How to Qualify for Benefits
The Social Security Administration uses a five-step process to determine eligibility for disability benefits. They ask the following five questions:
The first question in determining whether you are disabled is income. Do you have earnings that disqualify you from disability regardless of whether you have a disabling medical condition. You may earn up to a certain amount each month before you are considered performing Substantial Gainful Activity. Currently that amount is $1,310.00. If you earn more than this amount you are not disabled and the inquiry stops at step one.
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The table listing Substantial Gainful Activity amounts by year is here.
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Learn more about how working and disability here.
If you do not earn too much money, then the second question asked is whether you have a qualifying medical condition.
Social Security will only consider medical conditions that are diagnosed by a qualified medical source, such as a doctor, psychologist, physician's assistant, or a registered nurse.
The medical condition must have lasted or will last twelve months or longer.
Finally, the medical condition must cause more than minimal limitations in your ability to work. You can have multiple severe and chronic medical conditions.
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Medical conditions are also called Impairments.
The third question asked is whether or not your medical conditions meet a Listing. Social Security has a list of medical conditions they consider severe enough to prevent you from working. The medical conditions and their criteria are listed for each major body system. This list is called the Listing of Impairments.
If you meet a Listing, then you are disabled. If your medical condition is not listed then Social Security will ask whether your condition medically equals one of the listed impairments.
If you meet a Listing then you are disabled and the inquiry stops. If you do not meet a Listing, you may still be found disabled at the next step.
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Social Security has a separate list for Adults and a separate list for Children. They can be found here:
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The fourth question asked is whether or not you can perform your Past Work. Your Past Work is any work that you performed long enough to learn how to perform it and that you earned SGA levels of income.
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If you can perform your past work despite your medical conditions then you are not disabled. This determination is made based on your remaining abilities after all your medical conditions are taken into account. This is considered your Residual Functional Capacity (RFC).
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Your statements, your medical records, the statements of your doctors, employers, family and friends all help the judge determine your RFC.
There is a further question considered at the fourth step of the disability determination process, and that is where or not you meet the Medical Vocational Guidelines or the Grids.
The Grids consider your age, education, and your lifting abilities to determine whether you are disabled.
If you are unable to perform your past work then they ask if you meet the Grids.
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For example, you are disabled according to the Grids disable if you are fifty years old, limited to sedentary work (lift no more than ten pounds), only have a high school education and your past work is unskilled.
At age fifty-five, you are disabled if you can only lift twenty pounds for a third of the day and your past work is unskilled or your skills do not transfer to other work.
If you meet a medical vocational guideline and you are unable to perform your past work then you are disabled. If you don't meet a Grid, then you proceed to next question.
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The Medical Vocational Guidelines are listed here.
The fifth question asked is whether or not you can perform any Other work in the national economy.
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This question requires the testimony of a Vocational Expert. At your disability hearing he judge determines your remaining abilities and then asks the vocational expert if someone so limited can perform any other work in the national economy.
The vocational expert is usually a vocational rehabilitation counselor who is familiar with the Dictionary of Occupational Titles and US Bureau of Labor Statistics (O*Net). If they identify jobs that exist anywhere in the national economy in significant numbers then you are not disabled.
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If you are unable to perform any other work that exists in significant numbers in the national economy then you are disabled.
