Social Security Disability Rules and Requirements for Adults

Social Security awards two types of disability benefits to people who are unable to work full-time due to a medically determinable impairment—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). When you first apply for benefits, the agency will need to see that you meet the preliminary rules and requirements to legally receive either SSDI or SSI before claims examiners can determine whether you meet the medical definition of disability.

In order for your disability application to be approved, you must be both financially and medically eligible to receive benefits. Many claimants aren't aware of the difference between SSDI and SSI when they submit their application, or don't know that they need to meet certain legal requirements to get Social Security payments even with a disabling condition. Knowing the preliminary eligibility rules before you apply can help you avoid receiving a technical denial letter or increase your chances of success if you want to appeal a medical denial.

What Are the Legal and Financial Requirements for Disability?

It may come as a surprise to learn that you aren't automatically eligible to receive disability benefits even if you have a terminal illness or other seriously debilitating medical condition. That's because the Social Security Administration sets preliminary criteria for the legal payment of SSDI or SSI benefits based mainly on your work history and your current financial situation.

Current Earnings Rules

Social Security will first look at your current earnings amount, if any. The agency limits how much income you can earn and still qualify for disability benefits. This limit is called the substantial gainful activity (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 part-time, your earnings may be too high for you to qualify for disability benefits.

In 2025, the SGA level is $1,620 per month. You're generally allowed to work and earn up to this amount when you apply for disability benefits without having your income affect your eligibility. However, if you're ultimately awarded benefits, Social Security will likely adjust your disability onset date to reflect the point where your income dropped below the SGA amount. (That's because the agency doesn't consider you disabled if you're capable of earning SGA.)

Rules for SSDI

In order to get SSDI benefits, you must be currently insured under the 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. Essentially, you'll need to have enough "work credits" on the date you became disabled to qualify for SSDI.

The work requirements for SSDI vary by age, and they're a little stricter than for Social Security retirement benefits or Medicare coverage when you're 65. 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 ten years.

Rules for SSI

You don't need to have worked in the past to receive SSI, but the program has family asset and income limits. The income limit for the SSI program is based on the monthly federal benefit rate, which is adjusted every year to account for increases in cost of living. For 2025, the SSI rate is $967 per month ($1,450 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. The Social Security Administration doesn't offer any temporary disability benefits, but if you think you'll be able to return to work within twelve months, you may have other options (such as state short-term disability benefits or private long-term disability insurance).

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

Medical Rules for SSDI and SSI

Unlike the preliminary financial requirements, the medical definition of disability is the same for both SSDI and SSI. That means in order to qualify for either disability benefit, your medical condition must meet the strict requirements of a Social Security impairment listing or cause significant limitations preventing you from working at your past job or at a less strenuous job given your age, education, and skill set.

How Social Security Decides If You Have a Qualifying Disability

After you apply for benefits, Social Security requests your medical records from the doctors and clinics that you mentioned on your application. The SSA then checks to see if your condition is severe enough to meet one of its impairment listings. If you meet the qualifications in a listing, you're automatically found to be disabled, 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 10 pounds regularly, or not being able to stand or walk for more than two hours in a day. (For more information, see our articles on medical-vocational allowances and how you can qualify medically for disability benefits.)

What If I Don't Qualify for SSDI or SSI Disability Benefits?

The majority of disability applicants aren't awarded benefits on their first try. Depending on whether you received a technical or a medical denial, you may have several options available for your next steps. If Social Security denied you because you weren't able to show that symptoms from your medical condition met a listing or ruled out all jobs, you'll probably have better luck appealing the denial until you have a chance to talk with an administrative law judge.

Technical denials happen when Social Security doesn't even get to take a look at your medical records because you don't have enough work credits to be insured for SSDI and you're "overresourced" for SSI (meaning you have too much money and assets for this needs-based program). Technical denials are much harder to appeal because you can't change your past earnings record, for example. However, sometimes the agency made a clerical error or miscalculated your work credits. In these cases, you can appeal.

Whether you're going to appeal a technical or medical denial, it's a good time to consult an experienced disability attorney. Disability lawyers work on contingency—meaning they don't get paid unless (and until) you win—and many offer free consultations, so there's little risk in asking around to find a lawyer you feel comfortable working with.