How to Qualify for Social Security Disability Insurance

Even if you have a serious disability, qualifying for Social Security Disability Insurance (SSDI) benefits is far from a given. The Social Security Administration (SSA) is known for being very difficult and sparingly granting benefits. Here is how you qualify for SSDI benefits.

In general, there are two types of requirements to qualify for SSDI benefits:

  • A prior work history that had you paying into the Social Security system
  • A disability that falls under the definition of the term provided by the SSA (signifying how tough it can be, the SSA refers to the definition of disability as “strict)

In terms of your work history, you must have earned enough work credits to have qualified for the program. You will earn one work credit for each $1,510 of earnings, with the possibility of earning four work credits per year. Overall, you will need 40 work credits to qualify, with 20 earned in the last ten years. However, the number of work credits necessary can be lowered for younger workers.

SSA requires detailed medical evidence to prove that you have a qualifying disability. Generally, there are three requirements for a disability:

  • Your medical condition prevents you from working or engaging in substantial gainful activity.
  • Your medical condition keeps you from doing the work that you previously did or adjusting to other work.
  • Your medical condition will last for at least one year, or it will result in death.

As you can see, short-term and temporary disabilities will not qualify for the SSDI program. The key to qualifying for the program is showing that you can no longer work. Otherwise, you may be covered by either workers’ compensation or short-term disability.

There is a significant amount of work that you must do to qualify for the program. One of the key determinations that the SSA will make is whether your condition is severe enough to qualify for benefits. The SSA maintains a list of disabilities that are presumed to be severe enough to enable you to receive benefits. Otherwise, the SSA will make a determination of your eligibility on a case-by-case basis.

Even if you have a condition, the SSA claims officer will still make their own determination of whether they think you can work. First, the SSA will decide whether you can perform the job that you had before your disability. If the answer is no, the SSA will then determine whether you can do any other type of work. The SSDI program uses the strictest definition of disability that keeps you from getting benefits if you can do any other type of work. The expectation is that you will take some kind of employment if you are able.

The expectation is that you will submit objective medical evidence from an acceptable medical source. Usually, MRIs and CT scans will qualify as objective medical evidence. Proving your disability can become more challenging if you are suffering from an illness that can be considered more subjective in nature and does not show up on objective medical scans. For example, you may have a condition such as post-traumatic stress disorder that is subjective and based on a psychiatric diagnosis. The SSA may not accept the evidence that you provide as part of your claim.

Once you submit your disability claim, it will take between 3 to 5 months to get a decision back from the SSA. Do not be surprised if you do not qualify for benefits when you first apply. Only 22 percent of initial SSDI claims are granted, while 63 percent are denied completely. You should make sure to provide a well-documented medical file with your initial application.

It is not always easy to qualify for SSDI benefits. The Social Security Administration has a rather high rejection rate for initial applications. The claim evaluator may not believe that you are disabled or that you have not fulfilled all the requirements to be eligible. Applicants have the legal right to appeal a denial of their application. They can request reconsideration of their decision before they seek to have their case heard by a judge. If you did not have an attorney assisting you with your initial application, you would definitely need legal help at this point. You should consider hiring a qualified Garden Grove social security disability attorney to help with your application, given how stringent the SSA can be in this area.