Does My Health Problem Qualify Me for Social Security Disability?
This is one of the first questions most people have. Does the illness you have count as a “disability?”
You can have a disease or disorder that people don’t picture when they think of disabilities and still get benefits.
The severity of your symptoms—and how they limit your everyday activities—are more important than your exact diagnosis.
Social Security has a large Listing of Impairments that comes with guidelines for what you need to prove for many different health conditions.
But you don’t even have to have an ailment on that list. Your diagnosis could be different but meet or equal the requirements of an impairment in Social Security’s official list and qualify for benefits.
Here are some common conditions qualifying for disability that we’ve seen at Wells, Manning, Eitenmiller & Taylor:
- Anorexia
- Anxiety
- Aspergers
- Attention Deficit Hyperactivity Disorder (ADHD)
- Autism
- Back pain
- Bipolar Disorder
- Cancer
- Chronic obstructive pulmonary disease (COPD)
- Crohn’s disease
- Chronic venous insufficiency (CVI)
- Depression
- Diabetes
- Fibromyalgia
- Heart disease
- Mental health conditions
- Neck pain
- Obesity
- Post-traumatic stress disorder (PTSD)
- Rheumatoid arthritis
This is not a complete list by any stretch. Many other physical and mental health conditions may qualify.
You may have chronic pain that does not show up clearly on a medical scan. You may have migraines that force you to lie down several times a month. Many mental health conditions affect your concentration, memory, pace or ability to be around other people.
Your symptoms can also change from day to day.
You might be able to complete an activity but need hours or days to recover. You may have a few good days followed by a severe flare-up. Social Security needs to understand what happens over time, not just how you looked during one short medical appointment.
Social Security must also consider the combined effects of your conditions.
A single condition might not appear disabling by itself. Different conditions put together could make regular work impossible.
Your age, education and work background also matter. Social Security may decide that you cannot return to a physically demanding job but could perform lighter work. Your evidence may need to show why lighter work would still be unrealistic.
Could you sit for most of the day? Could you use your hands repeatedly? Could you stay focused? Could you handle instructions and changes in your surroundings? Could you maintain dependable attendance?
To get a better idea of whether YOUR condition could qualify for disability benefits and what you need before you start your claim, reach out to our Oregon disability attorneys.
You Also Must Meet Non-Medical Requirements for Social Security Disability
In addition to having seriously limiting health issues, Social Security Disability has requirements for your work history and your work activity right now.
For Social Security Disability Insurance (SSDI):
- You must have earned enough “work credits” by working and paying Social Security taxes over the years.
- You can’t be currently working and making more than what Social Security calls “substantial gainful activity,” or SGA.
SGA is a monthly limit on how much you can earn from work and still qualify for disability benefits. Social Security adjusts the limit each year.
But earning less than the limit doesn’t automatically mean you qualify for benefits. Social Security may also look at:
- How many hours you work
- What duties you perform and how demanding they are
- Whether other people help you
- Whether your employer gives you special accommodations
- How often you miss work
- Whether you can keep up with other workers
- Whether your work attempt ended because of your health
Social Security also runs a disability benefits program called Supplemental Security Income, or SSI
SSI uses the same medical disability standard as SSDI, but you don’t need to meet the work history standard.
SSI is designed for people in severe, current financial need, so having worked and paid into the system isn’t a factor.
But to qualify for SSI, you have to show that you have strictly limited financial assets, which you don’t have to show for SSDI.
An individual can’t have more than $2,000 in savings, investments or investment property to qualify for SSI. An eligible couple can only have $3,000. This doesn’t count your primary residence and one car.
Some people only qualify for SSDI. Some only qualify for SSI.
It’s possible to qualify for both SSDI and SSI.
For example, if you worked enough years to be eligible for SSDI, but your income was low enough that your SSDI payments would be less than the SSI rate, you could get some of both.
What Is the Difference Between SSDI and SSI?
Here is a quick guide on the differences in qualifying for SSDI and SSI benefits:
| SSDI | SSI | |
|---|---|---|
| Work history | You need enough recent work credits from jobs where you paid Social Security taxes. | You do not need a specific work history. |
| Income and resources | Savings or assets outside of your current income don’t matter for eligibility. | Strict income and resource limits apply. |
| Medical standard | You must meet Social Security’s adult disability definition. | The same adult medical standard applies. |
| Benefit amount | Calculated using your average past earnings. | Based on a federal maximum and reduced by countable income. |
| Health coverage | Medicare follows after a waiting period. | SSI recipients qualify for Medicaid coverage. |
| Five-month waiting period | Income benefits start accruing five months after the date Social Security determines your qualifying disability officially began. | No other waiting period besides the wait for the system to process your claim. |
| Time period covered | In some cases, you could get SSDI payments that cover months before your application date. | The SSI benefits clock only starts from the time you apply. |
| Benefits for family members | Certain eligible family members may qualify for benefits based on your work record. | SSI doesn’t pay dependent benefits, though children with disabilities can qualify on their own. |
5 Questions to Check if You’re Eligible for Disability Benefits
Another way to look at your eligibility for Social Security Disability is to take it step by step.
Social Security uses these five questions:
| What Social Security Asks | What It Means for You |
|---|---|
| Are you doing substantial work? | If you’re earning less than substantial gainful activity (SGA), you’re in the running. |
| Is your condition severe? | It must significantly limit basic work activities and meet the one-year expected duration rule. |
| Does your condition meet or equal an impairment listing? | You can either have a diagnosis on Social Security’s list, or have other health problems that limit you in the same way. |
| Can you perform your past work? | Social Security compares your limitations with what your former jobs actually required. |
| Can you adjust to other work? | Social Security considers your skills, age, education and work experience to decide if it’s still feasible for you to do less strenuous work. |
This is how you start: Tell our Social Security Disability attorneys about your struggles.
Tell us what happened to your health. Tell us about the job you had to leave, the activities at home you can no longer manage and the worries you have about your financial future.
We will listen, take time to understand what you’re going through and help you move forward.
How Do You Show Social Security that You Qualify for SSD?
It’s one thing to say you meet all the rules for Social Security Disability.
But you have to prove it.
Providing strong medical evidence to back up your claim is the core of every Social Security Disability application.
Social Security has thousands of rules for who gets benefits. The government is always trying to ensure people who get financial help truly meet the disability qualifications.
That makes the process tougher. You need records and documents, such as the following:
- Reports from doctors
- Medical test results
- Documents from medical exams
- Medical imaging
- Records of medical procedures
- Records of surgeries
- Records of hospitalizations
- Treatment plans
- Treatment results
- Prescription lists
- Explanations of your job duties
- Statements about you from family, friends, co-workers, neighbors or clergy
If this seems like a lot, that’s because it is.
A diagnosis alone usually is not enough. Social Security needs to know, in great detail, exactly how your condition stops you from doing everyday tasks.
Part of your claim is getting an assessment of your “residual functional capacity (RFC),” which shows what level of activity you can still do.
Your medical records should help answer questions such as:
- How long can you sit, stand or walk?
- How much can you lift or carry?
- Can you bend, kneel or climb stairs?
- Can you use your hands in detail work?
- Can you remember and follow instructions?
- Can you concentrate long enough to finish tasks?
- Can you interact appropriately with other people?
- Can you cope with stress or unexpected changes?
- How often do you need extra breaks?
- How frequently would you miss work?
- Do your medications cause fatigue, dizziness, confusion or other debilitating side effects?
Social Security may find that you can lift only a certain amount, stand for limited periods or perform only simple tasks. It then compares those abilities with your past work and other jobs it believes you could perform.
So accurate information about your past jobs is important. A job title doesn’t tell the full story. You should explain what your work actually required, including:
- How much you lifted
- How long you sat, stood or walked
- Whether you operated equipment
- Whether you worked around hazards
- How much concentration the job required
- Whether you dealt with customers or the public
- Whether you supervised other people
- How quickly you had to complete tasks
Your medical evidence should also show what happens over time.
Should You Work with a Disability Lawyer to Qualify for Benefits?
There’s not any rule that you need a disability lawyer to apply for Social Security Disability benefits.
But it’s a good idea.
Making all of this legwork easier is why the disability attorneys at Wells, Manning, Eitenmiller & Taylor are here.
And results have shown that having a disability attorney on your case can improve your chances of winning benefits at key steps in the process.
Our lawyers can help you:
- Assess what kind of benefits you may qualify for
- Respond to forms and questions
- Identify medical evidence Social Security needs
- Present your physical and mental limitations
- Describe your past work
- File your initial application
- Update your evidence as your case continues
- Appeal a denied application
- Prepare for a hearing with a disability judge
- Seek Appeals Council review if needed
- Take a case to federal court
Not every disability law firm handles cases through federal court. Wells, Manning, Eitenmiller & Taylor does when the facts and law support taking that step.
Go easier on yourself in a difficult time by getting skilled and caring help. There’s no fee unless you win.
At Wells, Manning, Eitenmiller & Taylor, a lawyer personally starts your case. You don’t have to wait for a denial before asking us for help.
We take time to understand your health, your work and the problems you experience each day. We don’t treat disability claims like widgets moving down a conveyor belt.
Let’s get you support to take care of yourself and your family.
We’re with You Every Step of the Way
Whether you’re trying to determine if you’re qualified for disability benefits, you need help filing your application, or you received a denial notice and want another chance, our law firm helps from the beginning and stays by your side.
Have a Question about Disability Benefits?
Your health is bad. You can’t work. Your financial stability is threatened. So your head is swimming with questions. How will you get by? How does Social Security Disability work? We’ve gathered answers. See them here:
Disability FAQs »
Hear from a Wells, Manning, Eitenmiller & Taylor Client
“I highly recommend them to anyone filing a Social Security claim. We found (the attorney) to be diligent, straightforward and efficient.”
