What are the Social Security Disability, SSI Requirements For How Disabled You Have to Be?

There are guidelines and requirements that determine how disabled you have to be to receive Social Security or SSI disability benefits.

The Social Security definition of disability defines a disabling condition as any medically determinable mental or physical impairment that has prevented a person from performing substantial gainful activity for twelve continuous months, or is expected to do so for twelve months, or is expected to end in death.

Note: Substantial gainful activity, or SGA, is a monthly earnings amount that Social Security considers to be self-supporting. In other words, it is effectively an earned income limit and to be considered disabled and eligible to receive benefits an individual cannot work and earn more than the limit in effect for a given year (to see the current SGA earnings limit).

Determining if an individual is disabled

There are two main factors Social Security uses to determine how disabled you are and whether or not you qualify for disability. The first is if you have a medically determinable impairment (meaning that your condition is diagnosed and supported by objective medical evidence). The second is if your disabling condition prevents you from performing work activity at a level that is considered substantial gainful activity, or SGA.

The first step in the disability evaluation process is determining the severity of a person's disabling condition. Social Security Disability examiners do this by requesting medical records or evidence from the treating medical sources that a person provides during their disability interview. If they do not have medical records, or they have no current medical records (medical records have to be no more than ninety days old to be considered current), Social Security will schedule a consultative examination to determine a current status of their condition and the limitations caused by their condition.

Disability approvals through the list of impairments

At this point, Social Security uses a disability handbook, "Disability Evaluation Under Social Security" to evaluate the severity of a physical and/or mental condition or conditions. This disability handbook--also known as the social security list of impairments, or simply the listing--contains impairment listings that address all body systems as well as the criteria needed to meet or equal the severity requirements for Social Security Disability and SSI disability.

If a person's disabling condition meets or equals the disability guidelines contained in an impairment listing they will be considered medically disabled enough and will receive monthly disability benefits provided they meet the non-medical requirements of SSD or SSI.

Medical vocational allowance approvals

Unfortunately, most people who file for Social Security Disability do not meet or equal the criteria requirements of an impairment listing. However, they still have a chance of being approved for disability if the disability examiner determines that they are unable to perform any of their past work (jobs that were performed in the past fifteen years in which they earned SGA for three months or more) and that they are also not able to perform any other type of work activity that their skills, education, and training might qualify them for because of their condition.

In order for a disability examiner to determine whether or not a disability applicant can perform any of their past work, they must determine their residual functional capacity (what they are able to do in spite of the limitations of their disabling condition or conditions). Once they determine an disability applicant's residual functional capacity, they use vocational guidelines to evaluate the individual's ability to perform any of their past work or any other type of work.

Social Security Disability examiners consider age, past work, the transferability of work skills, residual functional capacity, and education to determine if a person can be approved through a medical vocational disability allowance.

Simply stated, Social Security uses both medical and vocational guidelines to determine the severity of medical impairments, and vocational guidelines to determine if an individual is disabled for Social Security or SSI disability benefits.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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