How Social Security Decides if You are Disabled

Published on: April 27, 2015

Social Security Application DisabilityThe Social Security Administration (SSA) uses a set of guidelines to determine whether you qualify for disability benefits or not. These are not very straightforward, and may cause confusion, which is why it is important you are aware of these guidelines, and understand how the SSA handles each case, before submitting an application for a disability or for supplemental security income benefits.  

Before applying, make sure you have extensive documentation on your medical condition for your disability diagnosis (or disabilities).

SSDI and SSI: What’s the Difference?

First off, when applying for disability, you need to know whether you will be applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Both cover benefits due to disability, but each comes with differing factors of eligibility. SSDI requires you to have worked for a certain period of time based on your age before becoming disabled - this is determined by the SSA in the form of work credits, and covered based on your tax contributions to Social Security throughout your working life.

On the other hand, SSI is based on more financial qualifications and need. SSI funds are meant to go to citizens whose income falls under the SSI federal benefit limit (which is $733 in countable income for eligible persons in 2015). For both, you must be qualified as medically disabled to receive benefits.

The SSA takes these factors into account when looking at your application for disability benefits (this applies for both SSDI and SSI):

  • Your medical condition must exceed or be expected to exceed 1 year, or result in death

  • If your medical condition is “severe” and limits your daily activities

  • Your working history, and what you can do now compared to before your medical condition

The requirements you must have for SSI are:

  • Earn little to no monthly income - it must be below the SSI federal benefit rate

  • Possess countable assets worth less than $2,000 if single, and less than $3,000 if married

Keep in mind your home and household goods don’t count toward your assets. You also may qualify for both SSDI and SSI. We recommend getting in contact with a trained disability expert, who can review your application and determine if you are eligible, under the medical guidelines, to pursue the full amount of SSDI and SSI benefits you deserve.

Be prepared to supply any and all work history and tax paperwork, as well — for SSDI, the SSA takes these factors into account while reviewing your application. Once the SSA reviews it, your application is sent to a state agency, usually going by the name of Disability Determination Services (DDS), where your medical condition is evaluated. When assessing a medical condition, they look to see if the criteria for disability benefits is met based on the evidence in your file.

Just because your medical condition isn’t in the Blue Book doesn’t mean that you’re not able to receive benefits. You can present evidence from medical providers that your symptoms match the degree of severity listed in the disability Blue Book. If you’re not sure, it’s time to consult with a disability professional, who can make sure you have all the necessary documentation for proving disability.

Key Takeaway

Determining how the SSA is going to handle your case can be a guessing game, especially if you are unsure or not confident with your application: let a trained and compassionate disability expert review your application and ensure your best chances to receive disability benefits.

An application can take months to process, so it’s important that you submit it with the best documentation possible. In the event your case gets denied, we will represent you in an appeals claim and hearing — talk to us today about your application.


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