How Do You Qualify For Social Security Disability Benefits?

How Do You Qualify For Social Security Disability Benefits?

Social Security Disability Insurance (SSDI, sometimes also abbreviated as SSD) is a benefits program with the Social Security Administration that pays monthly benefits to you if you become disabled before retirement age and are not able to work. To qualify for SSDI benefits, you must first have worked in jobs and paid Social Security taxes. That’s why some people know it as “workers disability.”

Eligibility for Social Security Disability

To qualify for disability benefits under the SSDI program, you must have worked a certain number of years in a job and paid Social Security taxes taxes (FICA).  More specifically, you must have earned a certain number of work credits. A worker can earn up to four work credits per year.

[Note: If you have not worked long enough and earned enough credits when you become disabled, you may still apply for Supplemental Security Income (SSI) instead, if you have low income and assets.]

Work Credits

The number of work credits you need to qualify for SSDI benefits depends upon how old you were when you became disabled. Generally you need 40 credits, 20 of which were earned in the last 10 years ending with the year you become disabled. However, younger workers may qualify with fewer credits.

The rules are as follows:

  • Before age 24–You may qualify if you have 6 credits earned in the 3-year period ending when your disability starts.
  • Age 24 to 31–You may qualify if you have credit for working half the time between age 21 and the time you become disabled. For example, if you become disabled at age 27, you would need credit for 3 years of work (12 credits) out of the past 6 years (between ages 21 and 27).
  • Age 31 or older–In general, you need to have the number of work credits shown in the chart below.Unless you are blind, you must have earned at least 20 of the credits in the 10 years immediately before you became disabled.
    Born after 1929, Became Disabled At AgeNumber of Credits You Need
    31 through 42
    62 or older

For example, if you are 50 years old when you become disabled, you need 28 work credits according to the chart above – or to have worked for seven years (and at least five of those years must have been within the last 10 years).

For more information on eligibility for SSDI, see Legal and Financial Requirements for SSDI.

You Must Have a Severe Medical Disease or Condition

Then you must have a medical condition that meets Social Security’s definition of disability. SSDI benefits are only available to those with a severe, long-term, total disability.

Severe means that your disease or medical condition must interfere with your ability to perform basic work-related activities.

In general, Social Security pays monthly cash benefits to individuals who are unable to work for a year or more due to a disability. Thus, long-term means that your condition has lasted is expected to last at least one year.

Total disability means that you are not able to perform “substantial gainful activity” (SGA) for at least one year. If you are currently working and make over a certain amount ($1,070 per month in 2014 for disabled applicants, $1,800 for blind applicants), Social Security will find that you’re performing SGA and that you are not disabled enough to qualify for SSDI benefits.

For more information on whether you satisfy the medical requirements for SSDI, see Medical Eligibility for Disability Benefits.

Approval for Disability Benefits

If your claim for disability benefits is approved, you will not receive SSDI benefits until you have been disabled for five months. This “waiting period” means that even if you are approved right away (for instance, because you just had a liver transplant), you would still have to wait five months for your checks to start.

However, it is more likely that your initial application will not be approved for months (or even years), typically after at least one level of appeal. In such a case, you would be paid disability backpay starting with the sixth month after your disability began (your disability onset date).

After you are paid your back due benefits that are due and owing, you should get a disability benefit check each month. If your household income is over a certain amount, you may even have to pay taxes on your disability benefits.

Your family members may also be eligible for a partial monthly benefit. For more information, see our section on How to Get Disability Benefits for Your Dependents.

You can keep receiving SSDI as long as your medical condition prevents you from working. The SSA may still perform a continuing disability review (CDR) on your file every one to three years to determine if your condition has improved (and therefore your benefits should be cutoff).

Denial of Disability Benefits

If your SSD application is denied (and over 65% of most initial applications are denied), you can appeal the decision. You must, however, request a review of the denial within 60 days of when you receive the denial letter. The first step of the appeal process in most states – including Florida – is the Request for Reconsideration. In a Request for Recon, your claim is evaluated by someone who did review the initial claim. Another claims examiner is assigned to the claim. If you are denied again at the Reconsideration level, you can appeal to the next stage by requesting a hearing with an Administrative Law Judge who works for the SSA.

Disability Benefits Continue to Retirement Age or Return to Work

Disability benefits usually continue until you either: (a) reach retirement age or (b) begin to work again on a regular basis.

If you are receiving Social Security disability benefits when you reach full retirement age, your disability benefits automatically convert to retirement benefits, but the amount remains the same.

Should your medical condition improve, there are a number of special rules (called “work incentives”) that provide continuing benefits and health care coverage to assist you in returning back to work.

The following links break down the requirements more closely:

If your medical condition (or medical conditions) keep you from being able to hold a full time job, you may be eligible for disability benefits. Mr. Ortiz is an experienced SSDI attorney, and provides free case evaluations to disability claimants. Call him at 850-898-9904 to schedule your appointment today.