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How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay

What makes you disabled for SSD, Social Security Disability Benefits, OR SSI?



 
Social Security Disability and SSI cases are decided on the basis of a fundamental decision: can the claimant perform work activity that provides a substantial and gainful income? Working at this level is referred to as SGA, or substantial gainful activity.

For practical purposes, it means working and earning a certain minimum amount each month (the gross earnings amount that is the current SGA limit can be viewed here: How much can you work and earn before becoming ineligible for SSD or SSI?)

In other words, if you retain the ability to work but only at a level that is below the SGA earnings limit that is in effect for a given year, then you may be considered disabled by Social security.

The actual definition of disability states that, to qualify for disability, the following must be true:

1. The person filing for disability must have a medically determinable basis for the impairment that they claim to be disabling. What does SSA mean by "medically determinable"? This simply means that the claimant's diagnosis, and the limitations and restrictions that result from their diagnosed condition, must be documented, i.e. proven by medical evidence. This will typically mean medical records obtained from the various doctors who have treated a claimant (but also including hospitals and specialized clinics).



2. The person applying for disability must have a condition that is severe enough to prevent them from being able to work and earn a substantial and gainful income.

3. This level of severity must persist for at least one full year in order for an individual to be awarded disability benefits.

Whether or not a person can engage in substantial and gainful work activity will determine whether or not they meet the qualifications for disability under either the SSD (Social Security Disability) or SSI (supplemental security income) program.

How is it proven that a case actually meets the definition of disability used by the social security administration? If the medical evidence shows that the claimant's current physical and/or mental abilities are not up to the task of doing any of the jobs that they might have done in the past 15 year period (this is what SSA considers to be the relevant work period), then it is possible that they may be approved for disability.

However, the inability to return to a past job is only part of the equation. Once a return to past work is eliminated as an option, a claimant's file (which includes their medical records, statements from a treating physician--referred to as a residual functional capacity statement or medical source statement--work history reports, and questionaires regarding their activities of daily living) must also demonstrate that the claimant lacks the ability to use their education and job training, given full consideration of their age and functional limitations, to do some type of other work.

The inability to work, of course, at a level that allows the individual to earn a substantial and gainful income, must last for at least one full year. If the individual's state of disability does not last for a full year, the claim will be turned down as durational denial.

What happens if a disability claim is denied on the basis of duration, i.e. that the condition was not disabling for long enough a period of time? The claimant may elect to further pursue the claim by following the appeal process. Filing appeals is always preferable to filing a new claim since the filing of appeals will advance the case further along in the system.

The first appeal, the request for reconsideration, is handled in an identical fashion to the disability application and is simply processed by a different disability examiner. And, not surprisingly, the rate of denial on reconsiderations is very high. In fact, the percentage of denials at the recon level typically exceeds 80 percent.

Getting through the recon level, though, allows a claimant to file the second appeal in the SSD and SSI system. That appeal is known as a request for hearing before an administrative law judge. At a hearing, a claimant will, statistically, stand a much higher chance of being awarded benefits, particularly when the case is A) properly prepared and B) properly presented to the presiding judge.








Essential Questions

What is the Social Security Disability SSI list of impairments?

Can you work while getting or applying for Disability?

How Often Does Social Security Approve Disability The First Time You Apply?

Tips for getting Social Security Disability or SSI benefits approved

What medical conditions will get you approved for disability?

What kind of Mental Problems Qualify for Disability?

Receiving a Disability Award Letter

Conditions Social Security will recognize as a disability

Previously answered questions regarding SSD and SSI

Applying for disability in your state



Most popular topics on SSDRC.com

Social Security Disability SSI Questions

The listings, list of disabling impairments

Can a mental illness qualify you for disability?

Disability Lawyers prevent unnecessary denials

How much Social Security Disability SSI back pay?

How to apply for disability for a child or children

Filing a Social Security Disability SSI application

Filing for disability - when to file

How to apply for disability - where to apply

Qualifications for disability benefits

How to Prove you are disabled and Win your Disability Benefits

Qualifying for Disability - The Process

How to get disability for depression

Getting disability for fibromyalgia

SSI disability for children with ADHD

What is the Application Process for Social Security Disability and SSI?

Common Mistakes to avoid after being denied for Disability

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What makes you eligible for Social Security Disability or SSI?



New and featured pages on SSDRC.com

Who can help me file for disability?




Related pages:

If Am Medically Disabled, Can Social Security Still Turn Me Down for Disability for Some Reason?
How will Social Security find you disabled?
When is a Person Considered Fully Disabled by Social Security?
Being Determined Medically Disabled for Social Security Disability
How Does Social Security Decide If You Are Disabled Or Not?
What makes you disabled for SSD, Social Security Disability Benefits, OR SSI?
How Disabled Must You be to get Social Security Disability Approved?
How Disabled Do You Have To Be To Collect Social Security Disability or SSI?
If I apply for disability and my doctor says I am disabled, is there a waiting period to receive benefits?
If my account goes over $2000 asset limit, will it cause a problem for SSI?
If you apply for disability in Nevada
Getting a Disability Lawyer in Nevada



These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.