Do I Qualify For Disability Benefits?

Who is Eligible for Social Security Benefits?

You could qualify for Social Security Disability (SSI or SSDI) if you have a physical or mental condition that limits your ability to perform substantial gainful activity. The disability must have lasted, or be expected to last, for at least twelve months or result in death. You must also be under the age of 65 and have worked five out of the last ten years. (If you have not worked 5 of the last 10 years, you may still qualify for Supplemental Security Income or SSI). A qualifed social security advocate or attorney can help you determine exactly what you qualify for.

The Main Factors of Eligibility

#1 - Have you worked five of the last ten years?
The first factor in determining eligibility for disability benefits (SSDI) is whether you are considered insured. To be insured you typically must have worked five of the last ten years, although this time requirement is less for younger applicants who have not had as much time to work. Most applicants for disability benefits who have been employed will be insured. However, those who don't qualify for SSDI may for Supplemental Security Income (SSI), whether they have been employed, if their income is low enough.

#2 - Have you been (or expect to be) disabled for at least 12 months?
To be eligible you must also meet the durational requirement. The durational requirement means you must have been or expected to be disabled for at least twelve months, or the disability is expected to result in death.

#3 - Are you under the age of 65?

#4 - Can you perform "substantial gainful activity"?
It is important for you to understand what the Social Security Administration (SSA) means by substantial gainful activity. Substantial gainful activity is the ability to perform any regular job or work-like activity. Even volunteer work or school attendance will be considered. The test for disability is not about whether you can or cannot perform your current or previous job. Neither is the test about whether you can or cannot find employment. The test is about whether you can do any job or work-like activity that is generally available. Work-like activity can mean working for wages, attending school, or any other work-like activity (such as volunteer work), even if you are not getting paid. In plain English, you are not eligible if you can perform any work, including sedentary (unskilled) labor.

If you apply for benefits and your claim is initially denied you should appeal the decision. If your appeal advances to an administrative hearing, a judge will consider your "residual functional capacity.." Residual functional capacity is the key to proving your disability. The SSA defines residual functional capacity as your ability to perform work-like activities given your physical and mental limitations. In other words, the judge will decide what is the most activity you can do on a regular and continuing basis. Regular and continuing basis means a full 40-hour per week or equivalent work schedule.

#5 - Has a doctor provided a diagnosis and medical evidence that support your disability claim?
Finally, your disability must be supported by medical evidence. There is no simple explanation for what medical evidence is needed. The SSA requirements only state that you must provide a diagnosis of a medically determinable physical or mental condition that result from anatomical, physiological or psychological abnormalities, which can be demonstrated through medically acceptable clinical and laboratory diagnostic techniques. Essentially, your physical or mental disability must be established through medical evidence consisting of signs, symptoms, and laboratory findings, supported by adequate doctors' reports. A qualifed social security advocate or attorney will know exactly what you should provide.

If your condition appears on the SSA's Listing of Impairments (link here to bottom navigation bar "Disabling Conditions"), your condition will likely receive a favorable finding if you meet the specific criterion for the listed impairment. However, this is usually very difficult to accomplish. Otherwise, you must provide enough evidence to convince the judge your condition is serious enough to significantly limit your ability to perform work-like activities.

Some genuine cases are difficult to diagnose with objective testing, so a legal representative can best present your doctor's reports properly and convince the government that you deserve benefits. If you have concerns, have your disability claim reviewed free by an advocate or attorney in your state.

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