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How the Social Security Administration Determines Eligibility for Disability Benefits

Applicant Applying for Social Security Disability You have seen the deduction for OASDI (or FICA) on your paystub since your very first job, so now that you are unable to work because of a disability, you logically assume that you will now be able to collect the benefits you need to get by. After all, you have contributed to the program your entire working life. However, approval for Social Security Disability Insurance (SSDI) is not quite that easy. In order to determine your eligibility, the Social Security Administration (SSA) will evaluate your application based on several factors. We give you an overview here.

Qualifying Conditions and Gainful Activity: Understanding SSDI Eligibility

In general, to be approved for disability benefits, you must have paid into the system and you must have a serious medical condition that prevents you from performing any kind of work. Before considering your application, the SSA will make sure you have worked long enough and recently enough to be eligible to apply by evaluating the work credits you have earned. If you meet that requirement, they will then ask the following questions:

  1. Are you currently working? If you are working at the time of your application and earning more than $1,220 a month in 2019, which is considered substantial gainful activity, you will not be considered disabled and your application will not proceed further.
  2. Is your medical condition severe? Your condition must prevent you from being able to do the basic physical requirements of a job such as lifting, standing, walking, sitting, and remembering and must limit you from these activities for at least a year. If you meet this standard, your application will move on to the next step. If you do not, you will be denied.
  3. Is your condition found in the Listing of Impairments? The SSA maintains a list of conditions—known as the Blue Book—that it considers to be serious enough to be disabling. If you have been diagnosed with a condition that is on the list, your application will move on to the next step. If your condition is not listed, the SSA will determine if it is at least as serious as a condition that is on the list.
  4. Can you do your job? Just having a condition that is on the Listing of Impairments, or is as serious as a listed condition, is not enough to qualify you for SSDI. In this next step, the SSA will determine whether the condition prevents you from being able to complete the tasks required of your job. If it does not, your application will be denied.
  5. Can you do some other work? If you can’t do what is required or your previous job, the SSA will then evaluate whether you are capable of doing your job with modifications or doing some other job. If you can’t, your application should be approved.

The SSA doesn’t just ask you these questions and take your word for it. Instead, their Disability Determination Services (DDS) consults medical records and a variety of experts to determine the answers.

Strengthening Your Application With the Help of an Attorney

As many as 70 percent of initial SSDI applications are denied each year because the applicant failed to meet one of the criteria listed above. Often, the denial comes down to an incomplete application. When you work with a Social Security disability attorney at Keller & Keller in Indianapolis, we will make sure your application is complete and that you have strong accompanying evidence. When the DDS evaluates your application, they will look at your employment, tax, and medical records, talk to vocational and medical experts, and ask you questions about your limitations. You can strengthen your application by making sure you have complete records—including a history of following doctors’ orders—and reliable evidence.

Contact Keller & Keller for SSDI Applications or Appeals in Indiana

Even though you might feel like the SSA owes you disability because you have spent years contributing to the system, unless you present a complete application, you will just be wasting your time. Whether you are applying for the first time or have been denied and want to appeal, now is the time to contact our disability attorneys. We will put our experience to work for you!

 

James R. Keller
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Partner at Keller & Keller

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