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

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

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The Social Security Administration (SSA) has several rules and requirements you must meet to be approved for disability benefits. To qualify for SSDI (Social Security Disability Insurance) benefits or SSI (Supplemental Security Income) disability benefits, you must be both financially and medically eligible.

To determine whether you meet the rules and requirements for disability, the SSA will first see if you meet the legal and financial requirements—that is, whether you've earned enough work credits for SSDI or have low enough income and assets for SSI. If you meet those qualifications, the SSA will look at the medical issues in your case—whether your illness or injury is disabling under Social Security's disability rules.

What Are the Legal and Financial Requirements for Disability?

Current earnings rule. Social Security will first look at your current earnings. The SSA limits how much income you can earn and still qualify for disability benefits. It's called the "substantial gainful activity level" (or SGA level). If you're not working much and your monthly income is low, you may qualify for disability benefits.

But if you're able to work full time (or even half time), your earnings may be too high for you to qualify for disability benefits. In 2022, the SGA level is $1,350 per month. You're generally allowed to work and earn up to this amount when you apply for disability benefits. Learn more about the SGA earnings limit for disability.

SSDI rules. In addition, 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 (FICA or self-employment tax), and
  • you haven't stopped working long enough for your SSDI insurance to expire.

The work requirements for Social Security disability are a little stricter than for Social Security retirement benefits or Medicare coverage when you're 65.

The work requirements for SSDI vary by age. But to give you an idea, a 55-year-old must have worked at least eight years to be eligible for benefits, and five of those years must have been within the last decade (ten years). Learn more about Social Security's work requirements and financial eligibility for SSDI.

SSI rules. For SSI, you don't need to have worked in the past, but the program has family asset and income limits. The income limit for the SSI program is based on something called the monthly "federal benefit rate" (FBR). The FBR in 2022 is $841 per month ($1,261 for couples). But the SSA doesn't count all of the income you earn from work.

The asset limit for SSI disability is $2,000 (but your house and car don't count). The asset limit for married couples is $3,000 and includes all of a spouse's assets except for IRAs and pension plans. Learn more about what counts toward your income and asset limits for SSI disability.

What Are the Medical Requirements for Disability?

One of the most important rules for Social Security disability is that your medical disability must have lasted, or be expected to last, for at least one year for benefits to be awarded. Social Security doesn't offer any temporary disability benefits.

In addition, you must be fully disabled—not partially disabled—to qualify for Social Security disability. Unlike workers' comp or veterans disability benefits, the SSA doesn't assign you a percentage of disability with SSDI or SSI, and it doesn't pay out partial benefits.

What Are the Qualifications for Disability?

To qualify for disability benefits, under either SSDI or SSI rules, you must have a medical condition that's severe and either:

  • meets the strict requirements of a Social Security impairment listing
  • makes working at any of your past jobs impossible, or
  • makes working at a less physically or mentally strenuous job impossible. (Social Security takes into account your education, age, and skill set when making this determination.)

How Social Security Decides If You Have a Qualifying Disability

After you apply for benefits, the Social Security will request your medical records from the doctors and clinics that you included on your application. The SSA will then check if your condition is severe enough to meet one of its impairment listings. If you meet the qualifications in a listing, you have a qualifying disability, and the Social Security determination process ends.

For instance, one way to meet the requirements of the impairment listing for lung cancer is to have a pathology report of a lung biopsy showing small cell lung cancer. If you have a qualifying pathology report in your medical records, Social Security doesn't need to see any evidence of how the cancer or the side effects of your cancer treatment limit your ability to work.

On the other hand, if you don't meet the requirements of an impairment listing, your medical records need to have evidence that your medical condition causes specific functional limitations that keep you from being able to perform job duties. Some examples of limitations that could qualify you for disability include not being able to lift 20 pounds regularly, or not being able to stand or walk for more than two hours in a day.

    Learn more about the rules for qualifying medically for disability.

    Updated June 30, 2022

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