If you cannot work due to a disability, you may qualify for Social Security Disability Insurance (SSDI) benefits. These benefits can provide financial support during challenging times.
A disability lawyer can break down the key requirements you need to meet to qualify for Social Security Disability benefits.
1. Work Credits
The first qualification for SSDI is having enough work credits. These credits are based on your work history and the amount you paid into Social Security taxes.
It’s important to note that the number of work credits needed can vary based on your age when you become disabled. For example, if you’re under 24, you may need as few as six credits earned in the three-year period ending when your disability starts.
The work credit system ensures that SSDI benefits are available to those who have contributed to the Social Security system through their work history. However, it can sometimes create challenges for younger workers or those with intermittent work histories.
2. Medical Condition Severity
The Social Security Administration (SSA) has criteria for what qualifies as a disability. To qualify for SSDI:
- Your condition must significantly limit your ability to do basic work activities such as lifting, standing, walking, sitting, or remembering for at least 12 months.
- The condition must be expected to last for at least one year or result in death.
- The SSA maintains a list of medical conditions, known as the Blue Book, that automatically qualify as disabilities if the criteria are met.
Even if your condition isn’t on the list, you may still qualify if the SSA determines that it is as severe as a listed condition. The Blue Book is divided into 14 categories, each covering a different body system.
Some included conditions are:
- Musculoskeletal disorders (e.g., severe back conditions)
- Special senses and speech (e.g., vision or hearing loss)
- Respiratory disorders (e.g., COPD, severe asthma)
- Cardiovascular conditions (e.g., heart failure)
- Digestive system disorders (e.g., inflammatory bowel disease)
- Neurological disorders (e.g., multiple sclerosis, epilepsy)
- Mental disorders (e.g., depression, anxiety, schizophrenia)
3. Inability to Perform Substantial Gainful Activity (SGA)
To qualify for SSDI, you must be unable to engage in what the SSA calls substantial gainful activity (SGA).
- The SGA limit for non-blind individuals is $1,550 per month.
- For statutorily blind individuals, the SGA limit is $2,590 per month.
SGA isn’t just about how much you earn. It also considers the nature of your work and how much you can do.
4. Age and Education
While not direct qualifications, the SSA considers your age and education level when determining your eligibility for SSDI:
- Younger individuals (under 50) are generally expected to have more capacity to adapt to other work.
- Those over 50, especially those over 55, may have an easier time qualifying if they have limited education or work experience.
- When assessing your ability to adapt to other work, the SSA considers your education level and any vocational training you’ve received.
The SSA uses the Medical-Vocational Guidelines, often called the Grid Rules, to determine if you qualify for a disability based on your age, education, and work experience. These rules acknowledge that as people age, it becomes more challenging to adapt to new types of work.
5. Citizenship and Residency
To qualify for SSDI, you must be:
- A U.S. citizen, or
- A lawful alien resident (including specific categories of non-citizens)
There are no duration of residency requirements for SSDI, unlike some other federal benefits.
For non-citizens, eligibility can depend on your specific immigration status.
Generally, you need to be lawfully present in the U.S. and fall into one of several categories, such as:
- Permanent residents (green card holders)
- Refugees or asylees
- Certain victims of human trafficking
- Certain other humanitarian immigrants
Even if you meet the residency requirements, you still need to meet all other SSDI qualifications, including having the necessary work credits.
6. Application and Documentation
While not a qualification per se, properly completing the application process plays a big part in receiving SSDI benefits:
- You’ll need to provide detailed medical records documenting your condition.
- Work history, including job duties and dates of employment, must be submitted.
- You may need to undergo a medical examination arranged by the SSA.
The application can be submitted online, by phone, or in person at your local Social Security office.
You’ll need to provide:
- Your Social Security number
- Birth certificate
- Medical records from all healthcare providers who have treated you for your condition
- Laboratory and test results
- A summary of where you worked and the kind of work you did
- Your most recent W-2 form or, if self-employed, your federal tax return
Common Reasons for SSDI Denial
Understanding why the SSA denies claims can help you avoid common pitfalls:
- Lack of sufficient medical evidence: This is one of the most common reasons for denial. It’s crucial to provide comprehensive medical documentation of your condition, including how it affects your daily life and ability to work.
- Failure to follow prescribed treatment: If you’re not following your doctor’s recommended treatment plan without a good reason, your claim may be denied.
- Continuing to work above the SGA level: If you’re earning more than the SGA limit, the SSA will likely determine that you’re not disabled for SSDI purposes.
- Not meeting the duration requirement: Your condition must be expected to last at least 12 months or result in death.
- Prior denials without new evidence: If you’ve been denied before and are reapplying without new medical evidence, you’re likely to be rejected again.
- Substance abuse contributing to the disability: If drug addiction or alcoholism is a contributing factor material to your disability, you may be denied benefits.
- Failure to cooperate: Your claim may be denied if you don’t provide requested information or fail to attend scheduled medical exams.
- Technical denials: These occur when you don’t meet the non-medical requirements, such as having insufficient work credits.
The Application Process
Applying for SSDI can take time:
- Initial Application: It can take 3-5 months for a decision
- Reconsideration (if denied): Usually takes another 3-5 months
- Hearing (if reconsideration is rejected): It can take up to a year or more to schedule
Given these timeframes, you should apply as soon as you become disabled and appeal quickly if denied.
How Liner Legal, LLC Can Help
At Liner Legal, LLC, we understand Social Security Disability law and can assist you by:
- Evaluating your case to determine if you meet the qualifications for SSDI
- Helping you gather the necessary medical evidence to support your claim
- Assisting with the initial application to ensure it’s complete and accurate
- Representing you in appeals if your initial claim is denied
- Preparing you for and representing you at disability hearings
Talk to a Disability Lawyer Today
If you’re considering applying for SSDI or the SSA denied you benefits, don’t hesitate to contact Liner Legal, LLC. Our team is dedicated to helping you with the process and getting you access to your benefits.
With Liner Legal, LLC on your side, you can focus on your health while we focus on getting you the benefits you deserve. Contact us today for your free consultation.
