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 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.
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
Social Security Disability SSI Exam tips
More Social Security Disability SSI Questions
Social Security Disability SSI definitions
What makes you eligible for Social Security Disability or SSI?
New and featured pages on SSDRC.com
Who can help me file for disability?
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?
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.