Social Security Disability Claims: Definitions and Explanations

What you need to know about Social Security disability benefits.When you start thinking about filing for disability with the Social Security Administration, one of your first questions would probably be how does the Social Security Administration define disability?

The basic answer is that a person is disabled if that person has a condition that prevents the ability to work for at least 12 months. This is not the same as an inability to find work or not having the skills to work.

What Are the Conditions That Can Qualify for Disability?

So, what are conditions? These are medically determinable physical or mental impairments. Having an examination performed by a licensed healthcare provider will help the SSA identify your conditions and how severe they are. If you haven’t had much treatment for your condition, Social Security might send you for an additional examination by a doctor who works with the Administration. This examination is generally brief and often will be limited in evaluating conditions that have symptoms that are sometimes better and sometimes worse. If you have a condition that gets better or worse, it is usually better for your health and for your case to get into consistent treatment with a doctor who has expertise in your condition.

Read More: Criteria Used to Determine Social Security Eligibility

What Are the Listings?

What are the Listings? As the name implies, they are a list of medical conditions with very specific symptom sets. The listings for adult conditions are available online. If you have a condition from the Listings exactly the way it is described in the listing, you will meet a Listing. If your healthcare provider or one from the SSA provides an opinion that you do not meet a Listing but your condition is roughly the same then SSA can determine that you “medically equal” a Listing.

Read More: Understanding the SSA's "Blue Book"

What If I Was in a Bad Car Accident or Had Major Surgery? Does That Qualify for Disability?

It could, but your condition has to be expected to result in death or to last for a continuous period of not less than 12 months. If you are expected to improve, but then do not, you could still be approved. Similarly, if you are not expected to improve, but then you do, you could still be denied. An experienced Social Security disability attorney can help you navigate this potentially complex process.

What Counts Is "Substantial Gainful Activity?"

This is the term used by the SSA to describe work (whether it is self-employment, gig work, contract work, or traditional employment) performed at a certain level of monthly income. This amount changes every year, but in 2021, the amount is $1310. If you do the math, that amount comes from a 40-hour week at roughly minimum wage.

Read More: Disabled But Currently Working? 5 Terms You Need to Know

Well, I Definitely Can't Do the Work I Used To. Does That Mean I'm Disabled?

Not necessarily. The SSA will determine whether you still have the ability to do any other kind of work – not just the kind of work you used to do. This is determined based on your age, your education level, the severity of your conditions, the skills that you developed in the work you used to do, and the physical and mental activities you can still perform. Altogether this determination is called your residual functional capacity. If your residual functional capacity indicates that you are able to transition to other kinds of work, the SSA will determine that you are not disabled.

Read More: 12 Myths About Social Security Benefits

Our Social Security Disability Attorneys Are Here Help

Whether you're just beginning your application for disability benefits, or you've already been denied and need to file an appeal, our Social Security disability lawyers are here to guide you through the entire process. Since 1936, we've been dedicated to getting disabled people the benefits they're entitled to. Contact us today to schedule your free, no-obligation consultation with our disability attorneys.

The Code of Federal Regulations gives the following definition of disability:

§ 404.1505. Basic definition of disability:

(a) The law defines disability as the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. To meet this definition, you must have a severe impairment(s) that makes you unable to do your past relevant work (see § 404.1560(b)) or any other substantial gainful work that exists in the national economy. If your severe impairment(s) does not meet or medically equal a listing in appendix 1, we will assess your residual functional capacity as provided in §§ 404.1520(e) and 404.1545. (See §§ 404.1520(g)(2) and 404.1562 for an exception to this rule.) We will use this residual functional capacity assessment to determine if you can do your past relevant work. If we find that you cannot do your past relevant work, we will use the same residual functional capacity assessment and your vocational factors of age, education, and work experience to determine if you can do other work. (See § 404.1520(h) for an exception to this rule.) We will use this definition of disability if you are applying for a period of disability, or disability insurance benefits as a disabled worker, or child's insurance benefits based on disability before age 22 or, with respect to disability benefits payable for months after December 1990, as a widow, widower, or surviving divorced spouse.

(b) There are different rules for determining disability for individuals who are statutorily blind. We discuss these in §§ 404.1581 through 404.1587. There are also different rules for determining disability for widows, widowers, and surviving divorced spouses for monthly benefits for months prior to January 1991. We discuss these rules in §§ 404.1577, 404.1578, and 404.1579.