The federal Social Security Administration (SSA) may pay monthly payments to individuals with a severe medical condition. These benefits are known as Social Security Disability Insurance Benefits, or SSDI benefits. An individual must satisfy medical, income, and work requirements to receive SSDI benefits.

What Medical Requirements Must be Satisfied?

To receive SSDI benefits, an individual must be incapable of working because of a severe medical condition. The severe medical condition must have lasted or be expected to last a year or more, or be expected to result in death. The government uses an evaluation process to determine whether an individual has a severe medical condition.

Your state’s Disability Determination Service (DDS) determines whether your medical condition is severe. A severe medical condition is one that is substantially limiting. The condition must  limit the ability to perform basic work tasks, such as sitting and standing. The limitation must exist for at least 12 months, and be permanent

The DDS looks at whether your disability is the medical equivalent of an impairment in the federal government’s “listing of impairments.”  This listing contains medical conditions that the federal government considers severe enough, to prevent a person from performing gainful work.

The DDS then looks at whether your disability prevents you from performing work you used to perform. If the disability does not prevent you from performing such work, you are not considered to have a “severe medical condition.” Therefore, you will not receive SSDI benefits. If the disability does prevent you from performing this work, the DDS then looks at whether you can perform other work. If you cannot perform any type of work, you will qualify as an individual with a “severe medical condition.” 

What are the Work and Earnings Requirements for Social Security Disability Benefits?

To be entitled to SSDI benefits, an employee must have a serious medical condition, and have worked for a certain period of time. When an individual is working, that individual earns social security work credits. Currently, for every $1,410 in wages earned, an individual receives one credit. Up to four credits can be earned in a year.

The number of credits needed for SSDI eligibility is measured by the age at which you became disabled. Generally, an employee must have 40 credits, of which twenty were earned in the last ten years of becoming disabled. 

To assess whether an employee has met these requirements, the government uses two tests: the “duration of work” test and the “recent work” test. Under these tests, if an individual became disabled in, say, 2020, the individual must have earned 40 credits overall. 

Of these, twenty must have been earned between 2011 through 2020, the year when the individual became disabled. Younger workers who have fewer than 40 credits might be eligible for SSDI. The SSDI program recognizes many younger workers have not accumulated 40 credits when they become disabled.

What Income Might Reduce the Amount of My Benefit Payment?

Some disabled individuals receive workers compensation benefits or state temporary disability benefits. In such cases, the individual may not earn the full amount of SSDI benefits. Under the law, an individual may not receive over 80% of the average income earned before they became disabled. 

The government regards workers compensation and temporary disability payments as income. SSDI payments are not reduced when a worker receives supplemental social security income (SSI), Veterans Administration (VA), or private or government pension benefits.

What Do I Need to File an Application for Disability Benefits?

When filling out the application for benefits, an individual must provide basic information. This includes information such as social security number, a birth certificate, and a description of the work they perform. Individuals must also provide medical information. 

This includes doctor contact information, medication information, and lab results. Once the government receives all of this information, it will either approve or deny your claim. If your claim is denied, you have the right to appeal. 

How Do I File an Appeal for Disability Benefits?

Appeals may be filed online. A common form of appeal is called a “medical reconsideration” appeal. In this appeal, the individual appeals a determination that their medical condition was not severe enough. 

In a “non-medical reconsideration,” the individual appeals from a finding that their income was too high to receive SSDI benefits. The government provides additional levels of appeal.

How Long Do Disability Benefits Last?

The government may periodically review your case to determine if you still qualify for benefits.  to determine if individuals still qualify for benefits. Benefits will stop if the government determines you are no longer disabled.The government notifies individuals before it reviews a case.

Do I Need the Help of a Lawyer with a Social Security Disability Benefits Claim?

If you need help with applying for social security disability benefits, receiving benefits, or appealing from a denial of benefits, you should contact a government lawyer. An experienced government lawyer can assist you with applying for benefits. The lawyer can file an appeal of benefits denial on your behalf.