What Are the Rules and Requirements for Social Security Disability Cases?

There are rules on both medical eligibility and financial eligibility for disability benefits.

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The rules and requirements for Social Security disability cases are fairly simple. Essentially, to be eligible for either SSDI or SSI disability benefits, claimants must be financially eligible and medically eligible. The Social Security Administration (SSA) examines medical issues (that is, whether your illness or injury is disabling) as well as legal/financial issues (that is, whether you have earned enough credits for SSDI or have low enough income and assets for SSI). 

Medical Issues

A claimant must have a medical condition that is severe and either:

  • meets the requirements of a Social Security impairment listing
  • prevents them from working at any of their past jobs, or
  • prevents them from doing any other job, given their education, age, and skills.

Another important rule is that a claimant's medical disability must have lasted, or be expected to last, for at least one year for Social Security Disability Insurance (SSDI) or SSI (Supplemental Security Income) benefits to be awarded. For more information, see our article on qualifying medically for disability.

Financial Issues

On the legal/financial side, if claimants earn a certain amount of money per month, they are considered to be gainfully employed, and therefore not eligible for benefits. To learn what amount is considered "substantial gainful activity (SGA)," see our article on the SGA earnings limit for disability.  

For SSDI, you must be insured under the Social Security Disability Insurance program, meaning you've paid taxes into the system for the required number of years and your insurance hasn't expired because you stopped working too long ago. Learn about financial eligibility for SSDI.

For SSI, there are additional asset and family income limits. Learn about financial eligibility for SSI.

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LA-NOLO1:DRU.1.6.3.20141021.28794