The Social Security Administration (SSA) defines disability as the lack of ability to perform substantial gainful activity (SGA) because of a physical or mental condition that is medically determinable and that has lasted or is expected to continue at least 12 months or result in your death.
For children under 18 years old, the SSA defines disability as any physical or mental condition that causes marked functional limitations. The same as for adults, a child’s medical condition must be expected to last at least 12 months or result in the child’s death for the SSA to classify it as a disability.
What the SSA Considers a “Medically Determinable” Physical or Mental Impairment
“Medically determinable” sounds like somewhat of an abstract term, but the SSA provides a relatively straightforward explanation by what they mean by it. It is a medical condition featuring physiological, anatomical, or psychological abnormalities, and these irregularities must be detectable by diagnostic techniques that meet specific medical criteria.
The exact nature of those criteria varies based on the condition in question, but what is required is objective evidence, not doctors’ statements or observations.
What It Means to Not Be Able to Engage in “Substantial Gainful Activity”
Substantial gainful activity means gainful employment or work that allows you to support yourself.
Because such a definition leaves room for subjectivity, the SSA has established a specific threshold for SGA. If your earned income exceeds $1,180 per month before taxes, you are considered to be engaged in substantial gainful activity.
Note that the SGA threshold applies only to earned income, not total income. Depending on which disability program you are applying to, Social Security Disability Insurance (SSDI) versus Supplemental Security Income (SSI), there might not be any limit on the amount of passive or unearned income, such as from investments, that you can earn.
SSDI, because it is an insurance and not a welfare program, does not limit your unearned income. SSI, a means-tested program to provide benefits for the needy, sets strict limits on both your monthly income (earned and unearned) and total assets.
How to Prove That a Condition Meets the SSA’s Definition of a Disability
You have two ways to prove to the SSA that you are disabled. The first is to show that you meet all criteria for a “Blue Book” listing. The second is to obtain a medical-vocational allowance, approval based on the fact that your condition prevents you from working and earning a living.
The Blue Book
This is the master list kept by the SSA of conditions automatically approved for benefits. The catch is, not only do you have to be diagnosed with one of the states on the list to receive automatic approval, but you also must show that you meet all listed criteria for that condition.
Typically, the requirements for Blue Book conditions are strict and demanding to satisfy. For this reason, most applicants who get approved for SSDI and SSI do so by other means than meeting a Blue Book listing.
Medical-Vocational Allowance
If you are like most applicants and do not satisfy a Blue Book listing, you can apply for a medical-vocational allowance, this approval route requires supplying medical evidence along with:
- Work history
- Job skills
- Educational background
The SSA looks at your medical evidence, reviews your work history, and determines if it thinks you are physically or mentally capable of returning to a past job. By “past job,” the SSA does not mean only your most recent employment but any work you have performed over the previous 15 years.
So, if you most recently worked as a construction foreman but cannot return to that job because of physical limitations, the SSA might deny you benefits if it sees that you also have experience in an administrative role and it feels your condition would not prevent you from returning to that job.
The SSA also reviews your:
- Education
- Skills
- Job training
They match that information to a list of available jobs that you might not have performed in the past. If the SSA feels there is work out there that you are qualified to do and capable of working, it might use this as a reason to deny your application for benefits.
If You Need Assistance With Your Social Security Disability Application, Count On the Attorneys at the Disability Advantage Group
The attorneys at the Disability Advantage Group, focus on Social Security disability law, helping our clients campaign to win the disability benefits they deserve, even if they have been turned down in the past. Before applying for SSDI or SSI, speak with us to find out exactly how does Social Security define disability. We offer a free case evaluation. To schedule an appointment, call our office at 865-566-0800.