Social Security Disability Insurance (SSDI) eligibility depends on more than a diagnosis. The Social Security Administration (SSA) reviews an applicant’s work history and work credits. It also checks medical eligibility requirements. The SSA looks at whether a condition stops the applicant from doing past work or other jobs.
How past employment affects eligibility
SSDI provides benefits to workers with qualifying disabilities who meet the social security work history requirements. The number of credits required depends on the applicant’s age and when the disability began. The SSA reviews past relevant work, generally jobs performed within the past 15 years, to determine whether the applicant can still perform those duties. It considers the physical demands and mental requirements of those roles.
Several factors shape an SSDI claim:
- Work credits: The SSA checks whether the applicant has earned enough credits to qualify.
- Recent earnings: The SSA checks whether the applicant’s income exceeds the substantial gainful activity limit.
- Past job duties: The SSA reviews whether the applicant can still do previous work given their current condition.
- Ability to adjust: The SSA looks at whether the applicant can move to other available work.
Each factor contributes to the SSA’s overall determination of eligibility.
How the SSA evaluates a medical condition
A medical diagnosis alone does not qualify an applicant for benefits. The condition must prevent the applicant from engaging in substantial gainful work. It must also last at least 12 months or be expected to result in death. Some applicants cannot keep consistent attendance or work full-time. Pain, fatigue or trouble with memory and thinking can all play a role. The SSA reviews medical records and other evidence to assess those limits.
SSDI requires sufficient work credits. Supplemental Security Income (SSI) does not. SSI has income and resource limits instead. It also requires a qualifying disability, blindness or age 65 or older. Some applicants may qualify for both programs.
How federal and state agencies process SSDI claims
SSDI follows federal standards. State agencies known as Disability Determination Services handle initial reviews. Medical criteria are set at the federal level and apply uniformly. Some steps in the process may differ by state.
Work history, earned credits and the SSA’s review of functional limits all shape the outcome of a claim. Errors in an initial application can delay benefits. A Chicago attorney can review an applicant’s work history and find gaps in the record. The attorney can also explain how the SSA is likely to weigh each factor before a claim is filed.