Social Security Disability Definitions
Social Security Disability and SSI Overview
The Requirements for Disability
Social Security Disability and SSI Applications
Tips and Advice for Disability Claims
How long does Disability take?
Common Mistakes after Receiving a Disability Denial
Disability Denials and Filing Appeals
Social Security Mental Disability Benefits
Disability Benefits offered through Social Security
Benefits through SSI disability
Disability Benefits for Children
Disability Qualifications and How to Qualify
Social Security Disability and Working
Winning your Disability Benefits
Social Security Back Pay and the disability award notice
Disability Lawyers and Hiring an Attorney
Social Security Disability SSI List of Conditions
What is considered a Disabling condition by Social Security?
Social Security Disability SSI and Medical Evidence
Filing for Disability Benefits
Eligibility for Disability Benefits
SSDRC authored by Tim Moore
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What do you Need to Prove to Qualify for Disability Benefits?
How to prove you are disabled
and win 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
Information on the following topics can be found here: Social Security Disability Questions
Social Security Disability SSI decisions | The Disability Decision Process and What gets taken into Consideration | Getting Denied for Disability Benefits | Questions about Social Security Disability Approvals and Being Approved | Social Security Disability Hearings | Social Security Medical Examinations | Social Security SSI Doctors | Social Security Disability Representation | Social Security Disability SSI Reviews