and
  3. The disability has lasted or is expected to last for at least one year or is expected to result in death.

Those eligible for SSDI benefits will receive a payment amount based on the average lifetime earnings before the disability occurred. The severity of the disability does not play a role in how much you will receive.

The benefits generally continue until you can work again regularly and there are also provisions called “work incentives” that provide sustained benefits and health care coverage to help you transition back to the workforce.

If you receive Social Security disability benefits upon reaching the full retirement age, usually 65 years old, your disability benefits will automatically convert to retirement benefits. However, the amount of benefits you receive will remain the same.

Social Security Work Credits Criteria

In addition to being classified as disabled, Social Security work credits criteria also need to be fulfilled. The number of work credits you can receive is determined by your annual wages earned or self-employment income. Regardless of the amount that you’ve earned or how long you’ve worked, each individual can only earn up to four credits per year.

The amount required for a work credit varies every year. In 2020, for example, for every month you earned $1,410 in wages or self-employment income, you could earn one work credit. Once you’ve earned $5,640, you’ve reached the maximum number of credits you could earn in that year.

Depending on how old you are when you become disabled, the number of work credits needed to qualify for disability benefits will vary. The SSA website states that one would need 40 work credits, with 20 of those 40 work credits earned in the immediate ten years before you become disabled. Nonetheless, there are instances where younger workers qualify with fewer credits.

When Should You Apply for the SSDI Benefit?

You should apply for social security disability benefits as soon as you learn of your disability. The time taken to process a disability application may take three to five months. After approval, you will not receive the SSDI benefits until five months of disability have been completed.

To apply for social security disability benefits, you will have to complete an application for Social Security benefits. The application process becomes faster if all the documents and additional information are timely provided. For assistance with your disability application, contact our team of advocates for a free evaluation.

As long as your disability prevents you from working, you are still eligible to receive SSDI benefits. Once you begin to receive benefits, the SSA will conduct a review every one to three years to determine whether you can continue receiving disability benefits or if you can return to work. This is known as a continuing disability review (CDR) on your file.

Other Benefits That May Affect Your Benefit Amount

If you receive disability benefits from any private long-term disability insurance policy, these benefits will not affect your SSDI benefits.

However, if you receive other forms of disability benefits from the government, such as workers’ compensation benefits or temporary state disability benefits, your SSDI benefits may be affected. In this case, you will only be qualified to receive up to 80% of the average earnings you made before you became disabled in SSDI and other disability benefits. Any SSI and VA benefits will not, however, reduce the SSDI benefit.

If the criteria for work credit applies and you qualify for the benefits, a process involving five questions is followed:

Are you working?

The SSA will assess whether your total hours worked and earnings are below a certain amount, which varies every year.

Is your condition severe?

The condition must significantly limit the ability to do basic work for a minimum of 12 months. These works include lifting, standing, walking, sitting, and remembering.

If the condition does interfere with basic work-related activities, the SSA will move on to the next criteria question.

Is your condition found in the list of disabling conditions?

The SSA will refer to the list of qualifying conditions to assess whether the condition meets the disability criteria. To determine whether your condition falls under one of the listings, you must evaluate whether your condition satisfies the criteria associated with the medical and findings listed under your specific condition. If the condition meets or equals a listing criterion, it will be seen as a qualifying disability. If the medical condition does not meet or medically equal the listing criteria, the state agency goes on to step four, asking the questions listed below.

Can you do the work you did previously?

Here it is decided if the medical impairment(s) prevents you from performing any of your past work. If it does not, then it will not be seen as a qualifying disability. If it does, the next step will be assessed.

Can you do any other type of work?

If you can’t do the work you did previously, it will be assessed whether it is still possible for you to do other kinds of work.

After considering all conditions, including age, education, past work experience, and any transferable skills, if it is not possible to do other work, it will be deemed a disability. If it is possible to do other work, the claim will be denied.

A decision that is denied can also be appealed with the help of a Social Security Disability lawyer, advocate, or representative.

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