Social Security Disability Insurance benefits or SSDI is one program that may offer you economic relief if you’re disabled because of an illness or injury.
It’s not easy, however, to qualify for SSDI.
To be eligible for these disability benefits, you have to meet some criteria.
First, you have to be unable to work because of a medical condition expected to last at least a year or result in death. You can’t have a partial, short-term disability, and you must meet the Social Security Administration's definition of a disability. The other thing is that you must be younger than your full retirement age.
If you qualify for these benefits, then members of your family might also be eligible to receive benefits based on your work record.
The primary thing that the Social Security Administration is trying to find out when you apply for SSDI is whether your disability is severe enough for you to qualify for benefits.
The following are some of the other things you should know about the SSDI claims process.
Are You Working?
The first thing the Social Security Administration will look into is whether or not you’re currently working.
If you are working and you’re making $1,301 a month or more, then this is what’s called substantial gainful activity.
If you earn more than the allowed level for substantial gainful activity, you’re not going to qualify for disability benefits, even if your impairment would otherwise meet the requirements. If you don’t have any earnings, or you have earnings, but they fall under the limit above, then your application or analysis goes to the next step.
The Severity of Your Impairments
The next phase of the assessment for SSDI is the severity of your impairments.
If the medical consultant assigned to your case or the claims examiner believes that your impairment or multiple impairments don’t limit your ability to work on a significant scale, then you might be considered to have a not severe impairment. Your claim will be denied if the examiner doesn’t find you to have a severe disability.
The medical conditions can range from not severe to incapacitating when it comes to the SSDI application process.
It’s not just the presence of an impairment that qualifies you for SSDI. It’s the impact of said impairment on your ability to physically and mentally function.
If your disability is found to be more than not severe, your analysis will move to the next phase.
How Does Your Disability Compare to the Listing of Impairments?
There’s something called the listing of impairments that’s used by the analyzing medical consultant or claims examiner. They compare your disability or disabilities to this Listing of Impairments to see if it’s on it.
The listings come from federal regulations.
Every impairment listed has a specific degree of medical severity required for you to be determined disabled.
If your condition meets the listed severity or goes beyond it, then there’s the assumption moving forward that it renders you unable to do substantial work.
If you have impairments that exactly match a listing criteria, then regardless of age, work experience, or education, you may be granted disability benefits.
If your impairment doesn’t precisely match something listed, then there’s a process to determine if there’s one that’s equivalent. This is called equaling a listing.
How Is Your Ability to Do Your Previous Job Affected?
When your impairments don’t meet any listing, then a claim or medical examiner will consider whether they’re severe enough to keep you from doing the type of work you did in the past.
If it’s not found to be the case that your previous line of work would be affected by your disability or impairments, then your claim will likely be denied on the basis that you can return to your previous career or line of work.
There’s something called residual functional capacity that’s important here. This is a way of saying how much functionality or ability you still have, despite your disability or medical condition. If it’s found that you can’t do your previous work, then your application may move onto the next step, which is to find out if you can do any job.
If the examiner handling your claim believes there’s other work you might be able to do that’s less demanding, either mentally or physically, they may deny your claim. Overall, it’s difficult to get SSDI or SSI benefits, and the approval process is lengthy and complex, which is why people often turn to outside help from attorneys.