Social Security Disability Guidelines

This post is divided into two parts. The first concerns the most basic eligibility requirements for social security disability and SSI and the second concerns how disability decisions are rendered.

Part One - basic eligibility

To be awarded social security disability benefits, an applicant must prove the following:

1. They must have a condition, physical or mental, that is considered severe.

2. The condition must have lasted, by the time a disability determination has been rendered, one full year...or it must possible, based on the medical evidence available, to make a projection that the condition will eventually last one full year.

3. The condition must be severe enough that it prevents the claimant from working and earning a monthly amount (gross, not net) equal to what is known as SGA, or substantial gainful activity.

Part Two - the decision making process

Claims for SSD (social security disability) and SSI are processed in the following steps.

1. A disability claim is taken by social security; typically, this occurs at a social security field office.

2. After the disability interview has been conducted, the appropriate paperwork has been completed, and the claim has been entered into the system, it is then transferred to a state agency where it is assigned to a disability examiner.

3. The disability examiner has the responsibility of rendering a medical determination on the case. To do this, the examiner will begin the process of gathering the claimant's medical records. This process may take weeks or even months. However, once the records have been gathered, the examiner will, in consultation with medical and mental consultants (physicians and psychologists who are assigned to the examiner's work unit), examine the case to decide the following:

A) The nature of the claimant's past work.

B) The requirements of the claimant's past work.

C) The claimant's mental or physical limitations that exist as a result of their condition.

D) Whether or not the claimant can return to past work, based on current mental or physical limitations.

E) Whether or not the claimant, if they are unable to return to their past, can engage in other forms of work.


Claimants, of course, who A) are found to be unable to perform their past work and B) are also found to be unable to perform some type of other work will C) typically be determined to be disabled and thus eligible to receive social security disability or SSI disability benefits.

From reading this post, several things should stand out clearly regarding the disability application process.

1. A person's work history may play a large role in deciding the outcome of a case. Thus, proper classification of one's past jobs is very important. And for this reason, claimants should provide full and detailed information regarding their work history when they are asked to complete and return work activity questionaires.

2. Medical records are key to proving a case. Therefore, claimants should not only provide exhaustive detail regarding their history of medical treatment at the time of application, they should also do this when appeals are filed. Additionally, claimants whose cases are being processed and who have obtained recent medical treatment should report this treatment to the adjudicator handling their case (at the hearing level, this will be an administrative law judge, at earlier levels the decision maker will be a disability examiner).













Return to:

Social Security Disability Secrets

Social Security Disability Requirements


Other Posts

How to get on disability
How long does it take to get social security disability?
SSA criteria and disability qualifications
What if you don't meet a Disability Listing in the Social Security List of Impairments
Social Security Disability - are There Retroactive Benefits
Qualify for Disability