SSDI Eligibility Criteria

SSDI Evaluation Process

The Social Security Disability Insurance (SSDI) evaluation process is designed to assess whether an applicant meets the legal and medical criteria for receiving benefits.

This process involves a detailed review of the applicant’s work activity, medical condition, and ability to perform past or alternative work.

The 5-Step Evaluation Process

The SSA uses a 5-step sequential evaluation process to determine whether an individual qualifies for SSDI.

Each step builds on the previous one, allowing the SSA to systematically assess an applicant’s ability to work and the severity of their medical condition.

Failure to meet the criteria at any step can result in a denial of benefits.

1.) Current Work Activity

The first step of the SSDI evaluation process focuses on the applicant’s current work activity.

The SSA examines whether the individual is engaged in substantial gainful activity (SGA), which refers to the ability to perform significant physical or mental work for pay.

Key aspects of this step include, but are not limited to:

• Substantial Gainful Activity (SGA): In 2024, earning more than $1,470 per month (or $2,460 for blind individuals) through work indicates that the applicant is engaging in SGA and may not be eligible for SSDI.
• Work for Pay: Any type of paid work, whether full-time or part-time, is evaluated. If an applicant is earning income above the SGA limit, their application will be denied at this step.

This step ensures that SSDI is reserved for individuals who cannot engage in any meaningful work due to their disability.

2.) Severity of Medical Condition

If the applicant is not engaged in substantial gainful activity, the SSA moves to step two, which evaluates the severity of the applicant’s medical condition.

The condition must significantly limit the individual’s ability to perform basic work activities.

The criteria for evaluating severity include, but are not limited to:

• Duration: The disability must be expected to last at least 12 months or result in death.
• Work Limitations: The condition must severely limit the ability to perform tasks such as lifting, walking, standing, or understanding and following instructions.

At this stage, the SSA assesses whether the medical condition is serious enough to interfere with the applicant’s ability to perform basic work tasks.

3.) List of Impairments

The third step involves comparing the applicant’s medical condition with the SSA’s Listing of Impairments, commonly referred to as the “Blue Book.”

This list includes medical conditions that are considered severe enough to automatically qualify for SSDI benefits.

Key elements of this step include, but are not limited to:

• Meeting the Listings: If an applicant’s condition matches or exceeds the severity of a condition listed in the Blue Book, they are automatically considered disabled.
• Equaling the Listings: Even if an applicant’s condition is not exactly listed, they may still qualify if their condition is medically equivalent to a listed impairment.

If the applicant’s condition is not on the list, the evaluation process moves to the next step.

4.) Ability to Perform Past Work

In step four, the SSA evaluates whether the applicant is capable of performing any of the work they did in the past.

This includes assessing their ability to return to their previous employment, based on their medical condition.

Important considerations for this step include, but are not limited to:

• Previous Job Tasks: The SSA examines the physical and mental requirements of past jobs and whether the applicant can still perform those tasks.
• Medical Limitations: The applicant’s medical condition is compared to the functional requirements of their previous work. If they cannot perform the same job due to their disability, the evaluation proceeds to the next step.

This step ensures that applicants cannot perform their previous job before considering other employment options.

5.) Ability to Perform Other Types of Work

The final step assesses whether the applicant can perform any other type of work available in the national economy.

The SSA considers the applicant’s age, education, work experience, and medical condition to determine whether they can transition to a different type of work.

Factors that influence this step include, but are not limited to:

• Age: Younger individuals may be expected to adapt more easily to new types of work, while older individuals may face more difficulty in transitioning.
• Education and Skills: The SSA evaluates whether the applicant’s education or skill set can be used in less demanding work environments.
• Medical Condition: The severity of the applicant’s medical condition is weighed against the physical and mental requirements of potential new jobs.

If the applicant is unable to perform any other type of work due to their condition, they will be deemed disabled and eligible for SSDI benefits.

Medical Criteria for SSDI Eligibility

To qualify for Social Security Disability Insurance (SSDI), applicants must meet specific medical criteria in addition to non-medical requirements.

The Social Security Administration (SSA) assesses an individual’s medical condition to determine if it is severe enough to prevent the applicant from performing substantial gainful activity (SGA).

How Social Security Defines Disability for SSDI

The SSA has a strict definition of disability they use to determine whether the applicant meets its definition of disability.

Applicants must demonstrate that their condition is expected to last for a significant period of time or until death.

Key elements of how Social Security defines disability for SSDI include, but are not limited to:

• Inability to Work: The SSA considers a person disabled if they cannot engage in any substantial gainful activity (SGA) due to their medical condition.
• Duration of Disability: The disability must be expected to last at least 12 months or result in death.
• Severity of Condition: The condition, whether a physical or mental impairment, must be severe enough to significantly limit the applicant’s ability to perform basic work-related tasks.
• Listing of Impairments: The SSA maintains a list of specific medical conditions that automatically qualify as disabilities if the criteria are met, though individuals can still qualify if their condition is equally severe as those on the list.

Medical Conditions That Meet SSDI Criteria

While any condition that meets the SSA’s definition of disability may qualify for SSDI, the agency maintains a comprehensive list of impairments that automatically meet the criteria.

This list, often referred to as the “Blue Book,” outlines various physical and mental conditions that the SSA recognizes as disabling if they meet the specific requirements outlined for that condition.

This can be done by submitting comprehensive medical evidence, including test results, doctors’ notes, and hospitalization records, to demonstrate the extent of the impairment.

The types of medical conditions that commonly meet SSDI criteria include, but are not limited to:

• Musculoskeletal Disorders: Conditions such as arthritis, spine disorders, and severe fractures that impair movement or cause chronic pain.
• Cardiovascular Conditions: Including heart failure, coronary artery disease, and chronic pulmonary hypertension.
• Neurological Disorders: Such as multiple sclerosis, epilepsy, and Parkinson’s disease, which affect the brain, spinal cord, or nerves.
• Mental Disorders: Severe mental health conditions, including depression, anxiety disorders, bipolar disorder, and schizophrenia.
• Respiratory Conditions: Chronic obstructive pulmonary disease (COPD), asthma, and other lung diseases that severely limit breathing and oxygen intake.

With TruLaw by your side, you won’t have to struggle through the SSDI application process alone.

We are dedicated to advocating for your best interests and helping you achieve a favorable outcome whether you are appealing a denied claim, or submitting your initial SSDI application.

Contact TruLaw by using the chat on this page for a free consultation to learn more about your eligibility to pursue compensation through SSDI benefits today.

Non-Medical SSDI Eligibility Criteria

When applying for Social Security Disability Insurance (SSDI), meeting non-medical eligibility criteria is just as important as satisfying the medical requirements.

These criteria focus on an applicant’s work history, contributions to the Social Security system, and current income levels.

Work Credit Requirements for SSDI

Work credits are earned based on an applicant’s work history and income, and they reflect the individual’s contributions to the Social Security system through payroll taxes.

To qualify for SSDI, applicants must have earned enough credits by working and paying into Social Security over a specific period of time, even if they satisfy the medical criteria.

The key aspects of SSDI work credits include, but are not limited to:

• Earning Credits: In 2024, one credit is earned for every $1,640 in wages or self-employment income. Individuals can earn up to four credits per year.
• Recent Work: Typically, individuals must have worked five out of the last ten years before becoming disabled.
• Total Credits: Younger workers may qualify with fewer credits, while older workers need more credits.
• Credits by Age: Workers under 24 may qualify with just six credits earned in the three years prior to their disability, while those aged 31 and older generally need at least 20 credits earned in the last 10 years.

Income Limits for SSDI Eligibility

In addition to work credits, the Social Security Administration (SSA) imposes income limits on applicants to determine SSDI eligibility.

If an applicant’s income exceeds the allowed amount, they may be disqualified from receiving benefits, even if they meet the other medical and non-medical criteria.

The main points of SSDI income limits include, but are not limited to:

• SGA Threshold: For 2024, the substantial gainful activity (SGA) limit is $1,470 per month for non-blind individuals and $2,460 for blind individuals.
• Income from Work: SSDI applicants cannot earn more than the SGA limit through wages or self-employment.Earning above this limit indicates that the individual can engage in substantial work.
• Unearned Income: Income such as interest, dividends, and spousal support does not count toward the SGA limit, so applicants may still qualify for SSDI if their only income is unearned.
• Trial Work Period: SSDI recipients are allowed a trial work period where they can test their ability to work while still receiving benefits, even if their earnings exceed the SGA limit.

How Age Impacts SSDI Eligibility

As individuals grow older, their ability to perform certain jobs and adapt to new work environments may diminish.

The Social Security Administration (SSA) uses a grid system to evaluate an applicant’s age, education, work experience, and ability to adjust to different types of work.

The impact of age on SSDI eligibility can be summarized as follows:

• Younger than 50: Individuals under the age of 50 must generally prove that they cannot perform any work available in the national economy.
• Ages 50-54: The SSA provides some leniency for individuals in this age group, considering the difficulty they may have in adjusting to new work types
• Ages 55-59: In this range, the SSA recognizes a more limited ability to transition to new employment. Applicants may qualify for SSDI if they can no longer perform their past work, even if they could potentially perform less demanding jobs.
• Ages 60 and above: The SSA applies the most lenient rules for those aged 60 and older, recognizing that transitioning to new work is especially difficult.

TruLaw: Your Trusted Resource for Social Security Disability Benefits

The lawyers at TruLaw and our partner law firms are currently accepting clients who need assistance determining their eligibility for Social Security Disability Insurance (SSDI) benefits.

A few reasons to choose TruLaw for your SSDI eligibility case include:

• If We Don’t Win, You Don’t Pay: The SSDI lawyers at TruLaw and our partner firms operate on a contingency fee basis, meaning we only get paid if you win.
• Expertise: We have years of experience handling Social Security Disability cases, which helps us anticipate what we can expect to see in your case and the regulations we will be required to meet.
• Successful Track Record: TruLaw and our partner law firms have collected over $3 billion dollars in compensation through verdicts and settlements on behalf of our clients in all 50 states.

If you or someone you love needs help determining eligibility for SSDI benefits, you may be eligible to receive legal assistance.

Contact TruLaw today using the chat on this page to receive an instant case evaluation that can determine if you qualify for an SSDI eligibility case today.