What Are the Non-Medical Requirements in a Disability Case?

When you apply for disability benefits through the Social Security Administration (SSA), you must meet both the medical and non-medical requirements. Read on to learn about the financial and legal eligibility requirements for Social Security disability insurance (SSDI) and Supplemental Security Income (SSI) disability benefits.

Financial and Legal Requirements for Disability

Generally, the first aspect of processing a disability claim involves the financial and legal requirements—issues that have nothing to do with your medical conditions or medical eligibility. The SSA calls these requirements "technical requirements."

The main barrier to getting disability benefits is earnings. It's possible to qualify for disability if you're working a bit. But if the SSA sees that you make too much money from work, you won't be eligible for benefits.

Social Security will also screen your file to see which disability program you're eligible for: SSDI or SSI. SSDI is for workers who've paid into the Social Security retirement system for years. SSI is for low-income people who don't qualify for SSDI. Each program has its own non-medical eligibility requirements.

SSDI Non-Medical Requirements

For SSDI (for workers who have paid Social Security taxes), the non-medical requirements focus on three things:

• whether you've worked and paid FICA taxes for the required number of quarters
• how much you're currently earning from work, and
• your citizenship or immigration status and where you live (if you live outside the United States).

SSDI is a type of disability insurance, enacted by Congress under Title II of the United States Code (§§401-433, subchapter II, chapter 7, Title 42). To be eligible to collect benefits, you must have paid the "premiums" (Social Security taxes) for long enough and recently enough. And because you must be disabled to get SSDI, you won't qualify if you're earning a substantial income from work.

Learn more about the non-medical requirements for SSDI.

SSI Non-Medical Requirements

SSI is the low-income, needs-based disability benefit, enacted by Congress under Title XVI of the United States Code (§§1381-1383f, subchapter XVI, chapter 7, Title 42). For SSI, Social Security will look at three things:

• your income
• your assets (or "resources"), and
• your citizenship or residency status.

You won't qualify for SSI disability if your income is above a certain threshold. Working much will usually make you ineligible, but other types of income (including unearned income) will also count toward the limit. And Social Security has a strict limit on how much you can have in assets, including things like:

• money in the bank
• stocks and bonds, or
• anything of value that you could sell to raise money.

In addition, if you're not a U.S. citizen, Social Security will look to see if you fall into a "qualifying alien" category. If you're subject to an active warrant for deportation or removal, you can't get SSI.

For more information, see our articles on the non-medical requirements for SSI.

Medical Requirements for Social Security Disability

If you meet the financial and legal requirements for SSDI or SSI, Social Security will next make a medical determination. To qualify for disability benefits, you must have a physical or mental impairment (or a combination of impairments) that meets Social Security's definition of disability, meaning that it makes you unable to do a substantial amount of work for a year or more.

You can meet the medical requirement in one of two ways:

• show that you meet the requirements of a listed condition in Social Security's Blue Book, or
• show that your condition prevents you from working at any type of job.

Medical determinations are handled by disability claims examiners (and by administrative law judges in cases that go to appeal).

Learn more about medical eligibility for disability benefits.

Who Decides If You're Eligible for Social Security Disability?

When you file a disability claim, the application is taken by a claims representative at the Social Security office. Claims reps don't evaluate claims for their medical eligibility, but they'll look at your nonmedical eligibility.

If the claims representative finds that you appear technically eligible for either SSDI or SSI, your claim will move on to Disability Determination Services (DDS), or a similarly named agency in your state. A DDS claims examiner will then decide whether or not you're medically disabled, with the help of a medical consultant.

But if the Social Security claims rep finds that you're working and earning more than the allowed limit or that you don't have enough work credits, you won't be eligible for SSDI. And if the rep finds that you also have too much income or assets to qualify for SSI, you won't be eligible for SSI.

In either of these cases, you'll receive a "technical denial." You usually receive notice of a technical denial fairly quickly.

However, as part of their medical eligibility assessment, claims examiners at DDS will also be interested in whether you're working and earning money. If a DDS claims examiner finds you're "engaging in substantial gainful activity" after you apply, you won't meet the financial requirements for disability. DDS can then issue you a technical denial, which can take a few months.

Learn more about technical denials in disability claims.