If my medical condition keeps me from working will I get Social Security Disability?

Certainly, one criteria of Social Security Disability and SSI eligibility is that you must be unable to work at any meaningful level for a period of not less than twelve months, which is the minimum duration length in order to be determined "disabled".

Note: for the social security administration, working at a meaningful level means working at the SGA, or substantial gainful activity level. SGA is an earnings limit that applies to anyone who is working and filing for disability or working and receiving disability benefits. (Current SGA limit)

The ability or inability to engage in work activity is a huge consideration when it comes to determining eligibility for Social Security Disability or SSI benefits.

However, the simple fact that a person is not working or has not worked for some time does not automatically guarantee that they will be medically allowed (another way of saying "approved") for Social Security or SSI disability. All applicants must go through the Social Security Disability medical determination process to determine if their condition or conditions meet the medical disability criteria set by Social Security.

This process is essentially the same regardless of whether a claim is being decided by a disability examiner at the initial claim or reconsideration appeal level, or by an ALJ (federal administrative law judge) at the disability hearing level.

What is involved in the disability determination process?

The process involves a review of a claimant's medical records and work history and is designed to answer the following questions:

1. Does the individual have a severe impairment versus a non-severe impairment?

2. Will the individual's impairment or impairments (which can be mental or physical in nature) be severe enough to make it impossible for them to work at a substantial and gainful level (meaning that they will be unable to work and earn what is considered to be SGA-level income) at:

A) Potentially any job they have done in the past


B) At any other type of work for which they might be vocationally suited (based on education, age, skills, and current physical and mental limitations) for at least one full year.

How does the social security administration's disability evaluation process answer these questions? The process begins with the adjudicator (depending on the level of the claim, this will be a disability examiner or a judge) gathering the claimant's medical records.

These will be reviewed so that the claimant's current limitations can be rated. Rating a person's physical and mental limitations is part of the process because this allows the adjudicator to determine if the claimant can go back to one of their past jobs.

And, of course, to make this determination, the adjudicator will not only need to review the claimant's medical records, but their work history as well.

In either case, the disability examiner or the disability judge will rely heavily on the information provided by the claimant. For instance, the claimant's medical records from a particular doctor or medical treatment source cannot be obtained if the claimant does not provide the correct name and contact information for the doctor or facility when they initially file for disability.

Likewise, the adjudicator cannot be expected to accurately determine if the claimant has the ability or inability to return to a past job or switch to some new type of employment if the claimant has not provided a proper job title and description for their past jobs.

Note: accurate job descriptions are essential because the examiner will, as part of the disability determination process, be required to identify the claimant's jobs in a reference source that lists the duties of the job as well as the requirements of the job)

In the final analysis, the answer to the question we began with is, yes, if an individual's medical condition keeps them from working, and they, therefore, meet the social security definition of disability, they will be approved for disability benefits by the social security administration.

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

Criteria for Social Security Disability SSI Eligibility