The SSD Qualification Process: What You Need to Know

photo of the top of a social security disability claim with a penEvery year, millions of Americans experience a debilitating condition that causes them to be unable to work. The loss of income often results in serious economic damage to the disabled person and their family. 

Some people will be able to find financial support for a short-term disability through programs such as Workers’ Compensation, private insurance or through personal savings and/or investments. But what if your disability is long-term, meaning it will not resolve within a year, if ever, or if it is likely to result in death? 

Social Security Disability Insurance (often referred to simply as “SSD”) is a program created by the Federal government to assist you financially during the time when you cannot work due to a disabling condition. (Note that SSD is a distinct program and should not be confused with “SSI,” or Supplemental Security Income). 

However, not everyone who applies for SSD benefits will be approved. This article will discuss how the Social Security Administration (“the SSA”) determines whether you meet the qualifications to receive monthly benefits for your disability.

Qualifying Work For SSD Benefits

With some exceptions (discussed below), the first qualification is that you must be an adult who has worked at a job or jobs covered by Social Security. This typically means jobs where Social Security payments were withdrawn from your check, or you were self-employed and paid self-employment taxes.

Your work must also have been both long enough in duration AND recent enough in time to when you became disabled. 

Here’s how that works:

The length of your work history must be sufficient in order for you to qualify for benefits under the SSD program.  This is calculated by the number of “work credits” you have accumulated over the course of your working life. 

You can earn up to four work credits in a single year, whether you worked for someone else or were self-employed. The amount required to earn work credits changes each year, but as of 2020, you earn one work credit for every $1,410 you earn in wages or self-employment income.

Generally speaking, and based upon your age, you must have earned 40 work credits during your working life in order to qualify for SSD benefits, and 20 of those credits must have been earned in the ten (10) years ending with the year you became disabled. 

However, there are important exceptions:

  •  If you become disabled before the age of 24, you may qualify if you have earned six (6) credits in the 3-year period ending when your disability began.
  •  If you are between the ages of 24 and 31, you may qualify if you have work credits for half the time between the age of 21 and the time you became disabled.
    •  For example, if you became disabled at age 27, you would need to have earned 12 credits, or 3 years of work out of the previous 6 years.
  • If you are 31 or older, you need to have at least 20 work credits in the 10-year period immediately before you became disabled.

A Qualifying Disability

rendering of a shoulder x ray, pain radiating from the shoulder jointYou must have a medical condition that corresponds with the Social Security Administration’s definition of disability, and the disability must be considered a “total” disability. A total disability in this case means that your condition prevents you from performing “substantial gainful activity”, (generally earning more than $1,260 per month [1], on average) for at least a continuous year, or on a permanent basis. 

This also means that persons with partial disabilities or short-term disabilities will not qualify for SSD benefits.

As a first step, you should get your doctor’s opinion as to whether your condition may be long-term and significant enough to prevent you from working. If you do choose to apply for benefits, your doctor’s support of your claim will be very important.

You are considered disabled for the purposes of receiving benefits through SSD if:

  1.  You cannot do the work that you did previously;
  2.  The SSA decides that you cannot adjust to other work because of your medical status; and
  3.  Your disability has lasted, or is expected to last, for at least one year or to result in death.

If you meet the work requirement discussed above and apply for SSD benefits, the Social Security Administration will then evaluate whether you qualify for benefits payments using a step-by-step analysis that includes the following determinations:

  • Whether you are currently working and earning more than $1,260 per month [2] is the first step.  If you are, you will generally not be considered disabled.
  • Next, the SSA will determine if your condition significantly limits activities associated with work, for example: lifting, standing, walking, sitting and remembering.  If your condition isn’t severe enough to prevent you from doing these activities, you will be unlikely to be considered disabled for SSD purposes.
  • The Social Security Administration maintains a comprehensive list of medical conditions that are considered severe enough to prevent a person from working.  This list is often referred to as the “SSA Blue Book” or simply, “the Blue Book,” and can be found here for adults.  Future articles in this series will discuss some of these conditions in more depth, but suffice to say you generally must have one of the conditions listed in the Blue Book in order to be considered disabled.[3]
  • If your condition is not on the list, then the SSA will determine if your condition is as severe as a condition that is on the list.
    • The SSA will then determine whether you can perform the work you’ve done in any previous job or self-employment you’ve held in the last 15 years.  If you can, you are considered to not have a qualifying disability.

If you cannot perform work you have done previously, an inquiry will be made as to whether you can perform any type of work despite your impairment(s).  The SSA will consider your age, your educational background, work experience and any transferable skills you may have. If it is determined you can still perform some type of work, you will generally be denied benefits.

[1] This number can change each year.

[2] As of 2020.

[3] Having certain conditions, such as acute leukemia, ALS (Lou Gehrig’s Disease) and pancreatic cancer, will expedite the qualification process.

Special Situations

Certain conditions and situations allow people to qualify for disability benefits outside of the determination process set forth above.

  • Blindness or Low Vision.  Persons who are blind, (defined as vision that cannot be corrected to 20/200 in your better eye, or for those with a visual field of 20 degrees or less, even with corrective lenses) can often qualify for SSD benefits.  Even if you do not meet the legal definition for blindness, your impaired vision coupled with other health problems that prevent you from working may allow you to qualify.
  •  Disabled Widows or Widowers.  If you have a condition that meets the definition of a disability, as outlined above, and your disability started before or within seven years of the death or your spouse or divorced spouse, and you are between the ages of 50 and 60, SSD benefits may be available to you on your deceased spouse’s work record. You need never have worked yourself. (Note that these benefits are different from Survivors Benefits which are also paid through Social Security).
  • Disabled Children. You may be eligible to receive SSD benefits for a disabled child or children under the age of 18 if that child is your dependent.
    • Note that disabled children can also apply for SSI Benefits, which is a separate program.
  • Disabled “Adult Children.”  In simple terms, disabled children can receive SSD benefits if their parent is either disabled or deceased. To receive these benefits, the child must have either:
    • A parent who is disabled or retired and entitled to Social Security benefits, or
    • A parent who died after having worked long enough to have qualified for Social Security benefits.
  • The disabled ‘adult child’ seeking benefits [4]  must be:
    • Younger than age 18;
    • 18-19 years old and a full-time student (no higher than grade 12); or
    • 18 years or older with a disability that began before the age of 22.

[4] These benefits are considered “child’s benefits” because they are paid on the parent’s Social Security earnings record.  Such an adult child can, under certain circumstances, include an adopted child, a stepchild, grandchild, or step grandchild.

An Online Screening Tool

The Social Security Administration operates a Benefits Eligibility Screening Tool (BEST), which can help you determine if you are eligible for benefits. This is not a formal application for benefits and none of your responses are recorded, so it may be helpful as you take your first steps in determining your eligibility.  

The survey takes about ten minutes to complete, but is not a guarantee that you are either eligible or ineligible for SSD benefits.

Deciding to Apply

close up on hands dialing on a smart phoneAs you can probably tell, there are a lot of rules, regulations and exceptions involved in applying for SSD benefits. There is also a lot of information to be provided to the Social Security Administration, and you want to be sure you’re providing the best documentation to support your application. 

If you are deciding whether to apply, a qualified Social Security Disability attorney is often your best resource. Everyone’s circumstances are different, and an experienced SSD attorney deals with a variety of disability claims on a daily basis. They will be best suited to help you decide whether to apply for benefits and the strength of your claim. 

If an SSD attorney believes you are entitled to benefits, they can help you prepare your application for filing, including all of the necessary supporting documentation. If your initial application is denied, as is the case in about 65% of applications, they can appeal the decision and work to achieve a successful outcome for you. 

In a recent survey, those who used an attorney were nearly twice as likely to receive benefits compared to those who pursued their case by themselves.

We hope this article has been helpful. For more articles on qualifying for Social Security Disability with specific conditions, check this page for the most up-to-date information.

Unable to work due to long term illness or disability?

At Martin, Harding & Mazzotti, LLP, our team of Social Security disability lawyers want to help guide you through the often complicated and stringent process of filing a claim, as well as defend your rights and get you the money you deserve for your disability.  

Contact us today for a free case evaluation by calling 1-800-LAW-1010 (1-800-529-1010). We’re here 24 hours a day, 7 days a week to take your call, or use our convenient contact form here.

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