Social Security Disability Resource Center

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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.








  • Index of Social Security Disability SSI Questions and Answers

  • 56 Answers to Social Security Disability SSI Questions







  • SSDRC Homepage:

    Social Security Disability and SSI Resource Center



    The Most Basic questions about Getting Disability Benefits

    Social Security Disability and SSI Back Pay Benefits

    Social Security Disability SSI and whether or not you can work

    How long does it take for Social Security Disability or SSI?

    Social Security Disability SSI Awards and Award Notices




    Tips, Mistakes, How to Qualify, and How to Win Disability

    Tips and Advice for Social Security Disability and SSI Claims

    Common Mistakes to avoid after being denied for Disability

    Disability Qualifications and How to Qualify for Disability Benefits

    Winning Social Security Disability or SSI, How to Win




    Denials, Appeals, and Getting a Disability Lawyer or Representative

    What you should know about Social Security Disability and SSI Denials

    Social Security Disability and SSI Appeal Process - How to file appeals

    Questions about Disability Lawyers and Hiring a Disability Attorney




    Various Types of Benefits including SSI, Mental, and Child benefits

    SSI Disability Benefits, Questions and Answers

    Social Security and SSI based on Mental Disability

    Social Security Disability or SSI Benefits for Children

    Disability Benefits through Social Security




    Information to start with regarding Disability Claims

    An Overview of Social Security Disability and SSI

    What is considered a Disabling condition by Social Security?

    The Disability Requirements to be eligible for SSD and SSI Benefits




    Filing for Social Security Disability or SSI Benefits

    Social Security Disability and SSI Applications

    Social Security Disability SSI List of Conditions and Impairments

    Social Security Disability SSI: Medical Evidence and Records

    Filing your claim for disability benefits

    Eligibility for receiving disability benefits




    Resources on this site

    Social Security Disability, SSI Terms and Definitions

    Previously answered questions regarding SSD and SSI



    The SSDRC Disability Blog




    For Individuals living in North Carolina

    Disability in North Carolina

    North Carolina Disability Lawyer

    Getting disability in North Carolina








    Related pages:

    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?
    Social Security Disability, ongoing education, and going to school?
    Can I file a disability claim for my adult child who lacks mental capacity?



    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