Who Can Apply for Social Security Disability Benefits?

Social Security Disability Benefits are a crucial safety net for individuals who find themselves unable to work due to a disabling condition. In the United States, the Social Security Administration (SSA) oversees and distributes these benefits to help mitigate the financial challenges of significant health-related work barriers. 

Social Security Disability (SSD) benefits are designed to provide financial assistance to individuals who cannot work due to a disabling medical condition. Generally, individuals can apply for SSD benefits if they meet the following requirements:

1. Work History and Work Credits

When navigating the complexities of qualifying for SSD benefits, having an expert advocate on your side can make a significant difference. This is why many applicants seeking to file claims or appeal denied benefits turn to premier social security law firms with proven track records. These specialized law firms understand the intricacies of the Social Security system and work tirelessly to help clients gather the necessary medical evidence, meet critical deadlines, and present a compelling case for eligibility. 

2. Duration Requirement

The disabling medical condition must meet the duration requirement, meaning it must have lasted or be expected to last for at least 12 continuous months or result in death. This requirement ensures that SSD benefits are reserved for individuals with long-term or permanent disabilities that significantly impact their ability to work and earn a living. Temporary or short-term disabilities that do not meet the duration requirement are not eligible for SSD benefits.

3. Exclusion from Substantial Gainful Activity (SGA)

To qualify for SSD benefits, applicants must refrain from engaging in substantial gainful activity (SGA) due to their medical condition(s). Substantial gainful activity refers to work that involves significant physical or mental activity and earns a certain amount of income set by the SSA each year. An individual earning above the SGA level is generally considered not disabled for SSD purposes. However, there are exceptions for individuals who engage in “unsuccessful work attempts” or participate in special work programs designed for individuals with disabilities.

4. Age Requirement

There is no minimum age requirement to apply for SSD benefits, but applicants must be younger than full retirement age to qualify. Additionally, special rules may apply to individuals who became disabled before the age of 22, allowing them to potentially qualify for SSD benefits based on their parent’s work history. These rules, known as “disabled adult child” benefits, provide financial assistance to individuals with disabilities who were disabled before the age of 22 and have a parent who is entitled to Social Security retirement or disability benefits.

5. Disabling Medical Condition

The most critical aspect of securing SSD benefits for diabetes or any other condition involves proving eligibility where the medically determinable impairment(s) meets the SSA’s definition of disability. For individuals with diabetes, this means the impairment(s) must be severe enough to prevent them from engaging in substantial gainful activity (SGA) for at least 12 continuous months or be expected to result in death. 

Examples of qualifying impairments, aside from diabetes when severe enough, include musculoskeletal disorders, cardiovascular conditions, respiratory illnesses, mental health disorders, neurological disorders, and immune system disorders. 

6. Non-Medical Eligibility Criteria

While SSD eligibility primarily focuses on the severity of the medical condition, individuals must meet some non-medical criteria. These include citizenship or legal residency requirements, age, and marital status. Generally, individuals must be U.S. citizens or legal residents to qualify for SSD benefits. However, there are exceptions for certain noncitizens, such as refugees and asylees. Additionally, SSD benefits are available to individuals of any marital status, whether single, married, divorced, or widowed.

7. Work Incentives

The SSD program includes various work incentives to encourage individuals with disabilities to return to work or engage in vocational rehabilitation while still receiving benefits. These incentives include trial work periods, extended periods of eligibility, expedited reinstatement of benefits, and protections for medical coverage. These incentives help individuals transition back to work gradually and ensure that they can maintain financial stability while exploring employment opportunities.

8. Substantial Gainful Activity (SGA) Threshold

To successfully navigate the complexities of the Social Security Administration’s regulations, individuals with multiple sclerosis (MS) often require support in MS disability legal battles, especially when it comes to issues like understanding the substantial gainful activity (SGA) levels. Legal assistance becomes crucial when individuals with MS must prove that even with earnings near the SGA level, their disability significantly impacts their ability to maintain employment. For 2022, the SGA level for non-blind individuals is $1,350 per month, while for blind individuals, it is $2,260 per month.

9. Medical Vocational Allowance

In cases where an individual’s medical condition(s) do not meet the specific criteria outlined in the SSA’s Listing of Impairments (also known as the “Blue Book”), the SSA may consider other factors, such as the individual’s age, education, work experience, and functional limitations, to determine eligibility for SSD benefits. This evaluation, known as a medical vocational allowance, assesses the individual’s residual functional capacity (RFC) and ability to perform gainful work activities, considering their impairments and vocational factors.

10. Continuing Disability Reviews (CDRs)

Once approved for SSD benefits, recipients are subject to periodic Continuing Disability Reviews (CDRs) to assess whether they continue to meet the eligibility criteria for disability benefits. CDRs aim to ensure that individuals receiving benefits are still disabled and unable to engage in substantial gainful activity. During a CDR, the SSA reviews medical evidence, work activity, and other relevant factors to determine whether the recipient’s medical condition(s) still meet the definition of disability.

Wrapping Up

Social Security Disability Benefits serve as an essential resource for individuals faced with disabilities that prevent them from maintaining employment. The application process ensures that those who genuinely need assistance receive it. It is necessary to recognize that while the process can be intricate and demanding, the objective is to extend support to the disabled who have paid into the system and now need its protection.