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How Does Social Security Define Disability?

Although technically anyone could be eligible for Social Security benefits, there are certain restrictions that will disqualify some applicants. An applicant must be able to prove that they are unable to work a full-time, eight-hours-a-day, five-days-a-week job due to a debilitating physical or mental condition that must be reasonably expected to last for at least one year. If the applicant is not working a full-time job, then the condition must prevent them from working a part-time job that in 2007, earned more than $900 gross a month.  

 

The Social Security is designed to only benefit those who truly need the assistance. In addition to having very specific restrictions, Social Security disability benefits are far from lucrative. As of 2008, the maximum monthly benefit an applicant could receive was slightly over $2000. Supplemental Security Income (SSI) pays even less than that. While it is true that not every employer provides health insurance, disability insurance provides Medicare and/or Medicaid to all recipients.

 

Of course, every situation is different and Social Security does allow for a few exceptions. For example, if a person is only able to work certain days, or if they are only able to work part time due to their mental or physical condition, they may still be eligible to receive Social Security benefits.

 

As it can be a complicated process, Social Security has established a checklist to help determine a person’s eligibility.

 

1. The applicant is unable to work to support themselves. The first requirement specifies that an applicant must be unable to work to support themselves as a direct result of their “physical or mental impairment.” If the applicant is able to work, they may still be eligible for Social Security disability benefits if they make less than the Substantial Gainful Amount (SGA), which was less than $900 a month as of 2007.

 

2. Circumstances prevent the applicant from performing their old job or any other job. Based on the applicant’s age, education and work experience, it must be determined that not only are they unable to perform their previous job, but any other occupation as well. Factors such as whether there are jobs in their area that they may or may not qualify for, even if it’s likely that the applicant might be hired if they applied, are not important. They must only prove that they are no longer able to perform past work, or any other reasonable occupation.

 

Thus the older the applicant is, the less skilled and the less educated, the greater their chances of being eligible for Social Security disability benefits. Generally, a high education has a very minimal impact on the decision. In fact, the Social Security Administration doesn’t even differentiate between high school and college-educated applicants. The only education categories it considers are high school grad, not high school grad, limited and illiterate.

 

3. Medical evidence of the disability must be provided. It is not enough to claim to be disabled. The applicant must be able to prove the disability with proper medical documentation from a licensed, credible source such as a doctor or hospital medical staff. Applicants should expect this as a basic requirement and be prepared with proper documentation.

 

4. The disability is expected to end in death or last at least one year. If it is unclear whether the condition could be terminal or last at least twelve months, it may still be worthwhile to apply for Social Security disability benefits. This particular area can be a bit tricky however, so it is recommended that the applicant seek expert advice to help them make a better decision.

 

As there are conditions that last more than a year where the person eventually is able to return to work, the Social Security Administration has allowed for something called a “closed period,” or being eligible to receive benefits for only a specific amount of time. The key here is to apply quickly as the window of eligibility is limited.

 

5. The applicant must meet certain SSA-determined “non-medical criteria.” This would be the “small print” portion of SSDI and SSI requirements. After establishing the applicant’s condition and their inability to support themselves, there are several specific rules that determine a person’s eligibility.

 

There are time requirements related to the applicant’s work history. How long did the person work for? How recently were they unable to work? Does the applicant abuse drugs or alcohol? Is the applicant wanted for any felony crimes? What is the applicant’s net worth? The SSA will want to consider if the applicant has a lot of assets such as property, an inheritance or a trust fund.

 

Fortunately, although there are many non-medical criteria to be considered, there are several loop holes that an expert will be able to help assess. Keep in mind that there are no gray areas and no percentages in this area; the SSA will either determine a person to be disabled or not disabled.

 


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How Does Social Security Define Disability? Disability Determination Disability Application Process
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What is Social Security Disability? SSDI SSI
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