Am I Eligible for Disability Benefits?

Am I eligible for Disability Benefits?

For persons dealing with severe impairments to their physical or mental health, working can be challenging, or impossible in some cases.  Many health conditions inhibit the performance of physical activities such as heavy-lifting or standing for extended periods of time, while others impact fine-motor skills or skills that require focus and concentration.

Unfortunately, persons who lack these types of skills and abilities are often unable to find or maintain certain jobs, or participate in the workforce altogether.  However, when their health limitations are to blame for their inability to work and earn an income, they may be able to receive some monthly pay in the form of Social Security disability benefits.

Social Security distributes disability benefits in two forms—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).  To be eligible for either, a person must first establish they are disabled as defined by the Social Security Act.  Once disability is established, they will qualify for disability pay if they meet the additional, non-medical requirements for SSDI or SSI eligibility.

Determining eligibility for disability benefits can be difficult, and requires an analysis of the following factors and circumstances.

Are You Unable to Work?

Just because you are disabled to some extent or are unable to engage in certain activities does not mean Social Security will find that your health prevents you from working.  Under the Social Security Act, a person is disabled only if they are unable to work or earn more than minimal income for a period of 12 months or longer due to a sufficiently severe health condition established by their medical records.

Social Security has a list of conditions called “Listed Impairments” that they have predetermined are severe enough to meet the above criteria.  If an individual’s medical records show they’ve been diagnosed with a listed impairment with designated attributes indicative of its’ severity, he or she will be considered disabled and medically eligible for disability benefits.  A person whose condition or diagnosis does not appear on the list may still be eligible, though, if their medical records show their condition shares the same severity attributes as those specified under an impairment listed.

When the requisite severity level cannot be established or confirmed based on medical records alone, Social Security must assess the impact of the applicant’s condition on their ability to work.   Applicants who are currently working and earning $1,310 or more in wages each month will not be eligible, as this demonstrates their ability to work despite any limitations caused by their condition.  In addition to assessing positions currently held, Social Security reviews the applicant’s past 15 years of work experience to determine whether their physical or mental health limitations prohibit them from performing all full-time jobs they held for 3 months or more during this period.

Depending on their age, educational level, and transferable skills, Social Security may also be required to assess the applicant’s ability to perform other types of work less physically and/or mentally demanding than that which was required for their past jobs.  An applicant over age 50 and without any past sedentary or “desk-job” experience will be found disabled from working so long as they did not acquire skills through past work that would transfer to a sit-down job. For example, a 52-year-old applicant who worked as a nurse for several years until a recent back injury would have a lesser chance of being found medically eligible for disability benefits, as he or she would have acquired skills as a nurse transferable to medical billing or hospital administration jobs.

Do You Meet the Requirements of SSDI or SSI?

If the applicant cannot perform any previous work nor other types of work, Social Security will find them disabled.  Whether they can receive disability benefits requires further analysis of additional, non-medical eligibility criteria for SSDI and/or SSI, however.  These requirements are detailed below, but generally require an applicant to have “insured” status to qualify for SSDI, and/or minimal income and assets for SSI.

Criteria & Requirements for SSDI

SSDI is available to disabled persons who are “insured” by SSDI because they’ve made sufficient contributions to the relevant Social Security fund by paying taxes on their wages or self-employment earnings over the years.  For an individual to be insured, they must have earned the requisite number of relatively recent work credits for a person becoming disabled at their age.  A work credit is granted to individuals who earn wages greater than or equal to a designated amount in one 3-month quarter of a year.  This amount fluctuates depending on the average wage rate, but is $1,470 in 2021.

Individuals who became disabled before age 24 must have earned at least 6 credits in the three-years prior to the onset of their disability, while persons who became disabled between age 24 and 31 must have earned work credits in at least half of the 3-month quarters that occurred since the age of 21.  Those who become disabled at age 31 or older must have at least 20 credits in the 10-year period proceeding the onset of their disability.

Some older applicants must have earned more credits overall to be eligible, though not all must have been earned in close proximity to the onset of the applicant’s disability.  A breakdown of the number of work credits and years worked required by applicants of varying ages is available here.

Criteria & Requirements for SSI

A disabled individual who does not meet the recent work or duration of work requirements described above may nevertheless qualify for disability benefits through SSI, depending on the income and resources they have available.

SSI is restricted to disabled persons whose income and resources fall below designated levels, which may be higher or lower based on the person’s marital status and living arrangements. In general, disabled persons are not eligible for SSI unless their household income is below the applicable Federal Benefit Rate, or FBR, which is currently $794 per month for single-persons and $1,191 per month for married couples.

The types of income that counts towards this monthly limit include wages earned by you or your spouse as well as most non-earned income and government benefits such as food stamps or housing assistance.  A portion of each income source is deducted from the month’s total household income, though, and does not count towards the SSI limit.  Also, if the SSI applicant or recipient has one or more dependents, further deductions may be taken.

In addition to their monthly income falling below the applicable limit, an applicant must have minimal available resources to qualify for SSI.  Available resources include cash as well as any asset that can be readily converted to cash and used to support the applicant and/or their family, apart from their home and one automobile used for transportation.  Persons who are single must own less than $2,000 in resources to be eligible for SSI, while a married person may jointly-own up to $3,000 in resources to be eligible.

For personalized recommendations or guidance when applying for disability benefits, call Reynolds & Gold Law at (417) 883-7800 to schedule a meeting with a Social Security Disability attorney.