SSDI: Do You Qualify?
Definition Of Disability
Specific criteria must be met to qualify for Social Security Disability Insurance Income
(SSDI). The Congress of the United States has defined disability, for purposes of
entitlement to disabled worker's benefits as the inability to engage in any substantial
gainful activity by reason of any medically determinable physical or mental impairment
which can be expected to result in death or which has lasted or can be expected to last
for a continuous period of not less than 12 months.
A person must not only be unable to do his or her previous work but cannot engage in any
other kind of substantial gainful work which exists in the national economy, considering
- work experience
It is immaterial whether such work exists in the immediate area, or whether a specific job
vacancy exists, or whether the worker would be hired if he or she applied for work.
"The worker's impairment or impairment's must be the primary reason for his or her
inability to engage in substantial gainful activity, although age, education, and work
experience are also taken into consideration in determining the worker's ability to do
work other than previous work".
5 Step Process To Determine Disability
Are you working? If you are and your earnings average more than $860 a month, you
generally cannot be considered disabled. Note: This amount increases annually. See: What
Is Substantial Gainful Activity (SGA)?
Is your condition severe? Your impairments must interfere with basic work-related
activities for your claim to be considered.
Is your condition found in the list of disabling impairments? Social Security maintains a
list of impairments for each major body system which are so severe they automatically mean
you are disabled. If your condition is not on the list, Social Security must decide if it
is of equal severity to an impairment on the list, and if so, the claim is approved.
Can you do the work you did previously? If your condition is severe but not of same or
equal severity with an impairment on the list, Social Security determines if it interferes
with your ability to do the work you did in the last 15 years. If it does not, your claim
is denied. If it does, further consideration is given.
Can you do any other type of work? If you cannot do the type of work you did in the last
15 years, Social Security determines if you can do any other type of work with
consideration given to age, education, past work experience, and transferable skills. If
you cannot do any other type of work, your claim is approved. If you can, your claim is
What Is Residual Functional Capacity?
Residual Functional Capacity (RFC) is the total of what one is left capable of doing after
impairments have taken their toll. Social Security identifies the level of work capability
in categories of:
- sedentary work
- light work
- medium work
- heavy work
Sedentary work is defined as "involving lifting no more than 10 pounds at a time and
occasionally lifting and carrying articles like, docket files, ledgers, and small tools".
Although sitting is primarily involved in a sedentary job, walking and standing should be
required only occasionally. Standing and walking should total no more than 2 hours per 8
hour workday, while sitting would total about 6 hours per 8 hour workday. Most unskilled
sedentary jobs demand good manual dexterity for repetitive hand and finger motions.
Light work is defined as "lifting no more than 20 pounds at one time with frequent lifting
or carrying of objects weighing up to 10 pounds". A good amount of standing and walking,
approximately 6 hours of an 8 hour workday, is usually required of jobs in this category.
Good use of hands and arms for grasping and holding is important also. A seated position
which involved extensive pushing and pulling of hand or foot controls would be included in
the light work category too.
In the age group 18-44, the maximum residual functional capacity allowed is "less than
For literate people of all education levels between age 45-49, the maximum RFC allowed is
also "less than sedentary".
Above age 50, with consideration given to education, and previous work experience, the
maximum RFC increases to sedentary, light, or medium.
The Standard of "Pain"
In 1984, Congress passed the Social Security Disability Benefits Reform Act, which defined
the standard of judgment on pain. It stated that:
"an individual's statement as to pain or other symptoms shall not alone be conclusive
evidence of disability as defined in this section; there must be medical signs and
findings established by medically acceptable clinical or laboratory diagnostic techniques
which show the existence of a medical impairment that results from anatomical,
physiological or psychological abnormalities which could reasonably be expected to produce
the pain or other symptoms alleged".
Though this act had an expiration date of 1986, it became the standard of judgment. In
1988, Social Security ruled there need not be objective evidence of the degree of pain.
Factors Used In The Judgement Of Pain
Several factors are used in the standard judgement of pain including:
- the nature of the pain
- pain intensity
Other factors which must be considered in determining proof of pain include:
- what causes the pain and makes it worse
- name, dosage, effectiveness, and side effects of pain medications
- treatment for pain relief other than medications
- functional restrictions
- daily activities
Other Symptoms And Health Problems
Many other health problems can directly interfere with an individuals ability to work.
These effects are also given consideration in the disability determination process.
Factors considered can include health problems such as:
- bowel problems
- inability to concentrate
- chronic sleep disturbances
- chronic fatigue
Listing Of Impairments
The specific list of severe impairments used by the Social Security Administration to
decide disability cases from Social Security Disability Determination (The Blue Book).
Problems To Overcome In Receiving Social Security Disability Benefits
More than one million people file for disability benefits with the Social Security
Administration each year.
The bad news is, nearly two out of three who apply for disability benefits will be denied.
The good news is, expert help is available to assist with the process and improve your
odds of winning your case. Search our Disability Attorney Database to
find a disability attorney near you.
Do You Need Representation?
Though initially designed to make it easy for people to represent themselves, it did not
take long for representatives to become involved in the disability process. Representation
in a Social Security Disability case can be valuable since:
- learning the details of the system can be difficult.
- rules are increasingly complex.
- experts know the details of the process.
- experts may improve your odds of winning disability benefits.
Step-By-Step Guide To Applying For Social Security Disability
This guide is a practical approach to the Social Security disability application process
for the disabled person who is thinking about applying and plans to do it without a
There are steps you can take to give yourself the best chance for a favorable decision on
your initial claim, thereby avoiding the lengthy appeals processes. This will involve some
effort, and success is not guaranteed. You will help yourself by doing your part to
present your case as strongly as possible.