One of the biggest questions when it comes to applying for disability benefits is; when does the SSA consider you disabled?
Generally, the SSA considers a person disabled when they cannot work anymore and earn a living due to a serious medical condition.
Only those with permanent or long-lasting disabilities qualify for Social Security Disability benefits. Terminal illnesses also qualify.
Read on to understand how the SSA determines whether you are disabled and the criteria used.
The SSA’s Definition of “Disabled”
A disability, in the Social Security context, is a long-term or permanent illness that hinders you from working in any capacity. A physical or psychological condition must prevent you from performing any “substantial gainful activity (SGA) to be deemed a disability.
The SSA will consider you disabled if you meet the following criteria:
- You cannot perform the task you used to before your medical condition.
- Your health condition limits you from performing other forms of work.
- Your disability has persisted for at least a year without interruption or will likely result in death.
Social Security does not cover short-term or partial impairments; only total disabilities are covered. Additionally, the SSA may ask you for documentation from your doctor or a disability expert to prove your disability.
The documents should detail your health problem when it started, how it negatively impacts your ability to work, the results of medical examinations, and the treatments you have received.
How the SSA Makes Its Determination
A state agency called Disability Determination Services (DDS) examines your application once the SSA has established that you are qualified for Social Security disability payments.
The state agency then goes through a step-by-step procedure to ascertain if you work and your level of engagement in work.
They also check the severity of your condition, determine whether it falls under a list of medically permissible disabilities, and whether you can perform in your previous job or other jobs based on your age, education, and medical limitations.
1. Whether you have a job and your monthly income exceeds the allowed limit
Generally, the SSA cannot consider you disabled if you are actively working and your wages average or surpass the maximum allowed limit (in 2014, the monthly threshold was $1,070).
The state agency will consider the next component if you are not working.
2. Whether or not your condition is “severe” and has persisted for at least 12 months
The SSA does not provide benefits for all disabilities. Your disability must have persisted for at least a year and be “severe” enough to prevent you from doing even the most fundamental activities, including sitting and walking. If not, the state agency could overlook your disability.
3. Whether your condition is on the list of disabilities
The SSA has a list of medical issues that are so severe that you are immediately considered handicapped. The SSA will determine your disability if your medical condition is included on the list.
But you could be disabled even if your condition is not on the list. If so, the SSA will examine the next component to assess eligibility.
4. Whether you can perform the duties you formerly did
If the SSA judges that your condition prevents you from performing your current or past jobs, even if it is not as severe as those on the list of pre-determined disabilities, you may be eligible for disability benefits.
The SSA will consider the last element if you cannot carry out the tasks you previously did.
5. Whether you can perform any other kind of work
Sometimes, an individual who cannot perform the work they previously did can adapt to some labor, despite their condition.
For instance, if you were a mail carrier, the agency examiner could examine whether you could shift to a job requiring less physically demanding labor.
The SSA will consider your medical problems, age, education, prior employment experience, and any transferrable skills you may have when reaching this decision.
So, if you wonder, “When does the SSA consider you disabled?” you have the answer now. The above are the conditions the SSA considers.
Special considerations may apply if you are blind or impaired vision, a child with a disability, a worker’s widow or widower, or an injured service member or veteran.
The Medical Evidence Needed to Prove Your Disability
The SSA may need to view the following, based on your condition:
- Clinical tests
- Blood tests
- Diagnostic notes
- Imaging scans
- Reports for any surgeries
- Your health care provider can provide any additional information to help the SSA better understand your diagnosis, treatment, and prognosis.
It is advisable to talk to your disability about a disability evaluation because this medical proof is crucial to your application. Before filing your claim, your physician can review your health records to ensure everything is accurate.
Can You Get Disability Benefits If You Do Not Meet a Disability Listing?
You may need to use your residential function capacity (RFC) as evidence of your disability if your disability does not appear in the SSA Blue Book listing.
RFC is an assessment of your residual work capacity. It looks into the following:
- The kind of work you are capable of performing
- How long you may continue performing these tasks
- How frequently can you perform them
The SSA typically assesses your RFC in three ways. Either a DDS examiner reviews your application and supporting medical documentation, as mentioned earlier, or
- Your physician fills out a specific form to gauge your skills, or
- An assessment with a different physician who will gauge your skills.
The SSA will consider you disabled if you cannot work in any capacity.
Get Help From an Experienced Disability Attorney Today!
The Social Security claims process can be challenging. An expert Social Security disability attorney may help ascertain your eligibility for disability benefits and handle any issues that may arise with your application.
It will be in your best interest to get in touch with a Social Security disability lawyer right away if you have any more questions concerning your eligibility for benefits under the Social Security system.
Legal Giant can help you find an experienced disability lawyer near you. Our partner attorneys will review your medical records to determine whether you have a qualifying condition, help with the application, and argue your case to ensure you get the benefits you need and deserve.
Contact us at 833-641-1650 to schedule a free consultation today.
