Do I Qualify For Social Security Disability Benefits?

As a disability advocate and speaker, I am often asked about qualifying for Social Security Disability Benefits. The government makes it sound very complex (as it does with many things!), when it really is not.

First, please understand that Social Security Disability is actually comprised of two distinct programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). The difference lies in whether or not you have worked long enough and paid into the Social Security system through your FICA taxes. If you have worked at least 50% of the previous ten years, you likely qualify for SSDI. If you have not, your application would be automatically redirected to the SSI program.

SSDI pays an average of $1000 monthly. The monthly SSI benefit, on the other hand, only pays about half of that amount. So, you can see that it is to your benefit to qualify for SSDI if you can. Your monthly SSDI benefit is based on your total lifetime earnings divided by the number of years you have worked.

Now, here is the definition of "disability" that Social Security uses: "A diagnosed medical condition, or combination of conditions, that prevents, or greatly impairs, a claimant from engaging in substantially gainful activity." Pretty technical definition, isn't it?

Let's break it down. You must have a "diagnosed medical condition, or combination of conditions". This means that a physician (as opposed to a nurse, social worker, or therapist) must officially declare in your medical records that you suffer from a particular illness. The opinions of non-physicians are taken into account, but what a physician says is what carries the most weight.

Your condition must "prevent, or greatly impair, you from engaging in substantially gainful activity". This means that your symptoms must make it difficult, or impossible, to earn more than $1000 monthly. It also means that you can work part-time and still be considered disabled. Most people do not realize this, and it causes many eligible people to not apply.

So, lets reword the definition very clearly. You are "disabled" under Social Security's rules if you suffer from a diagnosed illness AND are unable to earn more than $1000 due to the symptoms of your illness. If you earn more than $1000 monthly, you cannot be considered disabled, regardless of the severity of your condition. The one exception to this is if you are spending money out-of-pocket for medical care that enables you to continue working. Such things as doctor visit co-pays and the cost of medication would count, and Social Security will reduce your countable income dollar-for-dollar.

Much simpler now, isn't it?