The Social Security Administration (SSA) uses a five-step process to decide if you are disabled. The SSA asks five questions of the applicant and depending on his or her answers they grant or deny the claim for social security based on a disability.
Aside from satisfying the SSA’s disability requirements, you also must meet certain income and work history standards. These requirements differ based on whether you are applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
Social Security Disability Requirements
According to SSA.gov, Social Security uses a five-step process to decide if you are disabled enough to receive benefits. A variety of complementary evidence is also used to decide a disability claim. The overall decision involves the review of following five questions.
Are You Working?
Social Security will first verify whether you are currently working. If you are working, Social Security then checks to see if you are maintaining substantially gainful activity (SGA). As of 2018, SGA means work that brings in more than $1,180 per month. If you have a steady job and are earning above the SGA threshold, Social Security might deny your disability application.
If you are not currently working, or if you have sporadic, part-time, or marginal employment not classified as SGA, Social Security will forward your application to a disability examiner, who will go through steps two through five to determine if you are disabled enough to qualify for benefits.
Is Your Condition Severe?
Unlike other disability programs, Social Security does not recognize partial disability. Instead, it is an all-or-nothing proposition. A severe or full disability qualifies you for benefits, while anything less results in denial.
A severe disability prevents you from working and doing a substantially gainful activity. Ultimately, Social Security is concerned less with the specific condition you have and more with how that condition affects your ability to work and carry out daily living activities. We must prove that your disability burdens you with severe and constant daily hardships and that you are fully disabled.
Is Your Condition In the Social Security Blue Book?
The Blue Book is a master list of conditions to which Social Security refers to, which affects the speed of the approval process. If your medical condition is in the Blue Book, Social Security looks to see if you meet all the listed criteria for that condition. A note of warning: These criteria tend to be very difficult to meet, which is why most Social Security disability recipients do not get approved through a Blue Book listing.
If you do happen to satisfy the criteria for a Blue Book listing, Social Security might approve you on this basis alone. Otherwise, your application will move on to the fourth and fifth review questions.
Can You Return to Any of Your Previous Jobs?
When you apply for disability, Social Security requires you to submit a work history that includes not just your most recent job or two but every position you have held going back 15 years. Social Security then evaluates your condition on the basis of each of these jobs and determines whether you would be capable of returning to that job. Only by convincing Social Security that you cannot return to any past work can you get approved for disability.
Can You Do Any Other Work?
Social Security does not consider just the jobs you have actually held. It looks to see if there might be any jobs you have not done in the past but might be able to do in the future based on your skills and education. The agency might bring in a vocational expert (VE), a person who is familiar with your local job market as well as the skills and capabilities needed for the positions currently in demand.
Additional Requirements to Win Social Security Disability
Even if Social Security determines you are indeed disabled, you must meet the non-medical requirements of the program. In the case of SSDI, that means having a sufficient work history and enough payroll tax contributions from your years working. For SSI, it means having total income and total assets below certain thresholds. Your attorney can review your work and financial history and inform you of any potential challenges.