What Are the Qualifications to be Eligible for Social Security Disability Benefits?

If you are unable to work because of a physical condition, you may wonder if you would qualify to receive social security disability benefits from the federal government. The answer depends on the specific nature of your physical condition.

First of all, there are two main types of social security disability benefits: (1) Disability Insurance Benefits, which is shortened to DIB, and (2) Supplemental Security Income, which is referred to as SSI (this is a type of welfare benefit).

To qualify for DIB, a person must have worked and paid into the Social Security system for five of the past ten years.

To qualify for SSI, a person must have an extremely low household income and assets, but does not have to show they paid into the system.

If financially, a person meets the test for either DIB or SSI, then the person must qualify medically and vocationally in order to be found “disabled.” “Disabled” in the context of social security means that a person must be totally disabled or unable to be gainfully employed.

Now in order to qualify medically and vocationally for disability benefits, a person must pass a Five Step Disability Determination Process. Each step must be passed in order to move on to the next step. If a person fails at any step, the process stops and the person will be denied benefits.

Step 1: Is the person engaging in substantial gainful activity?

If the answer to this question is yes, then the person is not disabled. “Substantial gainful activity” means physical or mental activity performed full-time or part-time for an amount of money in excess of the amount defined as acceptable by the Social Security Administration. If you are working in 2015 and your earnings average more than $1,090 a month, you generally cannot be considered disabled.

Step 2: Does the person have a severe impairment?

A “severe impairment” is defined by the Social Security Administration as an impairment or a combination of impairments expected to last more than 12 months and/or result in death, and that significantly limits a person’s physical or mental ability to perform work activities.

Step 3: Does the person have an impairment or combination of impairments that meets or medically equals a listed impairment?

The Social Security Administration listings are a complex assortment of age-factored medical conditions and symptoms. The listings can be found on the Social Security Administration’s website. If your condition is not on the list, then in Step 4 the Social Security Administration determines whether you can do the type of work you did previously.

Step 4: Can the person perform his or her past relevant work?

If your condition is severe, but not at the same level of severity as a medical condition on the list, then the Social Security Administration looks to a type of medical finding referred to as a “residual functional capacity.” Evidence may come from the person’s treating doctors and from a medical expert hired by the Social Security Administration. The person can also offer testimony on this point.

Step 5: Is there any other work in the national economy, given the person’s age, education, past relevant work, and residual functional capacity that the person could perform?

If a person cannot do the work he or she did in the past, the Social Security Administration looks to see if that person is able to adjust to other kinds of work. If a person cannot adjust to other work, that person will likely be found disabled. If a person can adjust to other work, then that person will likely be denied disability benefits.

If a person makes it through these five steps, then he or she should be declared disabled. However, if that does not happen, an appeal may be in order. In general, there is a 60-day window in which to appeal a denial.