Overview of Disability
Disability Back Pay
Requirements for Disability
Applications for disability
Tips and Advice for Disability Claims
How long does Disability take?
Winning Disability Benefits
Common Mistakes after a Denial
Mental Disability Benefits
Denials for Disability
Appeals for denied claims
Disability Benefits from SSA
Child Disability Benefits
Qualifications and How to Qualify
Working and Disability
Disability Awards and Notices
Disability Lawyers, Hiring Attorneys
Social Security List of Conditions
What Social Security considers disabling
Medical Evidence and Disability
Filing for Disability Benefits
Eligibility for Disability Benefits
SSD SSI Definitions
SSDRC authored by Tim Moore
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What do you Need to Prove to Qualify for Disability Benefits?
There is no specific formula to qualify for disability benefits in either the social security disability or SSI disability program. However, in either program, the process is the same. An individual's medical records will be evaluated to determine if the following is true:
A) That the person filing for disability has a severe impairment - this means, regardless of whether the condition is physical or mental, it must impose significant limitations on the individual's ability to engage in normal daily activities (and, by extension of this logic, significant limitations on their ability to perform work activity or, if they are a child, significant limitations on their ability to engage in age-appropriate activities such as school work).
B) That the person filing for disability has an impairment that is long lasting. What does SSA mean by "long lasting"? In actuality, the concept is known as duration, meaning that a person's condition must be disabling for at least a period of twelve months. If an individual's condition is disabling according to the information provided by the claimant's medical records (which can include a statement from a personal physician) but not disabling for at least twelve months time, then the case will typically be denied.
Why do we say "typically denied"? Because when a claim is decided at the reconsideration appeal level or the level of an application for disability, then the durational requirement is an absolute. However, when the case is decided at the disability hearing level (meaning that it is being decided by a federal disability judge at the Office of Disability Adjudication and Review), it is sometimes the case that the claim for continuing, ongoing benefits will be denied but that the claimant will still be awarded for a closed period, meaning just the less-than-twelve month period that they were considered to be disabled.
What does the social security administration mean by disabled? The definition of disability is fairly simple. However, it is very different from the definition of disability used by the military and the veterans administration, and, likewise, very different from long term disability insurance programs.
To be considered disabled and eligible to receive disability benefits under either the SSD or SSI program, the condition (or set of conditions, as this is usually the case) must, as previously mentioned, be severe and must last at least twelve months in duration. However, in addition to this criteria, the individual's condition must also impose enough functional limitations that they are unable to work at the level of being able to earn a substantial and gainful income.
For child applicants, the definition of disability, of course, does not involve the inability to work, but the inability to engage in the activities of one's peers. Typically, child applicants for disability benefits are measured by their relative inability to perform academically, unless, that is, their claim for disability is being based solely on a physical condition.
Proving whether or not you are disabled will, ultimately, hinge upon what your medical records have to say about you, i.e. what are your limitations and do they cause enough functional limitations that you cannot be expected to work (or perform at the level of your peers if you are a child applicant)?
However, the information in your records is not always viewed in the same light and is dependent on who is looking at them. One might think that "the records are simply the records" and that two separate persons reading the same records should arrive at the same conclusions. But that is often not the case, which is why claims are so often denied initially and are later approved when a claimant's case gets to the hearing level. Obviously, there is some subjectivity involved.
And this is also, of course, why representation tends to be effective at the disability hearing level. Not only will a representative (this may be a disability attorney or a non-attorney social security representative) obtain additional documentation to strengthen the claim, but will often present a viewpoint of the case that will focus on A) why the case does meet the SSA definition of disability and perhaps B) point out why the case was erroneously denied at prior levels of the system.
Return to: Social Security Disability Resource Center, or read answers to Questions
Proving a Social Security Disability Case Often Means Getting a Statement from Your Doctor
What Can I Do to Improve My Chances of Winning Disability Benefits?
Proving Functional Limitations and why this is Important on a Disability Case
What do you Need to Prove to Qualify for Disability Benefits?
Proving the requirements for disability in North Carolina
How do you Win Benefits under Social Security Disability or SSI?
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria