How does the Social Security Administration define disability?

The Social Security Administration defines a “disability” as the “inability to engage in any substantial gainful activity by reason of any determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of no less than 12 months.”

The SSA will consider you disabled if:

  • You cannot do work that you did before
  • We decide that you cannot adjust to other work because of your medical condition(s)
  • Your disability has lasted or is expected to last for at least one year or to result in death.

What is the difference between SSI and SSDI?

The SSA runs two different disability programs, Supplemental Security Insurance (SSI) and Social Security Disability Insurance (SSDI). SSI is a financial need-based program for disabled individuals who haven’t earned enough work credits or haven’t worked at all in the past 10 years. SSDI is a disability program for workers who have earned enough work credits based on taxable employment in the past 10 years. Overall, the main difference resides in how long an individual has worked in the past 10 years.

What are the work requirements established by the SSA and what exactly are work credits?

The rule of thumb is that an individual must have worked at least 5 out of the past 10 years to qualify for Social Security Disability Insurance (SSDI). The SSA calculates this by awarding “work credits when an individual is employed and was paying Social Security taxes. Work credits are based on your income when you were working. Currently in 2019, one work credit is equal to $1,360, which will increase to $1,410 in 2020. An individual can earn no more than 4 work credits per year. To qualify for SSDI, you need to have earned at least 20 work credits in the past 10 years. If you fall below the requirement, you may still qualify for Supplemental Security Income (SSI).

Is it possible to receive both SSI and SSDI at the same time?

An individual may apply for both Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) simultaneously but can only receive one of the benefits at a time. There are some unusual circumstances in which an individual may receive SSI until becoming eligible for SSDI. However, you cannot receive both at the same time.

Can I receive Social Security disability benefits and still work at the same time?

The SSA gives out benefits based on an individual’s inability to work due to an illness or condition. The benefits are provided to compensate for the lack of “significant gainful activity (SGA).” An individual may earn a modest amount per month which will not be considered SGA. That amount currently is in 2019 is $1,220 per month.

Is there a list of illnesses that the SSA considers disabling?

The SSA provides two lists: (1) Compassionate Allowance List; and (2) Listing of Impairments. The Compassionate Allowance List is a discreet list of serious illnesses and conditions that automatically qualify as disabling without further evidence. The Listing of Impairments gives an overview of the major types of impairments that can be potentially approved for benefits. The list covers a wide selection of serious conditions but is not exclusive to these impairments. Any illness or condition, if severe enough, can potentially qualify for disability benefits.

What is the probability of being approved for Social Security disability benefits?

Due to the immense magnitude of new applications, severe budget cuts from the federal government and the unpredictable nature of the economy, the Social Security administration denies over 70% of the applications in the initial stage. The SSA might deny a valid case for several reasons including missing or not enough medical documentation, application was not completed correctly, applicant is working too many hours, etc. Approximately 12% of claimants who put in a request for reconsideration are approved and roughly 35% who put in a request for a hearing before an Administrative Law Judge (ALJ) are approved.

An effective alternative to raise your chances of approval is to seek help through a disability advocate or attorney. Disability advocates know how the social security system works and will efficiently handle your application by collecting all necessary evidence and documentation. A disability advocate will also continue to help you through the appeals process should you get denied. For more information, contact us on our “contact page” or text us using the link on this page. There is no obligation.

Can I get both worker’s compensation and Social Security disability benefits?

Yes, it is possible to receive both at the same time however there is a counterbalance. In the majority of states, when an individual receives workers compensation it reduces their social security disability benefits. In the minority of states workers compensations is reduced due there is approval of disability benefits.

Does the SSA consider a mental illness disabling?

Yes but it depends if the mental illness is severe enough to qualify. Hundreds of thousands of American beneficiaries receive disability benefits for their mental illnesses. If you would like to know if your mental illness qualifies for disability benefits, feel free to contact us on our contact page or test us using the link on this page for a pre-screening evaluation at no cost.

I have a child who is disabled. Can my child receive disability benefits?

Potentially. If your child is under 18 years old, your child may qualify for Supplemental Security Insurance (SSI) benefits as long as you (the parents) don’t exceed the SSA’s limits in income and assets. If your child is over the age of 18, your child may qualify for SSI while completely disregarding the parent’s income and assets. If you have questions about disability benefits for your children, contact us on our contact page or text us using the link on this page.

I have been taking care of my children at home and have not worked a job in several years. Do I still potentially qualify for disability benefits?

If I am receiving Social Security Retirement benefits, can I still receive Social Security Disability benefits as well?

In most instances, you cannot receive Social Security Disability benefits and retirement benefits at the same time. If an individual has been receiving disability benefits and has reached full retirement age, the SSA simply takes your disability benefits and transfers it to retirement benefits. The check will continue to be the same amount as your disability check, which is larger than a normal retirement check.

If my application is accepted, how much money can I receive from disability benefits?

The SSA determines the amount of benefits one receives by reviewing that individual’s past work history, the amount of income received, and the current household situation. In April of 2015, the national average SSDI payment given out to beneficiaries was $1,165 while the national average SSI payment was $541. The maximum payment allowed for SSDI in 2019 is $2,861. The maximum payment for SSI in 2019 is $771 and will increase in 2020 to $783.


How to apply for Social Security disability benefits?

To apply for disability benefits, an individual may go to the nearest Social Security office and wait in line (can be up to a couple hours at times) to file a claim in person, call the closest Social Security office and schedule a telephone interview, or file online. Filing through the SSA can be a frustrating and difficult task; an attorney can be of significant assistance in filing your application. To learn more about using a lawyer to assist with applying for disability benefits, contact us on our contact page or text us using the link on this page.

What documentation is needed before applying for disability benefits?

SSA will request your medical records from the doctors you identify in your application. Missing important documents, however, can result in an incomplete application that will be delayed or rejected. It is important to inform your doctors and medical experts of your intentions to apply. Your doctors should have all information and medical records that directly relate to your disability(s). These documents are necessary to support your claim and will help for a quick and timely response. For more information about documentation, contact us using our contact page or text us using the link on this page.

Who determines If I am approved for disability benefits?

Social Security Disability claims are sent to your state’s local Disability Determination Services Office (if your state has one) to be evaluated by a disability examiner working with a doctor. If the claim is denied and the claimant asks for reconsideration, the claim is sent through the same exact process but with a different examiner and doctor. If denied again and the claimant wants to appeal, the case is sent to an Administrative Law Judge for a final decision.

What is a Social Security Disability technical denial?

Over 27% of initial applications are denied before even being reviewed due to what is called a “technical denial.” A technical denial occurs when an applicant does not meet the general, non-medical requirements for disability benefits. Below are some common reasons for technical denials:

  • Not enough work history was shown for proper eligibility.
  • The claimant is currently working over the allowed limit.
  • The claimant is receiving too much in earned and/or unearned income.
  • The claimant has too much in assets.

The other 45% of Americans that are initially denied up to 52% have qualifying cases but the SSA denies them in hope that the claimant will not pursue an appeal saving the federal government money. The entire approval process may be extensive; but statistically a majority of claimants who face initial denials are awarded benefits later in the appeal process. An attorney can be of valuable assistance in successfully navigating this process.

What is a Residual Functional Capacity (RFC)?

Residual Functional Capacity (RFC) is the maximum work amount an individual is capable of despite their impairment(s). When your case is sent to the Disability Determination Services (DDS), a disability examiner and medical consultant will complete an RFC assessment on your claim. Based on medical record and work history, the consultant will determine your functional limitations, physical capabilities, and job restrictions. You may choose to have your own physician(s) fill out the RFC form if they are willing to do so. This provides an advantage because your physician(s) will be more knowledgeable about your impairments then the DDS consultant who never meets you in person.

How long does the disability application process take?

Disability claims can take a long time. The initial application process takes approximately 4 to 6 months for the initial decision. If denied, an individual has 65 days to file a request for reconsideration and will take approximately another 2 to 4 months to receive a decision from the SSA. The application processing time varies depending on your medical condition(s), documentation provided, and whether or not you were denied and would like to file an appeal. If your claim is denied on reconsideration, the appeal to an Administrative Law Judge can take 18 months or longer to schedule a hearing and obtain a written decision.

What are my options if the SSA denies me disability benefits?

When an applicant is denied at the initial stage, they have exactly 65 days from the letter of denials date to file a request for reconsideration. If an applicant waits more than 65 days to file an reconsideration, they will have to start the whole process over with a new application. If you are denied at the request for reconsideration level, you have another 65 days to file an appeal. If you need help filing an appeal or starting a new application, contact us on our contact page or text us using the link on this page.

What is the appeals council?

The Appeals Council is the last administrative decisional level for SSDI and SSI claims. The council consists of “approximately 71 Administrative Appeals Judges, 46 Appeals Officers, and several hundred support personnel.” The council reviews the Administrative Law Judge (ALJ) decisions and ensures national consistency in decision-making.

What are the fees associated with representation?

Attorney’s fees are regulated by the SSA itself and applies to all attorneys or disability advocates. The attorney receives one-fourth of the back due benefits or $6,000 whichever is less, and may require payment of actual out-of-pocket costs, but only if the claimant wins. Should the claimant lose the case, there are no fees involved and the attorney or advocate incurs all costs.

Is it necessary to hire an advocate or lawyer to represent me in my Social Security disability claim?

Assistance from an advocate or lawyer is not necessary. Individuals can go through the whole process themselves if they desire. However, statistically over 75% of applicants who apply on their own are denied even if their disability claim is valid. This happens due to several reasons including missing or not enough medical documentation; applicant didn’t complete the application correctly, etc. Legal assistance can significantly increase a claimant’s chances of approval. If you would like to learn more about having one of our lawyers assist with your claim, contact us on our contact page or text us using the link on this page.


What happens if I go to jail while receiving benefits? Do I lose my Disability benefits?

The SSA does not give benefits to an individual who is incarcerated even if they are disabled. If you are receiving benefits and become incarcerated, the SSA will take away your benefits once you have been in jail for more than one month. However, if you’ll be incarcerated for less than a month, the SSA will not take away your benefits and they will continue as normal.

What happens if I start to feel better while receiving disability benefits and I decide I want to return to work? Will I be allowed to work again?

You may return to whenever you like. However, depending on the benefits you are receiving and how much you’ll be earning while working, the SSA will re-evaluate your situation to determine if your impairment is still “disabling” and will change your benefits accordingly. If you are receiving Supplemental Security Insurance (SSI) and begin working, the SSA will reduce your benefits by subtracting part of your income from your payment and terminate them if you go over the SSI income limit.

The SSA has developed several work incentives for both SSI and SSDI to encourage disability beneficiaries to go back to work such as the “Plan to Achieve Self-Support,” “Work Expenses for Blind People,” and the “Trial Work Period.” Some of these programs will allow an individual to exceed the SGA limit for a given period and help beneficiaries find out if they are ready for the work force.

Can drug addicts and alcoholics get disability benefits?

The SSA is prohibited by Congress from giving benefits to individuals who are only having difficulty with drug addiction and/or alcoholism. Congress doesn’t want drug addicts and alcoholics to spend their disability benefits on drugs and alcohol. However, these individuals are just as susceptible to diseases, mental illnesses, and other impairments like any other person and could potentially qualify for disability benefits. If have questions about your eligibility and would like to speak in confidence about your situation, contact us using our contact page or text us using the link on this page.

If I move into a different state, what happens to my disability benefits? Will I have to re-apply or fill out a new form?

You will not have to re-apply for disability benefits if you move to another state. If you are receiving Social Security Disability Insurance (SSDI) and plan to move into another state, you will need to contact your local office to give them your new address to ensure you keep receiving important information from the SSA and your disability checks (if not direct deposit). If you are receiving Supplemental Security Insurance (SSI), moving into a new state can potentially change the amount of the monthly benefits you receive or could potentially disqualify you from receiving disability benefits depending on the new state’s restrictions.

What is the difference between Medicare and Medicaid?

The main difference between Medicaid and Medicare is that Medicaid is given to people with low income and assets. When an applicant is approved for Supplemental Security Insurance (SSI), they are automatically qualified for Medicaid due to the fact that they are disabled and have low income. Doctors are paid low rates when servicing anyone with Medicaid. This causes doctors to be more reluctant to take on these patients. However for Medicare, your income and assets are irrelevant. If you qualify for any of the Social Security Disability Insurance (SSDI) benefits, you will become eligible to receive Medicare after 24 months have passed. Doctors are paid at a higher rate with Medicare than Medicaid and will be more willing to provide service.