What Happens If You Are Unable to Work for Medical Reasons?

If you don't have a medical condition that's so severe you're eligible for immediate approval of disability benefits (called a "listing"), you'll need to prove you can't work anymore. You don't need to prove that you can't work at all due to medical reasons, but that you can't do a substantial amount of work. One way to prove this is to show that no jobs exist that you can perform full-time on a regular and sustained basis—for example, your condition would make you miss too much work.

What Does "Regular and Sustained Basis" Mean?

Generally speaking, being able to work on a regular and sustained basis means being able to do a full-time job—40 hours a week, 5 days a week, without too many absences. The term can also mean being able to work another equivalent schedule, like shift work consisting of 10-hour days for 4 days a week.

There's one exception: If your past work was part-time, the Social Security Administration (SSA) will consider your ability to do part-time work as evidence you can do work on a regular and sustained basis. For more information, see our article on part-time work and disability.

First, let's look at the minimum requirement for being considered able to work, which is being able to do a sit-down job for 40 hours a week, without needing special accommodations such as being able to lie down or take frequent breaks.

How Social Security Assesses Your Residual Functional Capacity

Social Security will prepare a residual functional capacity assessment (RFC) for you to determine what level of work you can physically do on a regular and sustained basis. An RFC is a detailed report that states the most you can do in light of your condition; for instance, heavy, medium, light or sedentary work.

If you have psychological or psychiatric conditions, the SSA will develop a mental RFC for you that discusses your ability to do the mental aspects of work, such as following directions, getting along with others, and completing work in a normal amount of time.

If the SSA determines you don't have the RFC to physically do your job anymore, and you don't have the mental or cognitive capacity to sustain the requirements of a sit-down job, you will be approved for disability benefits. A sit-down (sedentary) job requires you to be able to work eight hours a day, sitting for most of the time, with occasional (up to two hours per day) walking.

Non-Exertional Factors Affecting Disability

Even if the SSA determines you have the RFC to do sedentary work, you can still win your claim if you prove that your other medical symptoms make it impossible for you to do that work on a regular and sustained basis.

For example, if you have non-strength-related impairments (called non-exertional impairments) that prevent you from being productive for eight hours a day, Social Security should find you disabled. Here are some examples.

How Reliability and Attendance Affect Disability

Sometimes the severity of a claimant's illness or medical condition fluctuates and can cause the person to miss an unacceptable amount of work. If you can prove that your condition would make you miss too much work, the SSA might approve your claim. Often these applicants are denied because some days they are perfectly able to do their work, while other days they are out sick or hospitalized.

If an applicant has to stay home from work too often because of pain or take an excessive number of breaks due to pain, and doctor records support this, the SSA should find that the applicant can't sustain a full-time job. For more information on how Social Security treats pain, see our article on chronic disability and pain.

An Attorney Can Help in Borderline Cases

If your illness or medical condition prevents you from working five days a week, or makes you miss two or more days of work per month, you may be able to win disability benefits on appeal. An experienced disability attorney can help show that, although you have some work capabilities, you can't work on a regular and sustained enough basis to hold down a job.