Requirements to Qualify for Disability

Social Security and SSI disability have medical criteria and financial/legal criteria to qualify for benefits.

What are the requirements to qualify for Social Security disability benefits? The requirements fall into two main categories: non-medical eligibility and medical requirements for disability.

Non-Medical Requirements

The main non-medical requirement is that an individual can't be doing "substantial" work. To determine whether you meet this requirement,  Social Security primarily uses a monthly dollar amount above which you can't earn, but the agency may consider other factors as well if you are self-employed or receiving assistance at work.

Social Security's other non-medical requirements vary depending on which disability program you qualify for. Social Security Disability Insurance, or SSDI, is for those who have worked for a certain number of years paying into the Social Security Trust Fund. Supplemental Security Income, or SSI, is a need-based program for those with low income and assets.

For Social Security disability, an individual must be insured by Social Security; that is, he or she must have paid enough into the system to qualify for Social Security disability.  For SSI, there is no insured status, but to receive SSI disability an applicant cannot have more than a certain amount of income and resources.  In addition, both programs have different citizenship/residency requirements.  

Learn more about the  non-medical requirements for disability  for SSDI and SSI.

Medical Criteria

What most people think of as the requirements for disability is whether their medical condition is severe enough to put them out of work -- this is the medical portion of the eligibility requirements.

For many medical conditions, Social Security has specific criteria that must be met to qualify for disability benefits, contained in its "blue book," a manual of impairments. Some of the most common conditions listed in the blue book are problems with the heart, back, liver, kidneys, as well as most types of  cancer,  neurological disorders, immune disorders, and mental and emotional conditions.

Many common conditions, however, are not in the manual, such as fibromyalgia, carpal tunnel syndrome, ADHD, scoliosis, diabetes, interstitial cystitis, migraine headaches, and  Lyme disease.  In these cases, disability claimants either have to argue that their condition is equivalent to a listed condition because it is as serious or that their medical records indicate that  their ability to function is so poor that they are unable to return to their past work and that they are unable to perform another type of work, based on their age, education, physical or mental restrictions, and the work skills they possess. Most people who apply for disability are approved through this latter type of analysis, called a medical-vocational allowance, rather than meeting  a listing    or "equaling" the requirements of one of the impairments in Social Security's blue book.

Another medical requirement that applies to all medical conditions, both mental and physical, is the durational requirement -- how long you must be unable to work -- and the requirement that you are totally disabled.  

Learn more about the medical requirements for qualifying for disability.

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