SSA Disability Determination Process Explained [Video]
Written by Disability Qualification
October 17, 2021
Disability Lawyer Explains SSA Disability Claim Review Process
Watch the following video as our resident Disability Lawyer explains how the SSA reviews Disability claims:
SSA Disability Determination Process: 2 Part Test
The best way to explain SSA Disability Determination Process is is to look at it as a 2-part test:
- Part 1: Non-Medical Eligibility Requirements
- Part 2: Medical Eligibility Requirements
SSA Non-Medical Eligibility Requirements
The non-medical eligibility requirements are different for SSDI (Social Security Disability Insurance) and SSI (Supplemental Security IncomeA federal supplemental income program funded by general tax revenues (not Social Security taxes). It helps aged, blind, and disabled people who have limited income and resources by providing monthly cash payments to meet basic needs for food, clothing, and shelter. For more information, see Supplemental Security Income (SSI). More).
SSDI Non-Medical Criteria
The SSDI non-medical eligibility requirements consist of what are called work creditsAs you work and pay Social Security taxes, you earn credits that count toward your eligibility for future Social Security benefits. You can earn a maximum of four credits each year. Most people need 40 credits to qualify for benefits. Younger people need fewer credits to qualify for disability or survivors benefits. More. In order to be eligible for the system, you have to pay into it. It’s like an insurance policy. As you pay the premiums you eventually become insured under the SSDI program.
Work Credits: Non-Medical SSDI Requirement
- Work Credits are based on payments from your earnings
- A single work credit requirement is $1,470
- A person can accumulate up to 4 work credits per year
- Must earn a total fo 40 work credits
- Half (or 20 work credits) must be accumulated in last 10 years
In other words, you have worked for 10 years, five of those 10 need to have occurred in the last ten years.
For younger individuals who could not have accumulated ten years worth of work credits, the requirement is smaller.
SSI Non-Medical Criteria
The SSI non-medical eligibility requirements are needs-based. Similar to food stamps, you must demonstrate a financial need in order to qualify for the program.
SSI Needs-Based Requirements
The requirements, generally speaking, are different for individuals & couples.
- Individuals with income or assets of less than $2,000 for an individual
- Couples with income or assets of less than $3,000
Next Steps After Non-Medical Requirements
If you meet the non-medical eligibility requirements, Social Security will send your claim to Disability Determination Services (DDS). DDS will make the Initial Application or Reconsideration determinations based on your medical eligibility requirements.
SSA Medical Eligibility Requirements
The definition of disability requires someone to have an ailment that is so severe that it keeps an individual from being able to work to accomplish Substantial Gainful Activity (SGA).
The SSA defines SGA as:
- Working 40 hours a week
- Income of about $1,300 a month
If you’re unable to accomplish SGA because of your medical conditions, then you’d meet the medical eligibility requirements.
SSA Disability Benefits 5-Step Decision-Making Process
The SSA runs your disability claim through a 5-step process to determine whether or not you are truly unable to accomplish SGA & meet their definition of disability.
Step #1: Are You Working?
The first step in the process determines if individual is working. If you are working, there is no attorney that can convince a judge that you’re unable to work. If you are working, you’re not eligible for disability benefits. If you are not working, advance to Step #2.
Step #2: Do you have a severe impairment?
While most disability applicants have a severe impairment, it’s important to emphasize that you must have a severe impairment that prevents you from working. You’re not going to get disability benefits for a hangnail. If you have a severe impairment, advance to Step #3.
Step #3: Does your ailment meet a specific disability listing?
The SSA has compiled a database of nearly all qualifying ailments, along with their definitions. For example, let’s say you have a back issue. You can look up disability listings on Google, and you can find out what specific eligibility requirements need to be occurring with your back in order to meet the SSA’s definition.
If you are found to meet or equal a listing, you’ll be declared disabled at Step 3. If you’re not, the determination process isn’t over. You’ll advance to Step #4 if your specific ailment is not listed.
Step #4: Can you return to your past work?
If you are capable of performing your past work, then disability Social Security is going to say you’re not disabled. If you are not capable of performing your past work, advance to Step #4.
Step #5: Are there other jobs that you’d be capable of performing?
The SSA’s definition of disability does simply apply to your past work. It requires that you have an inability to do any job. This is not limited to your past work. You must be incapable of accomplishing Substantial Gainful Activity at any job.
If Social Security determines that there are jobs out there that you’re capable of doing, with some limited exceptions for the grid rules, then you will not be found to be disabled.
If Social Security determines that you’re not able to do any full-time work, then you’ll get a Favorable decision.
Disability Lawyer Provides Example
I use the example of a ticket-taker at a movie theater. That person can sit, they can stand, they can alternate between sitting and standing as often as they need to, as long as they stay in that general area. The heaviest thing they have to lift is a ticket, and the most complicated thing they need to know is theater 7 is on their left and Theater 8 on the right. What would keep you from doing a job like that 8 hours-a-day, 5-days a week.
FAQ for SSA Disability Determination
What Are The SSA Medical Eligibility Requirements?
What Are The SSA Non-Medical Eligibility Requirements?
Do I Qualify for SSD Benefits?
Browse our SSDI resource library to find clear answers and determine if you qualify for up to $3,627/month in SSD benefits.
Do I Qualify for Social Security Disability?
Browse our SSDI resource library to find clear answers and determine if you qualify for up to $3,627/month in SSD benefits.
I AM 84 YEARS OLD, RETIRED 1N 1995, AND RECEIVE REGULA SS CHECK, HAVE BEEN IN WHEELCHAIR ABOUT 6 MONTHS, DUE TO BOTH KNEES WEARING OUT, CARTAGES WORN OUT.
MY PROBLEM IS I CAN’T GO OUT THE HOUSE TO RETRIVE DAILY PAPER, PAPER PERSON THROWS PAPER BETWEEN SIDEWARK AND CURB, MOSTLY ON OR NEAR CURB.
I CALLED THE PAPER COMPANY “ADVOCATE” AND EXPLAINED MY PROBLEM—THEIR RESPONCE WAS “THEY CANNOT TELL THE CARRIERS WHAT TO DO, AS THEY ARE NOT EMPLOYES OF THE COMPANY,BUT ARE CONTRACTORS.
EVER HEARD OF HIRING A CONTRACT AND YOU CANNOT GIVE THEM INSTUCTIONS ???
I have already been denied that’s why I’m looking for a lawyer to help
If you take this case assessment, we’ll do our best to match you with a Specialist who can assist you with a free consultation.
I am fully disabled. I can not return to work. I receive disability. But only get 601.00 a month. I am trying to get supplemental to help me pay bills. I am 100 percent disabled. And will never be able to return to work
If you take this case assessment(https://disabilityqualification.com/disability-case-evaluation), we’ll do our best to match you with a Specialist who can assist you with a free consultation.