If you need disability benefits assistance, it can be hard to know where to begin! There is so much information out there to parse through- it can feel a little overwhelming. With so many important things to know, there is one basic question that can help you get started:
Does your condition meet the definition of disability?
If you’re in pain, this may seem like a question that has an obvious answer. Unfortunately, what you consider a disability may not meet the criteria set by Social Security. They have set out specific guidelines about what medical conditions qualify as a disability. This is one of the hardest parts of applying for disability benefits.
Even if you’re suffering, your disability may not be defined as a disability by Social Security.
The good news is that you can do an online disability evaluation to take some of the guesswork out of the equation for you! At BenefitsClaim.com, we offer a free online disability case evaluation.
But if you want to be more informed about how likely it is your disability benefits application will be approved, read the following Social Security Benefits questions to help you learn about what qualifies as a disability.
The 5 Big Questions
There are five essential questions that the Social Security Administration (SSA) uses to determine whether you have a qualifying disability. We are going to go over each of those questions in some detail.
1. Are You Working?
In order to qualify for disability benefits, you must be unable to engage in what is called substantial gainful activity (SGA). Basically, your disability must prevent you from working at full capacity. If you’re earning more than what the Social Security sets as a monthly earnings cap, you are generally considered to be engaging in SGA.
The monthly earnings cap before you’re considered to be engaged in SGA depends on your disability.
If you’re statutorily blind, for example, the cap for your monthly earnings is higher than other individuals. In 2022, that amount is $2,260 (pre-tax). If you are making $2,260 or more, you may not qualify for disability benefits. For non-blind individuals, the monthly earnings SGA amount is $1,350.
There are exceptions to this rule, so we highly recommend completing our free disability case evaluation to see if you qualify. The disability benefits attorneys on our team are very familiar with what cases can be considered exceptions to the SGA rules.
If your disability prevents you from earning the SGA amount or prevents you from working at all, you most likely qualify for disability. Depending on your income and resources, you may be able to apply for disability income or Social Security Income. If you don’t know what Social Security Income (SSI) and Social Security Disability Insurance (SSDI) are, check out our article about the differences between these two types of disability benefits.
2. Is Your Condition “Severe?”
A severe condition is one that significantly limits your ability to engage in basic work-related activities. This can be due to either a physical or mental condition. Work-related activities can include physical activities—such as sitting, walking, standing, or lifting—as well as mental activities, like remembering and concentrating, and interpersonal activities, such as talking to others and navigating conflict in a healthy way.
Your ability to do such activities must be inhibited for at least 12 months for you to qualify for disability benefits. If your medical condition does not fit these criteria, then it does not meet the Social Security’s definition of disability.
3. Is Your Condition Found in the List of Disabling Conditions?
There are 14 categories that the SSA recognizes as areas in which someone can have a disability. For each of the categories, there is a list of medical conditions that are considered severe enough to prevent you from engaging in SGA.
If your condition is not on the list, not to worry. There is an extra step, but you could still qualify for disability benefits!
In a case where someone’s medical condition isn’t already listed, the SSA needs to decide if the condition is as severe as those listed. They would need to process a new disability claim for you.
There are two options for expediting the process:
- The first option is Compassionate Allowances (CAL). This initiative was designed to quickly identify conditions that meet the Social Security’s standards for disability benefits. The types of conditions that Compassionate Allowances was made for include rare cancers and disorders that may not be listed in the 14 categories.
The CAL initiative is meant to reduce wait times for those with severe disabilities. However, the same rules apply to evaluate CAL conditions for both Social Security Disability Insurance (SSDI) and Social Security Income (SSI).
- The second option is Quick Disability Determinations (QDD). This option screens initial applications to quickly identify cases where “a favorable disability determination is highly likely and medical evidence is readily available.”
This helps Social Security to prioritize and expedite processing.
4. Can You Do the Work You Did Previously?
If Social Security decides that your medical condition prohibits you from performing any of your past work functions, they move on to the fifth question.
If you are still able to do any of your past work, you will not qualify for disability benefits.
5. Can You Do Any Other Type of Work?
After answering the previous question, Social Security will determine whether there is other work you could be doing despite your medical condition.
They consider your condition as well as your age, education, past work experience, and skills. Applicants aged 65 and older are more likely to qualify.
The transferability of your skills is also heavily considered. If you cannot do other work, Social Security will most likely decide that you qualify for disability benefits. If they decide that you are capable of doing other work, your claim will most likely be denied.
Applying for Disability Benefits Assistance
Determining whether your medical condition qualifies you for disability benefits can take some time. For those who try to apply for disability benefits by themselves, the process can be long, emotional, and downright confusing. It is worth your time and effort, as you may be able to receive up to $3,148 per month in Social Security Disability!
If you make a mistake or miss something on your application, your claim can be denied. Even if your claim goes through and gets approved, you may not get the maximum amount of disability benefits for which you truly qualify.
Many applicants benefit from working with a disability benefits lawyer. Teaming up with an attorney can make your application experience much easier and give you peace of mind. They can tell you what medical evidence and documentation is needed for your application, so you don’t have to worry about missing something or adding something irrelevant to your case.
Moreover, a disability benefits lawyer can help get you the maximum number of benefits for which you are eligible. We have a great article that goes into more detail- check it out here:
How a disability attorney can help with your disability benefits case evaluation
At BenefitsClaim.com, our case evaluation specialists can help you determine if your medical impairment meets the Social Security definition of disability. By taking our free online disability case evaluation, you don’t waste time trying to apply when you may not even qualify.
If your case evaluation specialist determines that you qualify, we can match you with a disability benefits lawyer on our team who can assist you with your disability benefits application. With legal counsel, you are much more likely to receive the Social Security disability benefits that you need. If you have other questions, you can visit our FAQ page or contact us via email.
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