SSDI Eligibility

Many people who are no longer able to work due to a serious disability may be eligible for government assistance in the form of Social Security Disability Insurance (SSDI) benefits. The eligibility requirements include both non-medical and medical criteria. One of the most important aspects in applying for SSDI benefits is understanding the process, as well as your right to benefits. Having handled Social Security cases for the last 34 years, Attorney Russell J. Goldsmith is both knowledgeable and sympathetic to those who need benefits. His legal team can provide personalized attention to guide you through the process and manage any issues that may arise.

The non-medical requirements for SSDI benefits eligibility primarily examine the work history and age of the applicant to determine whether he or she is insured for purposes of SSDI. This is typically referred to as the “earnings requirement.” Essentially, an applicant must have worked long enough in a job covered by SSDI to qualify. The Social Security Administration utilizes a system of work credits to determine whether an applicant has met the earnings requirement. Depending on the applicant’s age, he or she must have earned a specified number of work credits within a certain period before the time he or she becomes disabled. Applicants who are blind and those who are younger may also have different requirements.

The earnings requirement consists of two tests to determine whether an applicant has worked long enough and recently enough to qualify for SSDI benefits. The “recent work test” is used to verify that the applicant worked for a certain number of years before the disability. The length of the period varies depending on the age of the applicant. For example, applicants aged 31 and older must have worked and earned what are called quarters of coverage, earning 20 out of the available 40 quarters of coverage during the 10 year period prior to becoming disabled from working. The “duration of work test” determines whether the applicant has been employed in a job covered by Social Security for a certain amount of time. In general, the older the applicant, the more years he or she is required to have worked in an SSDI-covered job.

In addition, only those who are under retirement age can receive SSDI benefits. For most people, the retirement age is 65, although depending on the birth year, it can be up to 67. It should be noted that once one reaches full retirement age, benefits will be converted to retirement benefits.

Finally, if an applicant earns more income than a certain amount every month, he or she will generally be considered to be engaging in substantial gainful activity. An applicant who is engaging in substantial gainful activity does not meet the definition of “disability” under the Social Security Act. These income amounts are published by the Social Security Administration and tend to increase every year. For 2015, the monthly limit is $1,090 for most applicants, and $1,820 for statutorily blind individuals.

In addition to the earnings requirement, the applicant must also meet the disability requirement. As defined by the Social Security Act, an applicant is disabled if he or she is unable to engage in any substantially gainful activity due to a medically determinable physical or mental impairment that is expected to last one year or longer, or result in death.

Therefore, to be eligible, an applicant’s disability must be severe, preventing or strictly limiting the applicant from performing basic work-related functions, such as moving, sitting, or thinking. The disability must not only prevent an applicant from doing his or her current work, but also from engaging in any other substantial gainful employment, considering his or her age, skills, work experience, education, and medical condition.

In evaluating an applicant’s condition, the Disability Determination Services (DDS) utilizes a “List of Impairments.” The List of Impairments identifies medical conditions that are so severe that an applicant is automatically considered incapable of working if his or her condition meets the criteria for a listed impairment. In such cases, DDS will not consider whether the applicant can work in previous or other jobs. However, if the applicant’s condition is not on the list, DDS will then analyze the applicant’s medical impairments and determine the residual functional capacity for that applicant. DDS will also consider whether the applicant could do his or her previous work or other work, as described above.

The applicant’s condition must also be verifiable by diagnostic testing or other medically accepted techniques. Thus, conditions diagnosed by unlicensed caregivers, or conditions that cannot be confirmed by conventional testing or objective examination, may not be considered qualifying disabilities under federal law. Finally, the disability must be long-term, or expected to last for a period of 12 months or longer, or result in death. There are also special rules regarding people who are blind or have low vision, which a Social Security attorney can explain further.

There may be different eligibility requirements for special situations, which you can discuss with an attorney. To learn more about applying for SSDI from a lawyer who understands the process, schedule a free consultation with Russell J. Goldsmith by calling (800) 773-8622 or contacting the Law Offices of Russell J. Goldsmith online.