Rules and Requirements to Qualify for Social Security Disability or SSI

The rules and requirements to qualify for Social Security disability cases are relatively straightforward. In short, in order to be eligible for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability benefits, a claimant must satisfy both the medical and non-medical (financial) requirements for benefits. You should apply for benefits as soon as you are eligible.

For the medical requirements, Social Security will evaluate your claim to determine whether you have a medically determinable impairment (illness or injury) that is disabling.

The non-medical rules and requirements are where the SSDI and SSI programs of benefits differ. For disability insurance claims, Social Security will review your earnings history to determine whether you have earned enough credits for SSDI. In SSI claims, Social Security will evaluate your income and assets to determine whether you have a low enough income to qualify for SSI.

Medical Issues in SSDI and SSI Claims

A claimant must have a medically determinable impairment (medical condition) that is severe and either:

• meets all of the requirements of a Social Security listing of impairment;
• prevents the claimant from working at any of their past jobs or any other job, given their education, age, and skills.

Another important rule to qualify for SSDI or SSI is that the claimant’s medical disability must have lasted, or can be expected to last, for at least one year. For more information, see our article on meeting the medical requirements for disability.

Financial Issues in SSDI and SSI Claims

If a claimant is earning a certain amount of money per month in employment, then he or she may be considered to be gainfully employed not eligible for benefits. To learn what amount the Social Security Administration considers “substantial gainful activity” (SGA), see our article on the SGA earnings limits for disability.

To meet the legal/financial requirements for SSDI, you must be “insured” under the Social Security Disability Insurance program of benefits. That means you must have paid taxes into the Social Security system for a required number of years. The reported income also must be relatively recent. Work credits do expire, and your insured status can lapse if you stopped working too long ago.

SSI, on the other hand, is a welfare-based program of benefits. There are no work requirements for SSI. However, there are asset and family income limits.  Qualifying for SSI is like qualifying for food stamps.